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An analysis of nearly three decades of mortality data in the United States of America (USA) published in Nature Health has found that cigarette smoking accounted for nearly two-thirds of excess deaths among White Americans with lower levels of education.

People walking down the street in USA

Led by researchers at the Nuffield Department of Population Health and the Centre for Global Health Research at the University of Toronto, Canada, the study examined 33 million death records to quantify the contribution of smoking to widening disparities in death rates among White adult Americans by their level of education.

Life expectancy gains among adults in the USA have stalled in recent decades, driven mainly by worsening life expectancy among people with low education (11 years or less), and stagnation in the middle-education group (12 years). By contrast, life expectancy continues to improve in the high-education groups (13 years or more). These trends have been most pronounced among non-Hispanic White Americans – the focus of this study.

The researchers found that for the lower-educated, the risk of a 30-year-old White man dying before reaching age 80 increased from 65% to 79% over three decades. Among lower educated women, it rose from 44% to 67%. By contrast, the risk of premature death for those with higher levels of education fell from 44% to 34% among men and from 31% to 25% among women. Over the 30-year period studied, the gap in the risk of premature death between low- and high-educated men more than doubled, while the gap among women tripled.

Read the full story on the Nuffield Department of Population Health website.