Risk factors for laryngeal cancer in Montenegro

Laryngeal cancer is the most common head and neck cancer. There might be many risk factors for laryngeal cancer. Smoking, especially cigarette smoking and alcohol are indisputable risk factors. The authors of this paper assessed the presumed risk factors in order to identify possible aetiological agents of the disease.A hospital-based case-control study was conducted. The study group consisted of 108 histologically verified laryngeal cancer patients and 108 hospital controls matched by sex, age (+/-3 years) and place of residence. Laryngeal cancer patients and controls were interviewed during their hospital stay using a structured questionnaire. According to multiple logistic regression analysis six variables were independently related to laryngeal cancer: hard liquor consumption (Odd Ratio/OR/=2.93, Confidence Interval/CI/95% = 1.17 to 7.31), consumption more than 2 alcoholic drinks per day (OR=4.96, CI 95% = 2.04 to 12.04), cigarette smoking for more than 40 years (OR=4.32, CI 95% = 1.69 to 11.06), smoking more than 30 cigarettes per day (OR=4.24, CI 95% = 1.75 to 10.27), coffee consumption more than 5 cups per day (OR=4.52, CI 95% = 1.01 to 20.12) and carbonated beverage consumption (OR=0.38, CI 95%=0.16 to 0.92). The great majority of laryngeal cancers could be prevented by eliminating tobacco smoking and alcohol consumption.     

Bladder cancer, tobacco smoking, coffee and alcohol drinking in Brescia, northern Italy

The association between tobacco smoking, the consumption of coffee and alcohol and bladder cancer was investigated in a hospital-based case-control study in Brescia, northern Italy. A total of 172 incident cases (135 men and 37 women) and 578 controls (398 men and 180 women) were enrolled. As expected, cigarette smoking was strongly associated with bladder cancer. The odds ratios (OR) for coffee drinking adjusted for age, education, residence and cigarette smoking in current drinkers were 2.6 (95% confidence interval, CI: 1.1–6.1) in men and 5.2 (95% CI: 1.0–30.4) in women. A dose-response relationship was found in men, with the highest risk in the highest category of exposure: drinkers of more than 5 cups per day had an OR of 4.5 (95% CI: 1.2–16.8). The ORs for current alcohol drinkers were 2.1 (95% CI: 1.0–4.8) in men and 3.4 (95% CI: 1.2–9.7) in women; according to grams of ethanol drunk per day (grams/day, g/d) the ORs were: 1.7 (1–20 g/d), 1.6 (21–40 g/d), 4.3 (41–60 g/d) and 4.6 (61+ g/d) in men and 3.1 (1–20 g/d) and 3.9 (21+ g/d) in women. These results suggest that regular consumption of both coffee and alcohol can be independently associated with an increased bladder cancer risk.     

Cigarette smoking and male lung cancer risk with special regard to type of tobacco.

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.     

Respiratory symptoms and intensity of occupational dust exposure

Objectives: Occupational exposure to dusts may result in chronic respiratory symptoms. Methods: To investigate the utility of obtaining a history of occupational exposure to dust in US veterans, a respiratory health survey was conducted between 1988 and 1992 in a community-based cohort of US veterans in southeastern Massachusetts that were eligible for Veterans Affairs (VA) healthcare benefits but were not regular users. A mail questionnaire was used to obtain a history of cough, phlegm, and wheeze, work in a dusty job, and duration, type, and intensity of dust exposure. Information on cigarette use and other possible confounders was obtained. Results: In 2,617 white men, after the data had been adjusted for cigarette smoking, age, distance to the nearest major roadway, and chronic respiratory disease, the relative odds of chronic cough, chronic phlegm, and persistent wheeze attributable to occupational dust exposure was increased twofold. Risk also increased, based on exposure intensity. For heavy dust exposure the OR was 1.98 (95% CI 1.39–2.81) for chronic cough, 2.82 (95% CI 2.03–3.93) for chronic phlegm, and 2.70 (95% CI 1.95–3.75) for persistent wheeze. Conclusions: After active cigarette smoking and other possible confounders had been considered, it was found that dust exposure was related to respiratory symptoms in US veterans and that the greatest risk was attributable to heavy intensity exposure.Presented in abstract form at the 1994 annual meeting of the American Thoracic Society.     

