SOME STATES have added questions of their own to this year's death certificate, depending on interests in particular problems. These questions are just for state use, according to statistician George Tolson, National Center for Health Statistics, Hyattsville, Md.
Oregon Asks a Question
For example, Oregon elected to add a question on tobacco use (JAMA. 1988;260:1835). Other states have since done the same.According to indications on death certificates, Oregon's incidence of lung cancer and other respiratory disease correlated with tobacco use is higher than the national average, says Joyce Grant Worly, manager of the state statistical unit. The chance of having lung cancer is 13.5% greater in Oregon, she says, and 76.9% of the state's lung cancer cases have related tobacco use.Oregon residents have a 42.2% greater chance of having respiratory disease. Tobacco is associated with 70% of bronchitis, 81.8% of emphysema, and 76.6% of chronic airway obstruction cases in