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Lung Cancer, 3 (1987) 13-59 Elsevier 13 ABSTPJkCTS i. PREVENTION Determinants of Lung Cancer Risk in Cigarette Smokers in New Mexico. Pathak, D.R., Samet, J.M., Humble, C.G., Skipper, B.J. The Department of Family, Com- munity, and Emergency Medicine, University of New Mexico School of Medicine, Al- buquerque, NM 87131, U.S.A.J. Natl. Cancer Inst. 76: 597-604, 1986. Although cigarette smoking is the strongest known risk factor for lung cancer, the effects of specific smoking practices have not been completely characterized. The present study examines determinants of lung cancer risk in a population-based, case- control study conducted in New Mexico, 1980- 82. The study included 521 cases and 769 controls matched for age, sex, and eth- nicity. Either the index subjects or their next-of-kin were interviewed in person to obtain a detailed history of cigarette smok- ing and information concerning other risk factors. With the use of multiple logistic regression, a model was constructed of the effects of amount smoked, duration of smok- ing, cigarette type, and smoking cessation on lung cancer risk. Among current smokers, risk increased with each additional cigarette smoked per day (P < .001). For duration of smoking, the risk per year smoked in individuals 65 years and older was only one-third that in persons under age 65 years. With regard to cigarette type, a somewhat higher risk was found associated with smoking nonfilter cigarettes, but there was no evidence of decreasing risk as the extent of filter smoking increased. Lifelong filter cigarette smokers and smokers of both filter and nonfilter cigarettes were at lower risk than lifelong smokers of nonfil- ter cigarettes only. In ex-smokers, the pat- tern of variation of relative risk with amount and duration was similar to that in the current smokers. Excluding those who had stopped for 1 year or less, the relative risk declined exponentially with duration of smoking cessation (P<.01). These analyses confirm the strong benefits of smoking ces- sation and indicate possible reduction of risk from smoking filter cigarettes. Quantitative Models of Lung Cancer Mor- tality. II. Predicting Lung Cancer Mor- talities for a Population Depending on the Level of Smoking. Mantel, H., Forbes, W.F., Thompson, M.E., Gibberd, R.W. WHO Collaborating Centre for Reference on the Assessment of Smoking Habits, Faculty of Mathematics, University of Waterloo, Waterloo, Ont. N2L 3GI, Canada. Can. J. Public Health 77: 208-215, 1986. Making use of a model which adequately relates cigarette consumption and lung can- cer mortality for a number of different populations, future mortality rates are pre- dicted depending on various consumption pat- terns of cigarettes. Three scenarios are presented: the first is that the age/sex tobacco consumption per person remains at 1981-85 levels; a second scenario is that tobacco consumption will decrease 5% per quinquennium until stabilizing at 75% of the 1981-85 levels; a third scenario is that the age/sex tobacco consumption per person decreases 10% per quinquennium until stabi- lizing at 50% of the 1981-85 levels. As ex- pected, substantial decreases in lung cancer mortality rates are predicted under the as- sumptions of scenarios two and three. These results may be of value in emphasizing the importance of cigarette smoking in determin- ing the number of lung cancer deaths and the corresponding lung cancer rates and may thus be useful to public policy programs and as a means of encouraging individual smokers to reduce their cigarette consu~tion. Lung Cancer Detection. Results of a Ran- domized Prospective Study in Czechoslovakia. Kubik, A., Polak, J. Research Institute of Tuberculosis and Respiratory Disease, 18071 Prague 8, Bulovka, Czechoslovakia. Cancer 57: 2427-2437, 1986. A randomized prospective study of lung cancer detection was begun in 1976 to 0169-5002/87/$03.50 © 1987 Elsevier Science Publishers B.V. (Biomedical Division)

Determinants of lung cancer risk in cigarette smokers in New Mexico

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Page 1: Determinants of lung cancer risk in cigarette smokers in New Mexico

Lung Cancer, 3 (1987) 13-59 Elsevier

13

ABSTPJkCTS

i. PREVENTION

Determinants of Lung Cancer Risk in

Cigarette Smokers in New Mexico.

