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Lung Cancer Rate for Blacks No Longer Exceeds That of Whites

Healthy changes in African American smoking behavior credited for positive results

Final cigarette stubbed out, end of smoking

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En español | Black Americans have cut back on cigarette smoking in the past 60 years and — for the most part — eliminated racial disparities that historically found higher lung cancer rates among Blacks than whites, according to research from the American Cancer Society.

In a study published in JNCI Cancer Spectrum, the researchers found lung cancer rates have been on the decline for decades but have dropped at a steeper rate for Blacks. As a result, Blacks born since 1967 are no longer more likely to get lung cancer than whites. The study notes that historically higher smoking rates for Blacks no longer exist for those born since 1965.

Lung cancer is the leading cause of cancer death in the United States with about 80 percent of the total 154,000 deaths recorded each year caused by cigarette smoking, according to the American Cancer Society.

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Despite the overall declines, the study found one notable exception, identifying an increase in lung cancer incidence rates in Black men ages 43 to 48, higher than white men in the same age group. (Incidence is the number of newly diagnosed cases during a specified time.) The researchers attribute the disparity to tobacco company advertising in the 1990s that targeted minority youth.

"This increase likely reflects the steep rise in initiation of smoking among Black adolescents in [the] 1990s, which coincided with the R.J. Reynold's tobacco advertisement campaign targeting African Americans,” they wrote. “Between 1991 and 1997, the prevalence of current cigarette use among Black high school students doubled from 14.1 percent to 28.2 percent."

A 2007 study published in the journal Public Health Reports confirmed earlier reports that the tobacco industry had targeted African Americans through advertising in the 1990s. It found 2.6 times as many tobacco advertisements per person in Black neighborhoods compared with white neighborhoods. The study noted earlier research had found tobacco-related billboard advertising was more prevalent in Black neighborhoods in St. Louis in 1998 and in Los Angeles between 1990 and 1994.

Tobacco advertising was removed from billboards in 1999 as part of an agreement between the tobacco industry and state attorneys general, who had sued the industry claiming its advertising had targeted children.

Information from the National Cancer Institute's Surveillance, Epidemiology and End Results Program for 2017, the latest available, shows a downward trend in the incidence of lung and bronchus cancer for all races and ethnicities of all ages. Whites had the highest rates per 100,000 people at 57.6; Blacks had a rate of 51.3 per 100,000; Native Americans, 37.0; Asian and Pacific Islander, 35.4; Hispanics, 27.4. Rates for all the racial groups except whites include those of Hispanic ethnicity.

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