Non-occupational risk factors for cancer of the lower urinary tract in Germany

In a hospital-based case–control study conducted between 1989 and 1992 in Hessen (West-Germany) 300 cases (239 male and 61 female) of histologically confirmed cancer of the lower urinary tract (LUT) were individually matched to controls from the same hospitals with respect to sex, age and area of residence. Smoking of cigarettes was associated with an elevated risk of 2.80 in males (95% confidence interval (CI): 1.65–4.76) and 5.33 (95% CI: 1.55–18.33) in females, as compared with non-smokers. Variables like daily amount of smoked cigarettes, duration of smoking, age at beginning of cigarette smoking and time since smoking cessation showed a clear dose- and time–response relationship in males, but not in females. Elevated risks were observed for higher consumption of coffee, beer and wine, but – especially for the consumption of coffee – were drastically reduced after adjustment for smoking. A weak association was found between the daily fluid intake and bladder cancer in males. Among females a significantly decreased odds ratio (OR) of 0.34 (95% CI: 0.11–0.99) was found for a daily fluid intake of more than two liters. Protective effects and risk reductions of approximately 50% were found for the regular intake of raw carrots, kale, salads and fruits. The findings of this investigation support an association between lifestyle factors and cancer of the lower urinary tract.     

Bladder cancer and black tobacco cigarette smoking

A retrospective study was planned in the Hérault (Mediterranean) region of France where bladder cancer mortality and incidence rates are high. In the present paper, variations in bladder cancer risk according to various smoking-related variables, in particular time of exposure and type of tobacco, are examined. This case-control study with 219 male incident cases and 794 male population controls randomized from electoral rolls was carried out in 1987–89. Trained interviewers obtained information on demographics, dietary habits (coffee, alcohol, artificial sweeteners, vegetables, spices, etc.), occupational exposures and detailed history of tobacco smoking (average number of cigarettes per day, number of years of smoking, age at which they began and/or quitted smoking, use of filter-tip and type of tobacco). The odds ratio (OR) for cigarette smokers versus non-smokers was greater than 5. Results for number of cigarettes daily, duration of smoking and lifetime smoking showed a highly significant dose-response relationship, which was confirmed when these variables were treated as continuous in a logistic regression model. Eighty-eight percent of the smokers used black tobacco. Quitting smoking did not result in a significant reduction in bladder cancer risk. Higher risks were associated with starting to smoke at an early age (OR before age 13 versus after age 21=3.42; 95% CI 1.07–10.9) and with black tobacco smoking (OR black versus blond =1.63; 95% CI 0.73–3.64). Results suggest that black tobacco may be more harmful than blond tobacco and may have an early non-reversible role in bladder carcinogenesis.     

Lifestyle and other risk factors for thyroid cancer in Los Angeles County females

PURPOSE AND METHODS: We conducted a population-based case-control study of thyroid cancer. Cases were 292 women, aged 15-54 when diagnosed between the years 1980 and 1983 (145 diagnosed in 1980-81 and 147 diagnosed in 1982-83). Female neighborhood controls (n = 292) were matched to each case on birth-year and race. RESULTS: Among women < 35 years, thyroid disease in first-degree relatives increased thyroid cancer risk [odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.1-3.7]. Risk was not associated with fish consumption, although high childhood consumption of shellfish decreased thyroid cancer risk (OR = 0.2, 95% CI = 0.05-0.7 for consumption at least a few times weekly). Among papillary thyroid cancers (82% of cases), frequent adult consumption of saltwater fish decreased risk. Cancer risk was reduced with consumption of certain vegetables, wine, and tea. Other dietary variables, including milk, beer and hard liquor, and coffee were not related to thyroid cancer risk. Among the papillary sample, risk increased with longer use of multivitamins (OR = 2.9, 95% CI = 1.2-7.4 for > 10 years of use). Smoking and body mass were not associated with thyroid cancer risk. CONCLUSIONS: These results suggest a role of family history of thyroid disease and certain dietary variables in the etiology of thyroid cancer in adult females.     

