Historically, lung cancer incidence rates have been higher in Black people than White people among men of all ages and among younger women, likely reflecting historically higher smoking rates in Black adults.

That is no longer the case, and in women the trend has even reversed.

That is a big win for science and health nonprofit groups like ours, which have warned about the perils of smoking for our entire existence.

Smoking prevalence data and national lung cancer incidence rates by sex among contemporary young birth cohorts found that incidence decreased in both Black and White men born since about 1947 and in women born since abut 1957, with the declines steeper in Black people than White people. Those steeper declines led to the Black/White  gap disappearing in men born in 1967 to 1972 and reversing in women born since about 1967. Similarly, historically higher smoking rates in Black people versus White people disappeared in men and reversed in women born since about 1965.



There was one notable exception. The authors identified increasing lung cancer incidence rates in Black men born around 1977-1982, which indeed led to higher lung cancer incidence rates in Black than White men born during this period. "This increase likely reflects the steep rise in initiation of smoking among black adolescents in 1990s, which coincided with the R.J. Reynold's tobacco advertisement campaign targeting African-Americans," write the authors. "Between 1991 and 1997, the prevalence of current cigarette use among black high school students doubled from 14.1% to 28.2%."

The authors say that their findings have significant public health implications. It shows that education about the harms of smoking have worked, along smokers embracing smoking cessation and harm reduction tools like vaping, gums, and patches.

"While these patterns herald progress in reducing racial disparities in lung cancer occurrence and the success of tobacco control in the Black community, the increasing lung cancer incidence rates in Black men born circa 1977-1982 is concerning and underscores the need for targeted tobacco prevention interventions," the authors conclude.