河南省2004年中国国际戒烟竞赛参赛者一月随访

目的评价河南省2004年中国国际戒烟竞赛的效果。方法戒烟竞赛开展1个月后,对来自17个省辖市的7378名参赛者进行系统抽样,共抽取936名参赛人员,通过电话或面谈的方式进行随访。结果1个月戒烟率为53.0%;没有戒烟的人中,平均每日吸烟量由原先的18支/d降至为8支/d(P<0.05);多因素分析表明,年龄、文化程度、戒烟态度、参赛目标、使用特别戒烟方法与最终戒烟效果有关,而参赛目标对戒烟成功与否影响最大(P<0.001),其次是戒烟态度(P=0.0042)。结论戒烟竞赛的效果令人满意。通过营造全方位的戒烟氛围,戒烟竞赛使多种戒烟方法得以综合运用。     

云南省农村三个民族吸烟行为及对慢性阻塞性肺疾病的影响

目的 比较分析云南省农村汉族、纳西族和白族居民的吸烟行为及与慢性阻塞性肺疾病(COPD)患病的关系。方法 采用多阶段分层随机抽样方法抽取共7 534名≥35岁的农村常住居民进行问卷调查及肺功能检查。结果 云南省农村汉族、纳西族和白族的吸烟率分别为37.3%、40.6%和38.7%,现在吸烟率分别为28.5%、32.2%和30.5%,被动吸烟率分别为22.5%、38.3%和30.4%,COPD患病率分别为11.5%、17.7%和13.2%。3个民族吸烟率差异没有统计学意义(χ²=5.895,P=0.052),但纳西族的现在吸烟率(χ²=7.986,P=0.018)、被动吸烟率(χ²=102.849,P<0.001)、每天吸烟量(H=49.112,P<0.001)和COPD患病率(χ²=41.757,P<0.001)均最高，而初次吸烟年龄(F=4.812,P=0.008)、规律吸烟年龄(H=32.929,P<0.001)和戒烟次数(H=22.350,P<0.001)均最低。...     

辽宁省城乡吸烟者吸烟行为特征分析

目的分析辽宁省城乡吸烟者吸烟习惯及其特征,为吸烟行为危险因素控制提供基础数据。方法采用分层随机整群抽样方法在辽宁省抽取8 612名城乡居民进行慢性病行为危险因素调查,分析其中2 771名吸烟者1支烟抽吸长度和香烟雾吸入深度的水平和特征。结果辽宁省城乡居民吸烟率为32.2%,男性吸烟率(53.7%)高于女性吸烟率(11.6%),差异有统计学意义(χ2=1 746.708,P<0.01);吸烟量<10支/d、10~19支/d和≥20支/d的比例分别为22.63%、33.63%和43.74%;吸烟者1支烟抽吸长度<1/2支、1/2~3/4支和全部吸完的比例分别为7.49%、27.76%和64.75%;香烟雾几乎不吸入、吸入一点、吸入一半和吸入很多的比例分别为8.47%、21.25%、35.41%和34.87%;男性吸烟者吸烟≥20支/d,一支烟抽吸长度1/2~3/4支、香烟雾吸入很多的比例分别为45.99%、28.77%、36.59%,均高于女性吸烟者的33.79%、23.33%、27.25%(均P<0.01);相关分析结果显示,1支烟抽吸长度和香烟雾吸入深度均与吸烟量呈正相关(r=0.192、0.234,均P<0.01),1支烟抽吸长度与香烟雾吸入深度呈正相关(r=0.339,P<0.01)。结论不同性别、吸烟量的吸烟者1支烟抽吸长度和香烟雾吸入深度均存在显著差异,改变吸烟者吸烟行为模式,增加吸烟者中少吸和浅吸者比例,将有效降低吸烟者的健康风险。     