Pathak, D.R., Samet, J.M., Humble, C.G.,

Skipper, B.J. The Department of Family, Com-

munity, and Emergency Medicine, University

of New Mexico School of Medicine, Al-

buquerque, NM 87131, U.S.A.J. Natl. Cancer

Inst. 76: 597-604, 1986.

Although cigarette smoking is the

strongest known risk factor for lung cancer,

the effects of specific smoking practices

have not been completely characterized. The

present study examines determinants of lung

cancer risk in a population-based, case-

control study conducted in New Mexico, 1980-

82. The study included 521 cases and 769

controls matched for age, sex, and eth-

nicity. Either the index subjects or their

next-of-kin were interviewed in person to

obtain a detailed history of cigarette smok-

ing and information concerning other risk

factors. With the use of multiple logistic

regression, a model was constructed of the

effects of amount smoked, duration of smok-

ing, cigarette type, and smoking cessation

on lung cancer risk. Among current smokers,

risk increased with each additional

cigarette smoked per day (P < .001). For

duration of smoking, the risk per year

smoked in individuals 65 years and older was

only one-third that in persons under age 65

years. With regard to cigarette type, a

somewhat higher risk was found associated

with smoking nonfilter cigarettes, but there

was no evidence of decreasing risk as the

extent of filter smoking increased. Lifelong

filter cigarette smokers and smokers of both

filter and nonfilter cigarettes were at

lower risk than lifelong smokers of nonfil-

ter cigarettes only. In ex-smokers, the pat-

tern of variation of relative risk with

amount and duration was similar to that in

the current smokers. Excluding those who had

stopped for 1 year or less, the relative

risk declined exponentially with duration of

smoking cessation (P<.01). These analyses

confirm the strong benefits of smoking ces-

sation and indicate possible reduction of

risk from smoking filter cigarettes.

Quantitative Models of Lung Cancer Mor-

tality. II. Predicting Lung Cancer Mor-

talities for a Population Depending on the

Level of Smoking.

Mantel, H., Forbes, W.F., Thompson, M.E.,

Gibberd, R.W. WHO Collaborating Centre for

Reference on the Assessment of Smoking

Habits, Faculty of Mathematics, University

of Waterloo, Waterloo, Ont. N2L 3GI, Canada.

Can. J. Public Health 77: 208-215, 1986.

Making use of a model which adequately

relates cigarette consumption and lung can-

cer mortality for a number of different

populations, future mortality rates are pre-

dicted depending on various consumption pat-

terns of cigarettes. Three scenarios are

presented: the first is that the age/sex

tobacco consumption per person remains at

1981-85 levels; a second scenario is that

tobacco consumption will decrease 5% per

quinquennium until stabilizing at 75% of the

1981-85 levels; a third scenario is that the

age/sex tobacco consumption per person

decreases 10% per quinquennium until stabi-

lizing at 50% of the 1981-85 levels. As ex-

pected, substantial decreases in lung cancer

mortality rates are predicted under the as-

sumptions of scenarios two and three. These

results may be of value in emphasizing the

importance of cigarette smoking in determin-

ing the number of lung cancer deaths and the

corresponding lung cancer rates and may thus

be useful to public policy programs and as a

means of encouraging individual smokers to

reduce their cigarette consu~tion.

Lung Cancer Detection. Results of a Ran-

domized Prospective Study in Czechoslovakia.

Kubik, A., Polak, J. Research Institute of

Tuberculosis and Respiratory Disease, 18071

Prague 8, Bulovka, Czechoslovakia. Cancer

57: 2427-2437, 1986.

A randomized prospective study of lung

cancer detection was begun in 1976 to

0169-5002/87/$03.50 © 1987 Elsevier Science Publishers B.V. (Biomedical Division)