Associations of cigarette smoking and alcohol consumption with advanced or multiple colorectal adenoma risks: a colonoscopy-based case-control study in Korea

The associations between alcohol consumption and cigarette smoking habits and the risk for colorectal adenomatous polyps according to the detailed clinical information about polyps were assessed in a large colonoscopy-based study. The study enrolled participants who visited the National Cancer Center of the Republic of Korea for cancer screening between April 2007 and April 2009. In 1,242 newly diagnosed colorectal adenoma patients and 3,019 polyp-free controls, past smokers (odds ratio (OR) = 1.31, 95% confidence interval (CI): 1.04, 1.65) and current smokers (OR = 1.70, 95% CI: 1.37, 2.11) had increased risks for adenomas compared with nonsmokers. Cigarette smoking conferred an even higher risk for advanced adenomas and 3 or more adenomas than for low-risk adenomas or a single adenoma. Dose-response relations were observed among the daily number of cigarettes smoked, the duration of smoking, the pack-years of smoking, and the risk for adenomas. A longer duration of alcohol consumption was associated with a higher risk for advanced adenomas (for >28 years of consumption: OR = 2.0, 95% CI: 1.10, 3.64) and 3 or more adenomas (OR = 2.19, 95% CI: 1.27, 3.76). In conclusion, cigarette smoking and alcohol consumption play roles in colorectal carcinogenesis, and the association differs by the clinical features of the adenomas.     

Respiratory symptoms and obstructive lung diseases in iron ore miners: Report from the obstructive lung disease in northern Sweden studies

This is a population-based study on the prevalence of respiratory symptoms assessed by a mail questionnaire. The objective was to examine if work in an iron mine increased the risk of airway symptoms or obstructive diseases. The exposed group consisted of 114 previous or current male miners. Referents, 2472 males from the province, had never been employed by the mining company or worked as miners. Age, smoking and a family history of asthma were considered as possible confounders. The miners had an increased risk for respiratory symptoms (OR=2.2, 95% CI=1.4–3.1) including recurrent wheeze (OR=2.4, 95% CI=1.5–3.9), longstanding cough (OR=1.8, 95% CI=1.0–3.2), and for physician-diagnosed chronic bronchitis (OR=2.2, 95% CI=1.0–4.5). Attacks of shortness of breath and asthma manifestations were similar between miners and referents. Higher risks in miners were found particularly among the non-smokers for physician-diagnosed chronic bronchitis (OR=9.2, 95% CI=3.0–28) and for symptoms as well. A family history of asthma was less common among miners (9.2% vs. 17%, p < 0.05). We conclude that miners in a modern underground iron mine had an increased risk of respiratory symptoms. In contrast to other studies, this increased risk was particularly found in non-smokers. A family history of asthma may be an important confounder in occupational studies of respiratory diseases.     

Associations of Cigarette Smoking and Alcohol Consumption With Metabolic Syndrome in a Male Chinese Population: A Cross-Sectional Study

Background

Whether cigarette smoking and alcohol consumption are associated with the risk of metabolic syndrome (MetS) remains controversial. This study investigated the associations of cigarette smoking and alcohol consumption with MetS in a male population in China.

Methods

We conducted a cross-sectional study. A questionnaire was used to collect data on cigarette smoking, alcohol consumption, MetS status, and other related information from 8169 men aged 19–97 years. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between smoking and alcohol consumption and the risk of MetS.