宁夏回汉成年居民吸烟状况调查分析

  目的  调查宁夏回汉成年居民吸烟及二手烟暴露状况,为制定烟草控制措施提供依据。  方法  2013-2014年在宁夏6个监测点,采用多阶段分层整群随机抽样方法,通过面对面问卷调查收集慢性病相关危险因素信息,共调查18岁以上居民3 540人,用于吸烟状况分析的有效样本量为3 527人。对样本进行复杂加权后,分析不同民族、性别和年龄成年人吸烟及二手烟暴露状况。  结果  调查对象现在吸烟率为29.42%,男性(56.73%)远高于女性(0.92%)(χ2=1 197.785,P < 0.001);汉族现在吸烟率(32.04%)高于回族(23.09%)(χ2=15.325,P < 0.001)。现在每日吸烟率汉族(27.98%)高于回族(19.83%)(χ2=11.932,P=0.001),男性(49.41%)高于女性(0.73%)(χ2=1019.104,P < 0.001)。男性日均吸烟量(20支)高于女性(8支)(Z=-4.448,P < 0.001)。吸烟者戒烟率为12.54%。成年人二手烟暴露率为54.44%(95% CI:52.53%~56.36%)。  结论  宁夏成年居民吸烟率较高,但戒烟率较低,男性吸烟率高于女性,汉族吸烟率高于回族,人群二手烟暴露率较高,应针对重点人群采取控烟干预措施,降低吸烟率和二手烟暴露率。     

男性吸烟者吸烟利弊权衡及其与戒烟意向关系

目的探讨男性吸烟者吸烟利弊的权衡及其与戒烟意向的关系,为促进男性吸烟者采取戒烟行动和改善戒烟效果的干预提供理论依据。方法于2016年3—4月通过网络招募自愿参加调查的326名男性吸烟者进行问卷调查,内容包括一般人口学资料与吸烟情况问卷、尼古丁依赖评估量表、戒烟意向问卷和吸烟利弊决策量表。结果男性吸烟者感知吸烟益处和吸烟危害得分分别为(2.82±0.66)和(3.09±0.61)分,感知吸烟益处得分低于吸烟危害得分(t=6.37,P0.001);326名男性吸烟者中,有60.74%的人感知到吸烟的危害程度高于吸烟益处,有27.61%的人感知的吸烟危害程度低于吸烟益处,有11.66%的人吸烟危害和益处感知程度相等。男性吸烟者戒烟意愿和戒烟计划得分分别为(3.17±1.11)和(2.42±1.55)分,戒烟意愿得分高于戒烟计划得分(t=9.10,P0.001);相关分析结果显示,男性吸烟者吸烟利弊权衡与戒烟意愿、戒烟计划均呈负相关(r=–0.39、–0.24,均P0.001);多层次线性回归分析结果表明,男性吸烟者吸烟利弊权衡对戒烟意愿和戒烟计划均具有负向预测作用。结论男性吸烟者对吸烟的态度表现为既爱又恨,其戒烟意向往往处于高意愿低计划的状态;吸烟利弊权衡是其戒烟意向的重要预测因素。     

重度吸烟者的非吸烟妻子有较高的肺癌危险性

对日本 2 9个保健中心区 91 540名≥ 4 0岁的非吸烟妻子进行调查并随访了 1 4年 ,并根据她们丈夫的吸烟习惯进行了肺癌标准化死亡率评价。结果发现重度吸烟者的妻子发生肺癌的危险性比非吸烟者的妻子高 ,且观察到有统计学上显著的剂量反应关系 (Ｐ = 0 0 0 97)。当丈夫为不吸烟者或偶而吸烟者时 ,年龄 -职业标准化年肺癌死亡率为8 7/1 0万 ( 32 /2 1 895) ;当丈夫为戒烟者或每天吸烟 1～ 1 9支者时为 1 4 0 /1 0万( 86 /441 84 ) ;而当丈夫为每天吸烟≥ 2 0支者时死亡率为 1 8 1 /1 0万 ( 56 /2 51 4 6 )。这些数字得出危险性比率分别为 1 …     

