Dr Hilary Tindle: Tobacco Nation's High Rates of Lung Cancer

Individuals living within 1 of the 12 states that make up "Tobacco Nation" are at serious risk factor for lung cancer, said Hilary Tinde, MD, MPH, associate professor of medicine at Vanderbilt University.

Why are rates for lung cancer and tobacco-related diseases higher in the US region called “Tobacco Nation?”

“Tobacco Nation” is a nickname—kind of an infamous nickname—that was dubbed by the Truth campaign, which is a nonprofit organization based in Washington, DC. It refers to 12 states including states that are contiguous in the Midwest and South, including Tennessee, where we are now, and it refers to an area of the country where there are higher tobacco rates—so higher smoking rates compared to the rest of the nation.

And this is bad for the people living there, because smoking, of course, leads to bad things for health, such as lung cancer, other types of cancer, and heart disease and affects every organ in the body.

To give you a sense of how Tobacco Nation is different: if it were a country, these 12 states were a country, they would be the fifth worst in the world for smoking rates; so behind Indonesia and China and some other countries that don't have the public health infrastructure that we have.

And there are many reasons for Tobacco Nation. Poverty is a big one. Many of the counties in these particular states are rural or have a lot of people living below the poverty line. Poverty is very highly tied with higher smoking rates.

Another reason is attitudes and beliefs. These are regional, and the Midwest and the South have tended to grow tobacco, especially in the South, historically. People living in these regions, at least according to national surveys, may tend, more than other people not living in these regions, to endorse tobacco [and] more positive things that come from tobacco, like income, rather than the negative health effects.

Those are some of the reasons and some of the underlying foundation of how Tobacco Nation came to be.