50-Year Trends in Smoking-Related Mortality in the United States

Data from two historical and five contemporary cohort studies indicate that the risk of death from smoking-related diseases has increased among women since the 1960s, and the risk for women is now nearly identical to that for men. The disease risks from cigarette smoking increased over most of the 20th century in the United States as successive generations of first male and then female smokers began smoking at progressively earlier ages. American men began smoking manufactured cigarettes early in the 20th century; by the 1930s, the average age at initiation fell below 18 years. 1 , 2 Relatively few women smoked regularly before World War II; their average age at initiation continued to decrease through the 1960s. Women were not included in the earliest prospective epidemiologic studies in the 1950s, 3 – 5 since mortality from lung cancer among women was not . . .