2015年陕西省成人吸烟及“二手烟”现状调查

目的 描述2015年陕西省成人吸烟、“二手烟”、戒烟、日均吸烟量的流行水平。方法 采用多阶段整群随机抽样的方法选择调查对象,对陕西省监测点覆盖的监测人群,年龄18岁及以上进行入户面访调查,采用现在吸烟率、“二手烟”暴露率、对主动和被动吸烟的危害认知率、戒烟率等指标,依据抽样权重进行加权计算。结果 陕西省18岁及以上年龄吸烟率32.73%,现在吸烟率28.30%,男性和女性的现在吸烟率为53.78%和1.64%;城市现在吸烟率为24.52%,农村31.53%;每日吸烟率25.32%;现在每日吸烟者日均吸烟量16.98支,男性日均吸烟量17.14支,女性日均吸烟量9.74支;人群戒烟率为13.54%,男性戒烟率13.43%,女性17.11%;城市戒烟率13.90%,农村戒烟率13.30%;“二手烟”暴露率65.14%,对吸烟引起中风、心脏病、肺癌疾病的知晓率为30.8%,对被动吸烟引起成人心脏疾病、儿童肺部疾病、成人肺癌疾病的知晓率为36.0%。结论 陕西省18岁及以上居民的人群吸烟及“二手烟”暴露比较严重,戒烟率偏低,对烟草危害知识认知不足。     

山东省金乡县农村心血管病高危人群影响因素分析

目的 分析山东省金乡县农村心血管病高危人群影响因素,为心血管病防治提供理论依据。方法 数据来源于国家心血管病中心“心血管病高危人群早期筛查与综合干预”项目,选取2020-07-01-2022-06-30金乡县农村居住>6个月35～75岁的7 011名居民为筛查对象,调查内容包括问卷调查、体格检查和实验室检测。统计方法采用χ²检验和多因素logistic回归分析。结果 本次筛查出心血管病高危人数为1 502人,高危率为21.42%。其中男性高危人群检出率为24.64%,女性为19.09%。单因素分析结果显示,性别(χ²=31.30,P<0.001)、年龄(χ²=389.30,P<0.001)、婚姻状况(χ²=8.33,P=0.004)、超重(χ²=115.10,P<0.001)、肥胖(χ²=122.30,P<0.001)、吸烟(χ²=4.59,P=0.032)、收入高低(χ²=4.79...     

吸烟和戒烟的男性慢性阻塞性肺疾病患者肺功能变化分析

目的 调查吸烟和戒烟的男性慢性阻塞性肺疾病(COPD)稳定期患者肺功能的变化,促使不吸烟者不开始吸烟,吸烟者早期戒烟.方法 选择2007年10月至2008年12月102例男性COPD稳定期患者,进行问卷调查、体检、肺功能测定,分为54例吸烟者(吸烟组)和48例戒烟者(戒烟组),吸烟组根据吸烟指数再分为三个亚组(第1组,200年支≤吸烟指数<500年支,16例;第2组,500年支≤吸烟指数<800年支,17例;第3组,吸烟指数≥800年支,21例).进行组间肺功能的比较,分析吸烟和戒烟的COPD患者肺功能变化.结果 第2组肺功能指标较第1组下降(P<0.05),第3组肺功能指标较第2组和第1组下降(P<0.05),戒烟组肺功能指标较吸烟组升高(P<0.05).结论 随吸烟指数的增加,COPD患者肺功能的损害程度逐渐加重,戒烟可以改善COPD患者的肺功能,控制吸烟是预防和治疗COPD的最经济有效的方法之一.     

