Smoking and Death Rates—Report on Forty-four Months of Follow-up of 187,783 Men

The death rates from specific causes have been studied in relation to smoking habits in a group of 187,783 men between the ages of 50 and 69. During the period of the study 11,870 of these men died. For microscopically proved cases of cancer as well as for the total cases reported as cancer it was found that the death rates were higher among regular cigarette smokers than among men who never smoked, that the mortality ratio increased with the number of cigarettes smoked per day, and that the death rates were higher among pipe and cigar smokers than among men who never smoked. A total of 7,316 deaths occurred among regular cigarette smokers, an excess of 2,665 over the 4,651 that would have occurred had the age-specific death rates for smokers been equal to that for nonsmokers. Coronary disease accounted for 52.1% of the excess: lung cancer accounted for 13.5% and cancer of other sites likewise for 13.5%. An extremely high association between cigarette smoking and death rates for men with lung cancer was found in rural areas as well as in large cities. The most important finding of this study was the high degree of association between cigarette smoking and the total death rate.