Samuel H. Preston University of Pennsylvania Retirement Research Consortium Conference

1. Samuel H. Preston University of Pennsylvania Retirement Research Consortium Conference Washington, D.C. August 2, 2012 Projecting the Effect of Changes in Smoking and Obesity on Future Life Expectancy in the United States In Collaboration with Andrew Stokes and Bochen Cao, University of Pennsylvania and Neil Mehta, Emory University

2. Figure 1. Trends in Smoking and Obesity in the United States Sources: Cigarette consumption data per adult per year are extracted from Tobacco Situation and Outlook Report Yearbook. U.S. Department of Agriculture, October 2007. Obesity data based on measured body mass index in NHANES from 1960 to 2010.

3. Contrasting the Dynamics of Smoking and Obesity in the United States

4. Table 1A. Transition Probabilities across Categories of Body Mass Index, US Adults Ages 25-84, 1998-2008

5. Table 1B. Differences in Transition Probabilities (Standard Errors) between 1980-1990 and 1990-2000, US Adults Ages 25-84

6. Table 1C. Differences in Transition Probabilities (Standard Errors) between 1990-2000 and 2000-2010, US Adults Ages 25-84

7. Figure 2A. Actual and Projected Trends in Body Mass Index (Males)

8. Figure 2B. Actual and Projected Trends in Body Mass Index (Females)

10. Data and Methods for the Analysis of the Mortality Risks of Obesity Data: Baseline data are obtained by pooling NHANES 3 (1988-1994) and NHANES continuous waves 1999-2004. Mortality data are obtained from the National Death Index. Sample size: 21,554 respondents and 2,976 deaths Method: Discrete hazards model, controlling for sex, race/ethnicity, educational attainment and smoking

11. Baseline Model Parameters for Regression Equation Predicting Mortality as a Function of Current Obesity and Obesity at Age 25

12. Figure 3A. Effect of Projected Trends in Body Mass Index on Age-Specific Death Rates (Males)

13. Figure 3B. Effect of Projected Trends in Body Mass Index on Age-Specific Death Rates (Females)

14. Table 5B. Changes in Life Expectancy at Age 40 Resulting from Changes in Obesity

15. Figure 4. Trends in Smoking and Lung Cancer Mortality in the United States Sources: Cigarette consumption data: International Smoking Statistics (2011); Lung cancer mortality data: National Center for Health Statistics.

16. Figure 5. U.S. Male Lung Cancer Mortality by Cohorts

17. Figure 6. U.S. Male Lung Cancer Mortality by Period

18. Equation for Projecting the Mortality Effects of Smoking • Where, • is the death rate at age a in cohort c • is the mean cumulative number of years smoked prior to age 40 for cohort c at age a • is an indicator of age category a • is the coefficient of age category a • is the coefficient of

19. Figure 7. Mean Number of Years Spent as a Cigarette Smoker before Age 40 by Cohort

20. Figure 9A: Effect of Projected Trends in Smoking on Age-Specific Death Rates (Males)

21. Figure 9B: Effect of Projected Trends in Smoking on Age-Specific Death Rates (Females)

22. Table 5A. Changes in Life Expectancy at Age 40 Resulting from Changes in Smoking

23. Figure 10A. Effect of Projected Trends in Smoking and Body Mass Index on Age-Specific Death Rates (Males)

24. Figure 10B. Effect of Projected Trends in Smoking and Body Mass Index on Age-Specific Death Rates (Females)

25. Table 5C. Changes in Life Expectancy at Age 40 Resulting from Changes in Smoking and Obesity

26. Projected Changes in Life Expectancy at Age 40, 2010-2040 *Source: FelicitieC.Bell and Michael L. Miller. 2005. Life Tables for the United States Social Security Area 1900-2100. Social Security Administration Actuarial Study No. 120. Washington, D.C.