Smoking out cigarette risk.

Lung cancer has edged past coronary artery disease as the leading cause of "excess" deaths among U.S. cigarette smokers, according to a new report. One reason for the cancer's deadly new ranking: Smokers can rapidly lower their risk of coronary artery disease when they kick the habit, eliminating about half the risk during the first smoke-free year. By contrast, lung cancer retains 30 to 50 percent of its threat even a decade after quitting.

Using data from a prospective study of 1.2 million people, Donald R. Shopland of the National Cancer Institute and his colleagues projected that an estimated 157,226 cigarette-related cancer deaths will occur in the United States in 1991. The statistical analysis linked the vast majority of those deaths (123,111) to lung cancer. However, cigarette smoking was also associated with an estimated 34,0000 lethal cancers at other sites, including the mouth, bladder and kidney, the team found.

These numbers, reported in the Aug. 21 JOURNAL OF THE NATIONAL CANCER INSTITUTE, include only cigarette-linked deaths and thus underestimate the true cancer burden associated with the full range of tobacco products, the researchers warn. They estimate that an additional 14,000 deaths in 1991 will result from the use of pipes and cigars, which raise the risk of several cancers, particularly those of the mouth and esophagus.