Question

Lung cancer is the second most common cancer among men and women in the USA. You are hired as a manager-planner by one of the hospitals. The organization is interested in establishing a community outreach program promoting smoking cessation and lung cancer screening. The Board of Directors requested your services in processing the data collected through the prospective cohort study among male and female population visiting local gym. The data set is attached. Please use Excel or Epi Info to process the data. Chose the correct epi tool, provide a graphic representation of the processed data set and offer a conclusion as to the causative relationship between smoking and death. List the potential biases and provide a recommendation as to the study validity and reliability. Inform the Board of Directors (and your peers) about your findings.

Answer 1

1) Despite the many prior reports on the topic and the high level of public knowledge in the United States of the adverse effects of smoking in general, tobacco use remains the leading preventable cause of disease and death in the United States, causing approximately 440,000 deaths each year.Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis,stroke and coronary heart disease, which are among the leading causes of death in the United States. Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular disease.whereas, The first report established a causal association between smoking and lung cancer, and subsequent reports expanded the list of smoking attributable causes of death to include other cancers, cardiovascular diseases, stroke, and respiratory diseases.
2) Lung Cancer. More people die from lung cancer than any other type of cancer. COPD (chronic obstructive pulmonary disease) COPD is an obstructive lung disease that makes it hard to breathe.Heart disease,stroke,asthma,reproductive Effects in Women,Premature, Low Birth Weight Babies & diabetes.
Many public health policies are rooted in findings from medical and epidemiological studies that fail to consider behavioral influences. Using nearly 50 years of data from Framingham Heart Study male participants, we evaluate the longevity consequences of different lifetime smoking patterns by jointly estimating smoking behavior and health outcomes over the life cycle, by richly including smoking and health histories, and by flexibly incorporating correlated unobserved heterogeneity. Unconditional difference-in-mean calculations that treat smoking behaviors as random indicate a 9.3 year difference in age of death between lifelong smokers and nonsmokers; our findings suggest the bias-corrected difference is 4.3 years.Public Health, Discrete Factor Method.Many public health policies are rooted in findings from medical and epidemiological studies that often fail to account for health behaviors. We focus on smoking and mortality to demonstrate the importance of modeling behavioral contributions. Smoking is currently considered the leading preventable cause of death in the United States. According to the Centers for Disease Control, smoking causes 480,000 deaths each year and 8.6 million people have at least one serious illness due to smoking. Cigarette smoking is the primary causal factor in lung cancer and is a key risk factor in coronary heart disease.2 In addition to the obvious negative health consequences of smoking, the medical and epidemiological literatures contend that quitting smoking has significant benefits. For example, ten years after quitting, an individual faces a cancer risk one- third to one-half as large as if he had continued smoking. Quitting smoking before age 40 is associated with a 90 percent reduction in smoking related excess mortality. While we do not dispute that smoking causes significant excess morbidity and mortality, our research suggests that the accepted morbidity and mortality improvements accompanying smoking cessation may be overstated by as much as 50 percent.There is ample biological evidence linking smoking to deleterious health outcomes. Yet, some puzzling aggregate trends suggest calculations in the literature of these health impacts may be flawed. Over the last twenty five years adult smoking rates for both genders have fallen steadily to about half their initial levels, but the incidence of lung and bronchus cancer has doubled for women while declining for men. This variation could stem from heterogeneity in individual characteristics among the fifty million former smokers. While quitting smoking might suspend additional contributions to poor health, the precise nature of ones smoking history still predisposes that individual to cancers, heart disease, and other diseases.Ideally, longevity losses from cigarette smoking and the longevity gains from smoking cessation should be calculated from observed mortality differences following random assignment of lifetime smoking behavior. Because random variation in smoking histories does not exist, researchers must rely on observational data to measure the effects of smoking on morbidity and mortality. When using non-experimental data to obtain gain/loss predictions, identification of the causal effect of smoking on mortality is difficult precisely because observed smoking behavior over one’s lifetime is not random: individuals initiate smoking, may choose to quit smoking, and sometimes fail at quitting. These endogenous behaviors produce very different lifetime smoking patterns, which we capture using lagged smoking status and years of smoking experience, duration, and cessation. Therefore, the first contribution of this paper is determination of conditional impacts of the varying histories of smoking through joint estimation of smoking behaviors and health outcomes at frequent intervals over the life cycle. Our estimated model of smoking behavior and health outcomes over ones adult lifetime accounts for variation in endogenous individual smoking and health histories.