吸烟和戒烟的男性慢性阻塞性肺疾病患者肺功能变化分析

目的 调查吸烟和戒烟的男性慢性阻塞性肺疾病(COPD)稳定期患者肺功能的变化,促使不吸烟者不开始吸烟,吸烟者早期戒烟.方法 选择2007年10月至2008年12月102例男性COPD稳定期患者,进行问卷调查、体检、肺功能测定,分为54例吸烟者(吸烟组)和48例戒烟者(戒烟组),吸烟组根据吸烟指数再分为三个亚组(第1组,200年支≤吸烟指数<500年支,16例;第2组,500年支≤吸烟指数<800年支,17例;第3组,吸烟指数≥800年支,21例).进行组间肺功能的比较,分析吸烟和戒烟的COPD患者肺功能变化.结果 第2组肺功能指标较第1组下降(P<0.05),第3组肺功能指标较第2组和第1组下降(P<0.05),戒烟组肺功能指标较吸烟组升高(P<0.05).结论 随吸烟指数的增加,COPD患者肺功能的损害程度逐渐加重,戒烟可以改善COPD患者的肺功能,控制吸烟是预防和治疗COPD的最经济有效的方法之一.     

Smoking cessation and lung cancer mortality in a cohort of middle-aged Canadian women

PURPOSE: To determine the impact of smoking cessation on lung cancer mortality among women. METHODS: Survival analysis is used to assess the effect of smoking cessation on lung cancer death in the dietary cohort of 49,165 women aged 40 to 59 years enrolled in the Canadian National Breast Screening Study. RESULTS: During an average of 10.3 years of follow-up, 106 women died of lung cancer. The risk of lung cancer mortality among women who quit before age 50 (HR=0.26; 95% CI, 0.13-0.55 among women who quit at ages 40-49) or quit in the previous 10 years (HR=0.39; 95% CI, 0.22-0.69) is substantially lower than the risk among current smokers. Women who quit after age 40 or have quit for less than 20 years are at substantially higher risk of lung cancer mortality compared with never smokers. Both duration of smoking cessation and age at quitting have independent effects on lung cancer mortality, after controlling for number of cigarettes smoked per day and number of years smoked, as well as other potential confounding variables. CONCLUSION: These findings suggest that programs and policies to promote early cessation of smoking and prevention of relapse should be a public health priority.     

Attitudes toward tobacco cessation and lung cancer screening in two South African communities

ABSTRACT

Among men in South Africa, the prevalence of tobacco smoking is as high as 33%. Although smoking is responsible for most lung cancer in South Africa, occupational and environmental exposures contribute greatly to risk. We conducted a tobacco and lung cancer screening needs assessment and administered surveys to adults who smoked >100 cigarettes in their lifetime in Johannesburg (urban) and Kimberley (rural). We compared tobacco use, risk exposure, attitudes toward and knowledge of, and receptivity to cessation and screening, by site. Of 324 smokers, nearly 85% of current smokers had a <30 pack-year history of smoking; 58.7% had tried to stop smoking ≥1 time, and 78.9% wanted to quit. Kimberley smokers more often reported being advised by a healthcare provider to stop smoking (56.5% vs. 37.3%, p=0.001) than smokers in Johannesburg but smokers in Johannesburg were more willing to stop smoking if advised by their doctor (72.9% vs. 41.7%, p<0.001). Findings indicate that tobacco smokers in two geographic areas of South Africa are motivated to stop smoking but receive no healthcare support to do so. Developing high risk criteria for lung cancer screening and creating tobacco cessation infrastructure may reduce tobacco use and decrease lung cancer mortality in South Africa.     

Dependency, social factors, and the smoking cessation process: the doctors helping smokers study

We analyzed data obtained from a representative sample of the smoking patients (n = 1,338) of 66 family physicians to determine predictors of attempts to stop smoking, desire to quit smoking, and successful smoking cessation. Compared to subjects who made no attempt to quit smoking, subjects who tried to quit smoking tended to be younger, had tried to quit smoking in the year prior to the study, waited longer before smoking their first cigarette of the day, had more desire to quit smoking, and had more social support for quitting. Education and cigarettes smoked per day were not independently related to the subject making a quit attempt. Desire to quit smoking was associated with an attempt to quit in the year prior to the study and social support for smoking cessation (support of spouse, second most important social contact, and physician). Desire to quit smoking was not independently related to age, education, or dependency on cigarettes (measured by the number of cigarettes smoked per day and the length of time a subject waited before smoking the first cigarette of the day). Compared to subjects who tried to quit and failed, subjects who succeeded were older, smoked fewer cigarettes per day, and waited longer to smoke their first cigarette of the day. Spouse support, support of the second most important social contact, and advice of a doctor to quit smoking were not independently related to whether or not a cessation attempt would be successful. These data suggest that successful smoking cessation requires two components: social support to make an attempt to quit and the ability to overcome dependency on cigarettes to make the attempt successful.     

