Self-reported smoking and related health behaviors in South Carolina: A geographic analysis of incidence rates of smoking-attributed cancers

Purpose Smoking is associated with increased risk of adverse health effects, including increased risk of cancer, stroke, heart disease and premature mortality. Smoking cessation is touted as the best method to prevent these negative health outcomes. However, the rate of current smokers has not significantly declined in the last fifteen years in South Carolina. This study assesses current smoking and related health behaviors and investigates any possible association with incidence rates of smoking-attributed cancers in South Carolina. Methods Responses regarding current smoking behavior and voluntary seeking of medical care to the 2003 Behavior Risk Factor Surveillance System (BRFSS) survey conducted in South Carolina were obtained through the South Carolina Department of Health and Environmental Control (SC-DHEC) website. Incidence rates of all cancers for 1996 through 2000 were also obtained through the SC-DHEC website. Smoking-attributed cancers were classified based upon Centers for Disease Control (CDC) classification. Both smoking attributed and nonsmoking attributed cancer incidence rates were categorized according to counties. An analysis was conducted using Arc View Geographical Information System software. Results Geographic analysis identified Marlboro and Dillon counties has having the highest age-adjusted lung cancer incidence rates in South Carolina (Dillon – 118.9 and Marlboro – 135.0 per 100,000) while also having the largest percentage of current smokers (69.3%) and the largest percentage of smokers not seeking medical care (30.7%). These counties had the third and fourth highest rate differences between total 1996 to 2000 incidence rates of smoking-attributed cancers and the incidence rates of cancers not attributable to smoking. Conclusion Marlboro and Dillon counties have high smoking-attributable cancer incidence rates and the largest percentage of current smokers not seeking medical care. Ongoing surveillance such as BRFSS should be combined with health education in these at-risk counties.