Background: In many developed countries, immigrants live longer-that is, have lower death rates at most or all ages-than native-born residents. This article tests whether different levels of smoking-related mortality can explain part of the 'healthy immigrant effect' in the USA, as well as part of the related 'Hispanic paradox': the tendency for US Hispanics to outlive non-Hispanic Whites. Methods: With data from vital statistics and the national census, we calculate lung cancer death rates in 2000 for four US subpopulations: foreign-born, native-born, Hispanic and non-Hispanic White. We then use three different methods-the Peto-Lopez method, the Preston-Glei-Wilmoth method and a novel method developed in this article-to generate three alternative estimates of smokingrelated mortality for each of the four subpopulations, extrapolating from lung cancer death rates. We then measure the contribution of smoking-related mortality to disparities in all-cause mortality. Results: Taking estimates from any of the three methods, we find that smoking explains 450% of the difference in life expectancy at 50 years between foreign- and native-born men, and 470% of the difference between foreign- and native-born women; smoking explains475% of the difference in life expectancy at 50 years between US Hispanic and non-Hispanic White men, and close to 75% of the Hispanic advantage among women. Conclusions: Low smoking-related mortality was the main reason for immigrants' and Hispanics' longevity advantage in the USA in 2000. Published by Oxford University Press on behalf of the International Epidemiological Association. © The Author 2011; all rights reserved.

minority health Statistics as topic Lung neoplasms Health status disparities smoking Mortality

immigrant lung cancer indigenous people health risk survival analysis Health Status Disparities minority group human risk assessment immigration middle aged Population Groups priority journal Aged European American Databases, Factual cancer subpopulation Hispanic Americans Cross-Sectional Studies United States Humans ethnic difference Hispanic smoking life expectancy male Emigrants and Immigrants female Lung Neoplasms developing world Article cancer mortality data set major clinical study adult age European Continental Ancestry Group Sex Factors Age Factors estimation method census mortality