The relationship between stages and biochemical markers of smoking. Workplace-based cross-sectional and longitudinal studies

In order to clarify smokers' characteristics by "Stages of Change" based on Prochaska's transtheoretical model, we conducted cross-sectional and logitudinal studies with biochemical markers of smoking and smoking habits. In a workplace-based sample of 277 male smokers, we examined cross-sectionally the relationships between stages and biochemical markers of smoking which include expired carbon monoxide concentrations and urinary nicotine metabolite concentrations, and smoking habits which include the number of cigarettes smoked per day, yields of cigarettes, inhalation patterns, time to first morning cigarette, and quit attempts in the past. Additionally we examined longitudinally the relationship between stages and expired carbon monoxide concentrations, the number of cigarettes, and yields of cigarettes. In the cross-sectional study there were significant differences among stages on expired carbon monoxide concentrations (P = 0.006), urinary nicotine metabolite concentrations (P = 0.049), the number of cigarettes smoked per day (P = 0.001), and yields of cigarettes (P = 0.042) using analyses of variance. There were also significant differences among stages on time to first morning cigarette (P = 0.018) and quit attempts in the past (P < 0.001) using chi-square tests. In the longitudinal study for each level of elevation in stage during a one-year period, expired carbon monoxide concentrations decreased on an average of 2.3 ppm (P = 0.125) and the number of cigarettes smoked per day decreased on an average of 2.8 cigarettes per day (P = 0.07). However, the yields of cigarettes did not change during the one-year period.     

Mentholated cigarette smoking and lung-cancer risk

PURPOSE: Menthol smoking may lead to a greater increase in lung-cancer risk than smoking of nonmentholated cigarettes. Mentholation of cigarettes adds additional carcinogenic components to cigarette smoke and increases retention times for cigarette smoke in the lungs. Only two epidemiologic studies have been conducted on menthol smoking and lung cancer, and their results are conflicting. Of note, African American males have much higher rates of lung cancer than Caucasian males despite smoking fewer cigarettes per day. Because the consumption of menthol cigarettes is much more frequent among African Americans, it is of interest to examine the possible association between menthol smoking and lung-cancer risk in this population. METHODS: We examined the association between menthol cigarette smoking and lung-cancer risk among smokers by comparing 337 incident cases of lung cancer with 478 population controls enrolled in a case-control study of lung cancer. Information on smoking history and other known and potential risk factors for lung cancer, including dietary intake, was obtained by in-person interviews. RESULTS: The adjusted odds ratios did not differ appreciably between smokers of mentholated cigarettes versus exclusive nonmentholated cigarette smokers in the overall study group of smokers. The odds ratio (OR) for 32 pack-years or more of mentholated vs. nonmentholated cigarettes was 0.90 (95% confidence interval (CI) = 0.38-2.12) in African Americans and 1.06 (95% CI = 0.47-2.36) in Caucasians, and did not differ for either ethnic group (p = 0.98). CONCLUSIONS: Our results suggest that the lung-cancer risk from smoking mentholated cigarettes resembles the risk from smoking non-mentholated cigarettes. Our data do not support the hypothesis that the increased risk of lung cancer among African Americans is due to the increased prevalence of menthol smoking.     

