Tobacco smoke load and non-lung cancer mortality associations in Austrian and German males

Abstract

The millstone around the neck of tobacco control in Europe has been the influence of the tobacco industry on the governments of German speaking countries. This study attempts to estimate non-lung cancer mortality attributable to smoking in Austria during 1967-2006 and in Germany during 1973-2006. National estimates of the annual smoking-attributable fractions (SAF) were calculated for all ages in males, using lung cancer mortality rates as indicators of "tobacco smoke load" associated with cancer from active and passive smoking. In both countries non-lung cancer rates showed a nearly perfect linear correlation with lung cancer rates (R (2) = 0.95 in Austria and 0.94 in Germany) with a slope of 1.86 (95% confidence intervals [CI]: 1.71-1.99) in Austria and 1.77 (95% CI: 1.60-1.93) in Germany. In 2006 SAF of male cancer mortality for all ages were 61% in Austria (sensitivity range [SR]: 45%-70%) without autocorrelation and 61% in Germany (SR: 41-75%), if adjusted for possible autocorrelation. The similarity of the results is in line with the poor tobacco control measures in both countries until recently. Cancer prevention programs in Austria and Germany should focus on tobacco control, because 61% of male cancer mortality was associated with tobacco smoke load.