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Associations of Local Comprehensive Smoke-Free Ordinances With Cancer Incidence Trends in Louisiana
ORIGINAL RESEARCH — Volume 23 — July 23, 2026
PEER REVIEWED
Line graph of age-adjusted lung cancer incidence from 2015 to 2022. Orleans Parish declined steadily from about 58 to 46 cases per 100,000, Ouachita Parish declined most steeply from about 82 to 50 cases after a visible change in slope around 2016, and the remainder of Louisiana declined more gradually from about 67 to 59 cases.
Figure 1. Annual age-adjusted lung cancer incidence per 100,000 population for Orleans Parish, Ouachita Parish, and the remainder of Louisiana excluding those 2 parishes, 2015–2022. Rates were age-adjusted to the 2000 US standard population. Analyses included all diagnosed lung cancer cases (ICD-O-3 codes for lung and bronchus) reported to the Louisiana Tumor Registry between 2015 and 2022 (N = statewide incident cases during that period; registry data include all Louisiana residents). Points show observed annual rates from 2015 to 2022. To preserve comparability with the primary 2007–2022 Joinpoint analysis, the fitted lines shown are the corresponding model segments from the full series; thus, the Ouachita Parish line retains the 2016 joinpoint shown in Figure 2. Joinpoint regression identified no joinpoints for any group. Abbreviation: ICD-O-3, International Classification of Diseases for Oncology, 3rd edition.
Line graph of age-adjusted lung cancer incidence from 2007 to 2022. Orleans Parish declines steadily from about 75 to 47 cases per 100,000, the remainder of Louisiana declines more gradually from about 78 to 60 cases, and Ouachita Parish stays near 80 cases through 2016 before declining sharply to about 48 cases by 2022.
Figure 2. Annual age-adjusted lung cancer incidence per 100,000 population for Orleans Parish, Ouachita Parish, and the remainder of Louisiana excluding those 2 parishes, 2007–2022. Rates were age-adjusted to the 2000 US standard population. Data include all lung cancer cases (ICD-O-3 codes for lung and bronchus) reported to the Louisiana Tumor Registry from 2007 to 2022. Joinpoint regression identified no joinpoints for Orleans Parish or the rest of Louisiana. In contrast, one joinpoint was detected for Ouachita Parish: from 2007 to 2016, incidence declined slowly, followed by a sharp, significant decline from 2016 to 2022. Abbreviation: ICD-O-3, International Classification of Diseases for Oncology, 3rd edition.
Line graph of age-adjusted tobacco-related cancer incidence from 2007 to 2022. Orleans Parish declined most steeply from just above 220 to below 180 cases per 100,000, Ouachita Parish declined moderately from about 230 to 190 cases, and the remainder of Louisiana declined more gradually from about 233 to 211 cases.
Figure 3. Annual age-adjusted incidence per 100,000 population for cancers causally associated with tobacco use (including cancers of the lung and bronchus, larynx, oral cavity and pharynx, esophagus, bladder, kidney, pancreas, and stomach) for Orleans Parish, Ouachita Parish, and the remainder of Louisiana excluding those 2 parishes, 2007–2022. Rates were age-adjusted to the 2000 US standard population. Data included all relevant cancer cases reported to the Louisiana Tumor Registry from 2007 to 2022. Joinpoint regression identified no joinpoints for any group.
Multiseries line graph of lung cancer incidence from 2007 to 2022 stratified by parish and race. Rates declined in all groups. Orleans Parish non-Hispanic Black residents showed a steady decline from roughly 80 cases to cases in the mid-50s per 100,000, whereas Orleans Parish non-Hispanic White residents were flatter through 2017 and then declined sharply to cases in the low 30s. Both Ouachita groups declined from cases in the mid-80s to the upper-50s, and both racial groups in the remainder of Louisiana declined more gradually from cases in the high-70s to the low-60s.
Figure 4. Annual age-adjusted lung cancer incidence per 100,000 population stratified by race among non-Hispanic Black and non-Hispanic White people for Orleans Parish, Ouachita Parish, and the remainder of Louisiana excluding those 2 parishes, 2007–2022. In Orleans Parish, APC = −3.03 for non-Hispanic Black; APC = −0.20 for 2007–2017 and −8.41 for 2017–2022 for non-Hispanic White. In Ouachita Parish APC = −2.78 for non-Hispanic Black and −2.82 for non-Hispanic White. In the rest of Louisiana excluding those 2 parishes, APC = −1.62 for non-Hispanic Black and −1.53 for non-Hispanic White. Rates were age-adjusted to the 2000 US standard population. Data include all lung cancer cases (ICD-O-3 codes for lung and bronchus) reported to the Louisiana Tumor Registry between 2007 and 2022. Abbreviations: APC, annual percent change; ICD-O-3, International Classification of Diseases for Oncology, 3rd edition.
Multiseries line graph of tobacco-related cancer incidence from 2007 to 2022 stratified by parish and race. Most groups declined over time. Orleans Parish non-Hispanic Black residents declined from cases in the mid-250s to below 190 per 100,000, Orleans Parish non-Hispanic White residents rose slightly through 2017 and then declined to about 155 cases, Ouachita Parish non-Hispanic Black residents declined from about 255 to 185 cases, Ouachita Parish non-Hispanic White residents rose slightly through 2018 and then declined to about 190 caeses, and both racial groups in the remainder of Louisiana declined gradually.
Figure 5. Annual age-adjusted incidence rates per 100,000 population for cancers causally associated with tobacco use (including cancers of the lung and bronchus, larynx, oral cavity and pharynx, esophagus, bladder, kidney, pancreas, and stomach) among non-Hispanic Black and non-Hispanic White people for Orleans Parish, Ouachita Parish, and the remainder of Louisiana excluding those 2 parishes, 2007–2022. Rates were age-adjusted to the 2000 US standard population. Data include all relevant cancer cases reported to the Louisiana Tumor Registry between 2007 and 2022.
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