International Journal of Epidemiology, Vol 28, 614-619, Copyright © 1999 by International Epidemiological Association
L Armadans-Gil, J Vaque-Rafart, J Rossello, M Olona and M Alseda
BACKGROUND: The mortality rate from lung cancer (LC) increased sharply in
Spain between 1957 and 1986. This increase has been related to a previous
increase in cigarette smoking. Certain features of cigarette smoking which
were frequent among Spanish smokers (use of black tobacco and use of
cigarettes without filter) have been related to a higher risk of LC.
METHODS: A hospital-based case-control study was conducted between December
1986 and June 1990. The 325 male patients with lung cancer included in the
study (cases) were compared with 325 age-matched male controls without LC.
Occupation and lifetime tobacco consumption were requested using a
structured questionnaire. The LC odds ratios (OR) and 95% CI were estimated
with multiple logistic regression. RESULTS: Lung cancer risk increased with
cigarette consumption and duration of the habit. After adjusting for
lifetime cigarette consumption and for socioeconomic level, LC risk was
greater among black tobacco smokers than among exclusive blond tobacco
smokers (OR = 5.0, 95% CI: 2.0-12.7); LC risk among long-term (> or =20
years) filter- tipped cigarette users was lower compared to all other
smokers (OR = 0.4, 95% CI: 0.2-0.7). CONCLUSIONS: The main results of the
study (a higher LC risk among black tobacco users than in exclusive blond
tobacco users, and a lower LC risk among long-term filter-tipped cigarette
smokers than all other smokers) have been consistent with previous
case-control studies and with ecologic studies which took into account past
exposure levels.
ARTICLES
Cigarette smoking and male lung cancer risk with special regard to type of tobacco
Servei de Medicina Preventiva i Epidemiologia, Vall d'Hebron Hospitals, Barcelona, Spain. larmadans@cs.vhebron.es
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