Results

The prevalence of MetS was 15.2% in the study population. Proportions of current smokers and drinkers were 48.2% and 46.5%, respectively. Adjusted OR of MetS was 1.34 (95% CI, 1.01–1.79) among smokers who smoked ≥40 cigarettes/day compared with nonsmokers and 1.22 (95% CI 1.03–1.46) for those who consumed 0.1–99 grams of alcohol/day compared with nondrinkers. Adjusted OR was 2.32 (95% CI 1.45–3.73) among ex-drinkers who never smoked, 1.98 (95% CI 1.35–2.91) among ex-drinkers who were current smokers, and 1.34 (95% CI 1.08–1.68) among current drinkers who never smoked compared with those who neither smoked nor drank. There was a significant interaction between smoking and drinking alcohol on MetS (P for interaction is 0.001).

Conclusions

Our study indicated that smoking and drinking is associated with higher prevalence of MetS. Interactions between smoking and drinking on the risk of MetS in men in China may also exist. Our findings need to be confirmed in future case-control or cohort studies.Key words: cigarette smoking, alcohol consumption, metabolic syndrome, Chinese man, interaction     

Habitual coffee consumption and blood pressure: A study of self-defense officials in Japan

The study aims to examine the relationship between habitual coffee consumption and blood pressure. The subjects were 3336 male self-defense officials aged 48–56 years, who received a preretirement health examination at the Self-Defense Forces Fukuoka Hospital between October 1986 and December 1992. Average coffee intake in the past year was ascertained by a self-administered questionnaire. A significant inverse relation between habitual coffee consumption and blood pressure was found with and without adjustment for alcohol use, cigarette smoking, body mass index, glucose tolerance, and green tea intake. Green tea, another major source of caffeine intake in Japanese, was unrelated to blood pressure. The adjusted mean differences per cup of coffee consumed per day were –0.6 mmHg (95% confident interval [CI]: –0.9 to –0.3, p=0.0001) in systolic blood pressure and –0.4 mmHg (95% CI: –0.5 to –0.2, p=0.0002) in diastolic blood pressure. Habitual coffee drinkers had lower blood pressure than non-drinkers at any levels of alcohol use, cigarette smoking, obesity, and glucose intolerance. Our findings consolidate the previous observation that habitual coffee consumption was associated with lower blood pressure.     

吸烟与帕金森病关系的病例对照研究

目的　探讨吸烟与帕金森病 (PD)的关系。方法　采用以人群为基础的病例对照研究 ,调查在北京地区 55岁以上PD患病率调查中确诊及 2 0 0 2年 8月至 2 0 0 3年 1月在北京协和医院帕金森研究中心诊治的病例共 1 1 4例 ;以及性别、民族及居住地与其匹配的对照 2 0 5名。结果　吸烟与PD呈显著负相关联。以非吸烟者为对照 ,曾经吸烟者、现在吸烟者和过去吸烟者患PD的危险性低于对照 ,OR值分别为 0 .49(95 %CI:0 .30～ 0 .79)、0 .44(95 %CI :0 .2 3～ 0 .86)和 0 .54(95 %CI:0 .30～0 .96)。此外 ,对吸烟者分别按吸烟年限≥ 2 0年和 <2 0年、戒烟年限≥ 2 0年和 <2 0年以及吸烟量分层和logistic回归分析 ,其负相关联依然存在并具有剂量反应关系的趋势 (P <0 .0 5)。结论　吸烟与PD存在负相关联 ,今后应着重开展有关生物学依据的研究     

沈阳农村60岁以上人群良性前列腺增生危险因素的病例对照研究

目的：探讨各种危险因素与良性前列腺增生（BPH）的关系。方法：采用以人群为基础的病例对照研究，病例组为沈阳市某郊区农村60周岁以上BPH患者，对照组为无前列腺增生（排除前列腺癌、前我腺炎等疾病）的老年男性，病例与对照各100例，单因素分析采用χ^2检验，多因素分析利用非条件logistic回归分析。结果：多因素非条件logistic回归分析显示BPH发病与下列5种因素有关：患前列腺炎（OR＝5．577，95％CI：2．147－14．482）；20世纪80年代初每月肉类摄入量（OR＝4．930，95％CI：2．404－10．111）；舒张压（OR＝1．050，95％CI：0．480－0．881）。结论：患前列腺炎、80年代初每月过多摄入肉类、舒张压高可能是BPH的危险因素；吸烟量大、饮酒量大可能是BPH保护因素。     

