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Cigar and pipe smoking and cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

McCormack, Valerie A.; Agudo, Antonio; Dahm, Christina C.; Overvad, Kim; Olsen, Anja; Tjonneland, Anne; Kaaks, Rudolf; Boeing, Heiner; Manjer, Jonas LU and Almquist, Martin LU , et al. (2010) In International Journal of Cancer 127(10). p.2402-2411
Abstract
The carcinogenicity of cigar and pipe smoking is established but the effect of detailed smoking characteristics is less well defined. We examined the effects on cancer incidence of exclusive cigar and pipe smoking, and in combination with cigarettes, among 102,395 men from Denmark, Germany, Spain, Sweden and the United Kingdom in the EPIC cohort. Hazard ratios (HR) and their 95% confidence intervals (CI) for cancer during a median 9-year follow-up from ages 35 to 70 years were estimated using proportional hazards models. Compared to never smokers, HR of cancers of lung, upper aerodigestive tract and bladder combined was 2.2 (95% CI: 1.3, 3.8) for exclusive cigar smokers (16 cases), 3.0 (2.1, 4.5) for exclusive pipe smokers (33 cases) and... (More)
The carcinogenicity of cigar and pipe smoking is established but the effect of detailed smoking characteristics is less well defined. We examined the effects on cancer incidence of exclusive cigar and pipe smoking, and in combination with cigarettes, among 102,395 men from Denmark, Germany, Spain, Sweden and the United Kingdom in the EPIC cohort. Hazard ratios (HR) and their 95% confidence intervals (CI) for cancer during a median 9-year follow-up from ages 35 to 70 years were estimated using proportional hazards models. Compared to never smokers, HR of cancers of lung, upper aerodigestive tract and bladder combined was 2.2 (95% CI: 1.3, 3.8) for exclusive cigar smokers (16 cases), 3.0 (2.1, 4.5) for exclusive pipe smokers (33 cases) and 5.3 (4.4, 6.4) for exclusive cigarette smokers (1,069 cases). For each smoking type, effects were stronger in current smokers than in ex-smokers and in inhalers than in non-inhalers. Ever smokers of both cigarettes and cigars [HR 5.7 (4.4, 7.3), 120 cases] and cigarettes and pipes [5.1 (4.1, 6.4), 247 cases] had as high a raised risk as had exclusive cigarette smokers. In these smokers, the magnitude of the raised risk was smaller if they had switched to cigars or pipes only (i.e., quit cigarettes) and had not compensated with greater smoking intensity. Cigar and pipe smoking is not a safe alternative to cigarette smoking. The lower cancer risk of cigar and pipe smokers as compared to cigarette smokers is explained by lesser degree of inhalation and lower smoking intensity. (Less)
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publishing date
type
Contribution to journal
publication status
published
subject
keywords
pipe, cancer, cigar, smoking
in
International Journal of Cancer
volume
127
issue
10
pages
2402 - 2411
publisher
John Wiley & Sons
external identifiers
  • wos:000283563900017
  • scopus:78049507637
ISSN
0020-7136
DOI
10.1002/ijc.25252
language
English
LU publication?
yes
id
17fe885f-bcc1-4e6c-9685-a769b05dfecc (old id 1720473)
date added to LUP
2010-12-03 14:57:09
date last changed
2018-05-29 11:00:38
@article{17fe885f-bcc1-4e6c-9685-a769b05dfecc,
  abstract     = {The carcinogenicity of cigar and pipe smoking is established but the effect of detailed smoking characteristics is less well defined. We examined the effects on cancer incidence of exclusive cigar and pipe smoking, and in combination with cigarettes, among 102,395 men from Denmark, Germany, Spain, Sweden and the United Kingdom in the EPIC cohort. Hazard ratios (HR) and their 95% confidence intervals (CI) for cancer during a median 9-year follow-up from ages 35 to 70 years were estimated using proportional hazards models. Compared to never smokers, HR of cancers of lung, upper aerodigestive tract and bladder combined was 2.2 (95% CI: 1.3, 3.8) for exclusive cigar smokers (16 cases), 3.0 (2.1, 4.5) for exclusive pipe smokers (33 cases) and 5.3 (4.4, 6.4) for exclusive cigarette smokers (1,069 cases). For each smoking type, effects were stronger in current smokers than in ex-smokers and in inhalers than in non-inhalers. Ever smokers of both cigarettes and cigars [HR 5.7 (4.4, 7.3), 120 cases] and cigarettes and pipes [5.1 (4.1, 6.4), 247 cases] had as high a raised risk as had exclusive cigarette smokers. In these smokers, the magnitude of the raised risk was smaller if they had switched to cigars or pipes only (i.e., quit cigarettes) and had not compensated with greater smoking intensity. Cigar and pipe smoking is not a safe alternative to cigarette smoking. The lower cancer risk of cigar and pipe smokers as compared to cigarette smokers is explained by lesser degree of inhalation and lower smoking intensity.},
  author       = {McCormack, Valerie A. and Agudo, Antonio and Dahm, Christina C. and Overvad, Kim and Olsen, Anja and Tjonneland, Anne and Kaaks, Rudolf and Boeing, Heiner and Manjer, Jonas and Almquist, Martin and Hallmans, Goran and Johansson, Ingegerd and Dolores Chirlaque, Maria and Barricarte, Aurelio and Dorronsoro, Miren and Rodriguez, Laudina and Luisa Redondo, Maria and Khaw, Kay-Tee and Wareham, Nick and Allen, Naomi and Key, Tim and Riboli, Elio and Boffetta, Paolo},
  issn         = {0020-7136},
  keyword      = {pipe,cancer,cigar,smoking},
  language     = {eng},
  number       = {10},
  pages        = {2402--2411},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Cigar and pipe smoking and cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)},
  url          = {http://dx.doi.org/10.1002/ijc.25252},
  volume       = {127},
  year         = {2010},
}