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Mon Jan 28, 2013, 03:53 AM

 

The "American Paradox" -- highest rate of lung cancer deaths & deaths/smoker, lower rate of smokers

I knew that there were some countries, like japan, that had high rates of smoking but lower rates of lung cancer than the US, so started looking for information.

it turns out some of the differences are pretty startling: (figures from the 1997 WHO report: "Tobacco or Health: A Global Status Report, Country Profiles by Region, 1997")

For men, the US has the 4th-lowest prevalence of smokers (28%) of the 16 developed countries listed, after Sweden (22%), New Zealand (27%), and Finland (27%).

But it has both the highest rates of lung cancer death per capita & per smoker of all the countries studied.

Low-smoking nations:

% smokers (men)....LCDR/100,000.....LCDR/100,000 smokers...

Sweden 22%.....35.5....161.4
Finland 27%.....69.7.....258.1
New Zea 27%.....64.9.....240.4
USA 28%.....85.9.....305.7


High-smoking nations:

Japan 59%.....47.9.....081.2
Spain 48%.....69.0.....143.8
Israel 45%.....38.1.....084.7
Austria 28%.....66.2.....157.6


Sweden, with the lowest percent of smokers, also has the lowest rate of lung cancer deaths per capita (though not per smoker) -- but Israel is a close second even though it has the second highest percent of smokers.

Japan, though it has the highest percent of smokers, has the 6th lowest lung cancer death rate (as well as the highest life expectancy).

The US has the 4th-lowest percent of smokers, but is an outlier so far as lung cancer deaths, having both the highest death rate per capita and per smoker.

USA's outlier status is also true for women: a comparatively small percentage of american women smoke, but lung cancer death rates are the highest of all the comparison countries.

Figures are from the 90s.

http://www.kidon.com/smoke/percentages3.htm

Sources for statistics:
http://www.kidon.com/smoke/percentages.htm


Since the 1950s, lung cancer rates in American men have greatly exceeded those in Japanese men, despite a much lower prevalence of smoking in the United States. The mortality rates of lung cancer were two to three times higher in the United States during this period, although both countries experienced a substantial increase from 1955 to 1985.

Incidence trends were similar to mortality: the 19881992 lung cancer incidence in white males in the United States Surveillance Epidemiology and End Results program of the National Cancer Institute areas was 61.3 per 100,000 compared with 39.6 for males in Miyagi Prefecture.

During the same 30-year period, there was a decline in the prevalence of smoking from 54% in 1955 to 33% in 1985 in United States men, whereas the percentage of Japanese men who smoked increased from 76% in 1955 to a peak of 82% in 1965 before declining to 60% in 1992.

The rates of lung cancer in Japanese migrants and their offspring in the United States are similar to United States-born whites, which strongly suggests that most of the international variation in lung cancer rates is not attributable to ethnic differences in susceptibility.


http://cebp.aacrjournals.org/content/10/11/1193.long

The researchers say that maybe american cigarettes are more toxic, or maybe there are genetic differences (though they've already said US-born japanese have american-style death rates), or maybe it's 'lifestyle'.

all these strike me as piss-poor explanations.

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Reply The "American Paradox" -- highest rate of lung cancer deaths & deaths/smoker, lower rate of smokers (Original post)
HiPointDem Jan 2013 OP
DonCoquixote Jan 2013 #1
green for victory Jan 2013 #6
Lionessa Jan 2013 #2
surrealAmerican Jan 2013 #3
annabanana Jan 2013 #4
justabob Jan 2013 #8
MindPilot Jan 2013 #5
Ellipsis Jan 2013 #7

Response to HiPointDem (Original post)

Mon Jan 28, 2013, 04:08 AM

1. A possible clue

Now here is a disclaimer, we all know there is NO SUCH THING as a healthier cigarette, period. However, in America, the fine folks from Richmond and Winston-Salem are known to put additives in tobacco.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807204/
http://www.npr.org/2012/09/07/160752629/the-secrets-in-a-cigarette
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001145

Now, as the fact that got caught doing this is still being denied, we have no idea just how bad things are.

What is also striking is that, well, if any of you have ever smelled foreign cigarettes, you know they are stronger. For exampel, there are Gitanes, which used to be almost a national symbol of France, before they moved to Spain. To give you an idea, the Marlboro Red that we know in the states is considered a "blonde", a light one, whereas the more traditional one is the "burnette", which is stronger. Let's not even get into Galois, or as the English call them "Gollywogs", which are stronger than Gitanes.

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Response to DonCoquixote (Reply #1)

Mon Jan 28, 2013, 09:30 AM

6. the additives aren't a secret, and I'm pretty sure most or all regular brands have them

 

"This is the list of 599 additives in cigarettes submitted to the United States Department of Health and Human Services in April 1994. It applies, as documented, only to American manufactured cigarettes intended for distribution within the United States by the listed companies."


From my own experience the difference between organic tobacco and regular Marlboros is quite significant. Any smoker will tell you that after a few weeks their ashtrays have a layer of tar on them that has to be scraped off. It's disgusting. I used an ashtray for 10 years and didn't have to clean it once. Not once. It's not a great leap to imagine those sticky tars containing the burnt ashes of 599 chemicals, none of which has been tested for toxicity after being burned, collecting in ones lungs.


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Response to HiPointDem (Original post)

Mon Jan 28, 2013, 04:12 AM

2. I wonder if any of the studies break the cigs down further, say

 

by menthol or regular or lite, or filtered or filterless, and so on. Perhaps there's something to the chemistry of the more preferred cigarettes in the US.

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Response to HiPointDem (Original post)

Mon Jan 28, 2013, 08:10 AM

3. Might this have something to do with our health care system?

... or the lack of health insurance? Smokers are charged more for insurance than nonsmokers - that might cause more of them to be uninsured.

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Response to surrealAmerican (Reply #3)

Mon Jan 28, 2013, 08:11 AM

4. What YOU said!.. No paradox here at all.

Our crappy. profit-driven health care delivery system is deadly.

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Response to surrealAmerican (Reply #3)

Mon Jan 28, 2013, 10:51 AM

8. curious also about environmental factors

In the US we have been very resistant to the concept of environment being an issue in cancers of all kinds. I suspect our health care system is the biggest factor in the difference, but I do think we have a lot more carcinogens available via all kinds of products and services we interact with every day than do other countries with stricter controls.

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Response to HiPointDem (Original post)

Mon Jan 28, 2013, 08:44 AM

5. I suspect genetics

Perhaps Americans for whatever reason--over the past several generations--have become more susceptible to lung cancer than the older more homogeneous populations like Japan.

Anecdotal note: The only person I have ever known personally to die as a direct result of lung cancer had never smoked. OTOH, my grandmother smoked all her life...made it to 96.

Disclaimer: This is only my opinion and is not based on anything but my own experience and conjecture.

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Response to HiPointDem (Original post)

Mon Jan 28, 2013, 09:35 AM

7. Second hand smoke <-

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