Use of an age-period-cohort model to reveal the impact of cigarette smoking on trends in twentieth-century adult cohort mortality in England and Wales

We use an age-period-cohort (APC) model to estimate the contribution of smoking-related mortality to cohort changes in adult mortality in Britain since 1950. We show that lung cancer and overall mortality can be satisfactorily modelled using cohort relative risk and a fixed age pattern. The results of the model suggest that smoking by itself can account for a substantial fraction of change in cohort mortality for those born around the first half of the twentieth century. In particular, smoking provides an explanation for the higher-than-average improvement in the mortality of both males and females born around 1930. Our confidence in the correctness of the results of the models is strengthened by the fact that they are very similar to those of the Peto–Lopez and Preston–Glei–Wilmoth models that estimate the contribution of smoking-related to overall mortality.