Patterns of cigarette sales and lung cancer mortality in some central and eastern European countries, 1960-1989

Abstract

Background. Remarkable increases in lung cancer risk recently have been observed in the Central and Eastern European (CEE) area. This study examines the patterns of lung cancer mortality rates and cigarette sales in 1960‐1989 in seven CEE countries with a total population of 97.5 million and 43,000 deaths from lung cancer in the last year under study. Methods. Trends in cigarette sales and mortality rates from lung cancer in seven CEE countries were compared for the years 1960‐1989. Results. Among males, recent lung cancer death rates were the highest in Europe, and trends by country largely reflected the varied prevalence and duration of smoking in previous decades. For females, lung cancer mortality rates were much lower, although there were exponential rate increases. In the more recent birth cohorts, there were some declines in mortality rates among males, but not among females. Conclusions. The rising cigarette consumption through the 1960s, 1970s, and, in some countries, the 1980s is accompanied in most of the countries by rising lung cancer mortality rates for young adults. This increasing cigarette consumption will determine future trends in lung cancer, which will increase well beyond the turn of the century and will continue longer for females than for males. This outlook underlines the urgent need for comprehensive lung cancer prevention with the concerted control of smoking as a priority. The role of cofactors and their interaction with smoking deserve further exploration.

Changes in lung‐cancer mortality trends in Spain

“…The downturn in cigarette consumption since the 1960s combined with lower tar content of cigarettes was a clear precursor to the decline in lung-cancer mortality rates in the United States and the United Kingdom. 6 According to data from Tabacalera, a state owned company that monopolized the tobacco market in Spain until 1998, the continuous increase in cigarette sales began to decline in the early 1990s, with a decrease of 17.1% from 2,685.5 cigarettes per adult aged 15 years and older in 1991 to 2,226.2 in 1996. 16,17 However, sales of black tobacco, which has been related to a higher risk of lung cancer in case-control studies, 18 decreased over the last decades, falling from 94% of total sales in 1961 to 31.3% in 1996, being replaced by Virginia tobacco.…”

“…6 We analyzed trends in lung-cancer mortality in Spain from 1973-1997, using a Poisson log-linear age-period-cohort model.…”

Lung cancer mortality patterns in selected Central, Eastern and Southern European countries

“…Estimates of cancer mortality for the year 2000 for all 10 accession countries were derived from the Globocan 2000 software and database. 13 Age-standardized mortality rates (ASRs) were calculated for all ages combined and for age groups [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74] Hungary and Poland) and for age groups 20 -44, 45-64 and 65 and over (Estonia, Latvia, Lithuania, Slovakia and Slovenia) for each sex separately. The World Standard Population was used for age adjustment.…”

“…However, a previous analyses using data from former Czechoslovakia showed an increase of lung cancer mortality in the 1960s, 1970s and the first half of the 1980s. [23][24][25] Bray et al 3 describe how the decrease in tobacco smoking prevalence in men in many West European (EU members) countries has been reflected by a plateauing followed by a decline in lung cancer mortality 1-2 decades later (e.g., United Kingdom and Finland). In other Western countries, such as France, a modest drop in smoking prevalence led to a plateau in mortality (not decline).…”

Recent trends and future directions for lung cancer mortality in Europe

“…British Journal of Cancer (2002) Lung cancer is the most common cause of cancer mortality among men in Europe, and is becoming an increasingly important cause of cancer mortality among women . Lung cancer mortality patterns throughout Europe are very heterogeneous and largely reflect past smoking habits (Kubik et al, 1995), although changes in cigarette composition are also likely to be important. In order to clarify the changing patterns of lung cancer in Europe we have plotted the overall lung cancer trends among men and women for 20 countries from 1950 up to the most recent collection of data, usually 1996 -1998, depending on each country.…”