An analysis of American data has found that the death rate measured among smokers has risen over decades. Much of the increase is explained by the aging of the smoking population: As fewer young people start smoking, the average age of those who continue to smoke increases. The finding does not diminish the health dangers of smoking.
The link between smoking and morbidity and mortality is well established. Yet, when comparing data from different periods, the mortality rate for smokers appears to have increased. To understand why, Ralph Lawton, Jennifer Beam Dowd, Jonathan Skinner, and Alan Mira examined data from the United States National Health Survey from 1987 to 2013, which were linked to mortality records.
In the data we examined, a smoker’s probability of dying within five years rose from about 3.4% in the late 1980s to about 4.9% in 2012–2013. It’s easy to read these numbers as if smoking itself became much more dangerous during this period. But the mortality probability of a group also depends on the age of its members: older people tend to die at a higher rate than younger people, whether they smoke or not.
Fewer young smokers, more older smokers
The researchers broke down the data by age group and time period, comparing smokers with nonsmokers. According to their analysis, the change in the age distribution of smokers explains most of the increase in the overall mortality rate. The decline in smoking initiation among young people leaves a higher proportion of older people in the smoking group; in addition, the overall American population has aged.
This does not mean that cigarettes have become safer or that the health gap between smokers and non-smokers has disappeared. The study addresses a specific statistical question: why does the overall mortality rate in the smoking group change over time? Other factors, such as changes in smoking intensity, population characteristics, and medical care, may also affect the comparison.
Why is this important for public health research?
When comparing mortality rates across populations or across years, a change in the composition of groups can look like a change in the risk associated with a particular habit. Therefore, it is important to present rates by age, alongside the overall rate. The researchers suggest using the same analysis method to examine other age-related risk factors.
Questions and Answers
Is smoking less dangerous than we thought?
No. The study examines the reason for the increase in mortality rates over time; it does not dispute the health damage caused by smoking.
What is the difference between individual risk and group risk?
The age composition. In an older group, the mortality rate may increase even if the risk at a given age remains almost unchanged.
Does the data also describe Israel?
Not directly. The analysis was based on surveys and mortality records in the United States.
מקור: Lawton and others, Why the mortality penalty of smoking is rising over time, PNAS Nexus, September 22, 2026; Journal Notice to Editors.
