American Cancer Society Says Smoking Deaths Underestimated

HealthDay News — The American Cancer Society says deaths attributed to smoking may reach as high as 540,000, a significant increase from the 480,000 deaths reported by the U.S. Surgeon General. The findings were published in the New England Journal of Medicine.

“The Surgeon General’s report claims 480,000 deaths directly caused by smoking, but we think that is really quite a bit off,” lead researcher Brian Carter, MPH, an epidemiologist at the cancer society, told HealthDay. Carter’s team used data from five large databases that included 954,029 men and women aged 55 and older.

During about 10 years of follow-up, 181,377 people died. The death rate among people who smoked was three times higher than among those who never smoked. Most of those deaths were the result of diseases known to be related to smoking, such as certain cancers, heart disease, stroke, and chronic obstructive pulmonary disease (COPD). 

However, about 17% of the deaths in smokers were due to diseases that were not established as caused by smoking by the U.S. Surgeon General. Thus these deaths are not counted in estimates of the deaths from smoking, Carter said.

Carter said that smoking was associated with at least a doubling of risk of death from several causes, including kidney failure, intestinal diseases, hypertensive heart disease, infections, and respiratory diseases other than COPD. The risk of death from these diseases dropped after quitting smoking, the researchers found. 

Carter added that there is good evidence that smoking is a cause of death from these diseases, even though they are not yet included in estimates of deaths from smoking. In addition, smoking was linked with small increases in risk of death from breast cancer, prostate cancer, and other cancers, he said.


  1. Carter BD et al. N Engl J Med. 2015; doi:10.1056/NEJMsa1407211.