Aging smoker population explains rise in five-year mortality risk

by PNAS Nexus

edited by Swati Mestri, reviewed by Andrew Zinin

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Smoking kills. But why does smoking seem more likely to kill now than a few decades ago? In 1987, a smoker had a 3.4% chance of dying within five years. By 2013, a smoker had a 4.9% chance of dying within five years.

Ralph Lawton, Ellen Meara and colleagues discovered an answer to this puzzle by analyzing representative data from the 1987–2013 waves of the U.S. National Health Interview Survey (NHIS).

By dividing the NHIS years into three periods and estimating age-specific mortality in each, the authors demonstrate that the difference in the risk of death between smokers and nonsmokers at each age was about the same in each eight-year period.

For example, a 65-year-old smoker had a 10% higher chance of death than a 65-year-old nonsmoker in the late 1980s, and that risk was the same in the 2010s. The authors conclude that changing age distributions explain most of the increase in smoking-related mortality risk.

The U.S. population is aging. In addition, fewer young people are picking up the habit as smoking becomes less socially acceptable. Smokers are, on average, older than they were decades ago, and mortality risks associated with smoking rise with age.

According to the authors, similar methods could be used to examine the effects of other risk factors that vary with age, potentially including obesity, poor diet or lack of education.

Publication details

Why the mortality penalty of smoking is rising over time, PNAS Nexus (2026). academic.oup.com/pnasnexus/art … 93/pnasnexus/pgag280

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Swati Mestri

Swati Mestri holds a bachelor's degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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