吸烟及烟碱型乙酰胆碱受体亚单位α5基因rs17486278位点多态性对肺癌的交互作用

目的 探讨在中国男性人群中吸烟、烟碱型乙酰胆碱受体亚单位α5(CHRNA5)基因多态性与肺癌的关联及其交互作用.方法 采用成组病例对照研究设计,收集男性原发性肺癌病例204例,正常健康对照者821例.采用结构式问卷调查社会人口学特征、吸烟行为及健康状况等,采集静脉血检测CHRNA5 SNP位点rs17486278的多态性.应用多因素logistic回归模型分析吸烟、CHRNA5的基因多态性与肺癌的关系及其交互作用.结果 控制潜在混杂因素后,每天吸烟量＞15支者发生肺癌的风险高于不吸烟者(OR=3.49,95％CI:2.29～ 5.32),未发现CHRNA5上的rs17486278多态性与肺癌有统计学关联.进一步交互作用分析显示,每天吸烟量1～15支并携带rs17486278纯合变异基因型(CC)者对肺癌的发生存在正交互作用(OR=16.13,95％CI:1.27～205.33).根据rs17486278多态性和吸烟行为进行分层分析,与不吸烟并携带rs17486278野生基因型(AA)者相比,每天吸烟量1～15支并携带纯合变异基因型(CC)者、每天吸烟量＞15支并携带野生基因型(AA)者和每天吸烟量＞15支并携带杂合变异基因型(AC)者发生肺癌风险增高,OR直分别为8.14(95％CI:1.17 ～ 56.56)、3.84(95％CI:1.30～ 11.40)和5.32(95％CI:1.78 ～ 15.93).结论 在中国男性人群中CHRNA5的基因多态性与吸烟行为对肺癌的发生存在正交互作用.     

Lung cancer and occupation: results of a multicentre case-control study.

The objective of the current study was to estimate the risk of lung cancer attributable to occupational factors and not due to tobacco. At 24 hospitals in nine metropolitan areas in the United States, 1793 male lung cancer cases were matched for race, age, hospital, year of interview, and cigarette smoking (never smoker, ex-smoker, smoker (1-19 and > or = 20 cigarettes per day)) to two types of controls (cancer and non-cancer hospital patients). Information on usual occupation, exposure to specific potential carcinogens, and cigarette smoking was obtained by interview. Risk of lung cancer was increased significantly for electricians; sheetmetal workers and tinsmiths; bookbinders and related printing trade workers; cranemen, derrickmen, and hoistmen; moulders, heat treaters, annealers and other heated metal workers; and construction labourers. All of these occupations are potentially exposed to known carcinogens. Odds ratios (ORs) were increased for exposure to coal dust (adjusted OR = 1.5; 95% confidence interval (95% CI) 1.1-2.1). After stratification, this association was statistically significant only after 10 or more years of exposure. Lung cancer was also related to exposure to asbestos (adjusted OR = 1.8; 95% CI 1.5-2.2). The ORs increased with increasing duration of exposure to asbestos for all smoking categories except for current smokers of 1-19 cigarettes per day. The statistical power to detect ORs among occupations that were previously reported to be at increased risk of lung cancer but that failed to show an OR of at least 1.5 in the current study was small. The cumulative population attributable risk (PAR) of lung cancer due to occupation was 9.2%. It is concluded that occupational factors play an important part in the development of lung cancer independently of cigarette smoking. Because occupations at high risk of lung cancer were under-represented, the cumulative PAR of the present study is likely to be an underestimate of the true contribution of occupation to risk of lung cancer.     

Breastfeeding duration and perinatal cigarette smoking in a population-based cohort

OBJECTIVES: We examined the association between breastfeeding duration and maternal smoking before, during, and after pregnancy. METHODS: Data from the 2000-2001 Oregon Pregnancy Risk Assessment Monitoring System were used. Early weaning was defined as not breastfeeding at 10 weeks postpartum. RESULTS: At 10 weeks after pregnancy, 25.7% of mothers who initiated breastfeeding no longer breastfed. After controlling for confounders, quitters (mothers who quit smoking during pregnancy and maintained quit status after pregnancy) and postpartum relapsers (mothers who quit smoking during pregnancy and resumed smoking after delivery) did not have significantly higher risk for early weaning than nonsmokers. However, persistent smokers (mothers who smoked before, during, and after pregnancy) were 2.18 times more likely not to breastfeed at 10 weeks (95% confidence interval=1.52, 2.97). Women who smoked 10 or more cigarettes per day postpartum (i.e., heavy postpartum relapsers and heavy persistent smokers) were 2.3-2.4 times more likely to wean their infants before 10 weeks than were nonsmokers. CONCLUSIONS: Maternal smoking is associated with early weaning. Stopping smoking during pregnancy and decreasing the number of cigarettes smoked postpartum may increase breastfeeding duration.     

