Cigarette smoking-attributable burden of cancer by race and ethnicity in the United States

Cigarette smoking is the leading preventable cause of death and disability from cancer in the U.S. Smoking prevalence varies by racial and ethnic group, and therefore the smoking-related burden of cancer is expected to vary accordingly. We estimated the cigarette smoking-attributable Disability-Adjusted Life Years (DALYs) lost to cancer, overall and within racial/ethnic groups, using published DALY estimates, smoking prevalence from survey data, and relative risks from large cohort studies. In 2011, 2.6 million DALYs were lost to cancer due to cigarette smoking (27% of all DALYs lost to cancer). Smoking-attributable DALY rates were higher in men (968 per 100,000 people [95% confidence interval: 943-992]) than women (557 [540-574]). In combined sex analyses, DALY rates were higher in non-Hispanic Blacks (960 [934-983]) and non-Hispanic Whites (786 [768-802]) than in Hispanics (409 [399-421]) and non-Hispanic Asians (335 [320-350]). Smoking-attributable cancer burden was substantial in all racial and ethnic groups, underscoring the need for intensified tobacco cessation in all populations.