The risk of lung cancer with increasing time since ceasing exposure to asbestos and quitting smoking

Objectives

To examine if the risk of lung cancer declines with increasing time since ceasing exposure to asbestos and quitting smoking, and to determine the relative asbestos effect between non‐smokers and current smokers.

Methods

A cohort study of 2935 former workers of the crocidolite mine and mill at Wittenoom, who responded to a questionnaire on smoking first issued in 1979 and on whom quantitative estimates of asbestos exposure are known. Conditional logistic regression was used to relate asbestos exposure, smoking category, and risk of lung cancer.

Results

Eighteen per cent of the cohort reported never smoking; 66% of cases and 50% of non‐cases were current smokers. Past smokers who ceased smoking within six years of the survey (OR = 22.1, 95% CI 5.6 to 87.0), those who ceased smoking 20 or more years before the survey (OR = 1.9, 95% CI 0.50 to 7.2), and current smokers (<20 cigarettes per day (OR = 6.8, 95% CI 2.0 to 22.7) or >20 cigarettes per day (OR = 13.2, 95% CI 4.1 to 42.5)) had higher risks of lung cancer compared to never smokers after adjusting for asbestos exposure and age. The asbestos effect between non‐smokers and current smokers was 1.23 (95% CI 0.35 to 4.32).

Conclusion

Persons exposed to asbestos and tobacco but who subsequently quit, remain at an increased risk for lung cancer up to 20 years after smoking cessation, compared to never smokers. Although the relative risk of lung cancer appears higher in never and ex‐smokers than in current smokers, those who both smoke and have been exposed to asbestos have the highest risk; this study emphasises the importance of smoking prevention and smoking cessation programmes within this high risk cohort.     

Lung cancer and occupation: results of a multicentre case-control study.

The objective of the current study was to estimate the risk of lung cancer attributable to occupational factors and not due to tobacco. At 24 hospitals in nine metropolitan areas in the United States, 1793 male lung cancer cases were matched for race, age, hospital, year of interview, and cigarette smoking (never smoker, ex-smoker, smoker (1-19 and > or = 20 cigarettes per day)) to two types of controls (cancer and non-cancer hospital patients). Information on usual occupation, exposure to specific potential carcinogens, and cigarette smoking was obtained by interview. Risk of lung cancer was increased significantly for electricians; sheetmetal workers and tinsmiths; bookbinders and related printing trade workers; cranemen, derrickmen, and hoistmen; moulders, heat treaters, annealers and other heated metal workers; and construction labourers. All of these occupations are potentially exposed to known carcinogens. Odds ratios (ORs) were increased for exposure to coal dust (adjusted OR = 1.5; 95% confidence interval (95% CI) 1.1-2.1). After stratification, this association was statistically significant only after 10 or more years of exposure. Lung cancer was also related to exposure to asbestos (adjusted OR = 1.8; 95% CI 1.5-2.2). The ORs increased with increasing duration of exposure to asbestos for all smoking categories except for current smokers of 1-19 cigarettes per day. The statistical power to detect ORs among occupations that were previously reported to be at increased risk of lung cancer but that failed to show an OR of at least 1.5 in the current study was small. The cumulative population attributable risk (PAR) of lung cancer due to occupation was 9.2%. It is concluded that occupational factors play an important part in the development of lung cancer independently of cigarette smoking. Because occupations at high risk of lung cancer were under-represented, the cumulative PAR of the present study is likely to be an underestimate of the true contribution of occupation to risk of lung cancer.