Association between Emotional Eating and Frequency of Unhealthy Food Consumption among Taiwanese Adolescents

Emotional eating is one factor that increases the consumption of unhealthy food. This study aimed to investigate the association between emotional eating and frequencies of consuming fast food, high-fat snacks, processed meat products, dessert foods, and sugar-sweetened beverages (SSBs) in adolescents. The baseline survey data (2015) from the Taiwan Adolescent to Adult Longitudinal Study (TAALS) were fitted into multivariate logistic regression models adjusted for sex, school type, Body Mass Index (BMI), eating while doing something, nutrition label reading, skipping breakfast, smoking, binge drinking, sedentary lifestyle, physical activity, peer and school support, and parental education level. Among the 18,461 participants (48.5% male and 51.5% female), those exhibiting emotional eating were more likely to consume fast food (Odds ratio (OR) = 2.40, 95% Confidence interval (CI): 2.18–2.64), high-fat snacks (OR = 2.30, 95% CI: 2.12–2.49), processed meat products (OR = 1.92, 95% CI: 1.78–2.08), dessert foods (OR = 2.49, 95% CI: 2.31–2.69), and sugar-sweetened beverages (OR = 1.83, 95% CI: 1.70–1.98). Factors that were positively associated with unhealthy food consumption included eating while doing other activities, binge drinking, smoking, and sedentary lifestyle. Among all the covariates, nutrition label reading was the only factor that was inversely associated with frequent unhealthy food consumption. Sex and school type may moderate the effect of emotional eating on the frequent consumption of specific unhealthy food groups. In conclusion, adolescents with high emotional eating were more likely to report frequent consumption of unhealthy foods in Taiwan. Our findings showed that male participants appeared to consume fast foods, high-fat snacks, processed meat, and SSBs more often and dessert foods less often than females. Future longitudinal studies are recommended for understanding the causal relationship between emotional eating and unhealthy food consumption.     

Patterns of cigar use in Clifornia in 1999

Background: Adult cigar use in California increased substantially between 1990 and 1996.Methods: Cigar smoking prevalence is from the 1990, 1996, and 1999 California Tobacco Surveys (CTS), large cross-sectional random-digit-dialed surveys designed to identify trends in tobacco use in the California population. Questions added to the 1999 CTS allowed a more detailed assessment of cigar smoking patterns.Results: Adult cigar use prevalence increased from 2.5% (95% confidence interval [CI], 2.2–2.8) in 1990 to 4.9% (95% CI=4.5–5.3) in 1996, and declined to 4.4% (95% CI=4.1–4.7) in 1999. Nearly the entire decrease was accounted for by less use in adults who had never been cigarette smokers. Among current cigar smokers in 1999, 43.3% (95% CI=37.8–48.8) had not smoked a cigar in the last month, just 16.2% (95% CI=7.9–24.5) of never cigarette smokers smoked three or more cigars in the past month, but 10.4% (95% CI=5.0–15.8) of former cigarette smokers—the group with the highest level of cigar consumption—reported daily use.Conclusions: Cigar use may have peaked in California around 1996; in 1999, the intensity of use was generally at modest levels. California’s bans on smoking in bars and restaurants may limit cigar smoking while drinking, so that the observed patterns may or may not reflect those in the rest of the United States.     

Work in dry cleaning and the incidence of cancer of the oral cavity, larynx, and oesophagus.

OBJECTIVES: To investigate whether employment in dry cleaning, and potential exposure to perchloroethylene (PCE), were associated with increased risk of carcinoma of the oral cavity and pharynx, larynx, oesophagus, and gastric cardia. METHODS: Two population based case-control studies were carried out. There were 491 cases of carcinoma of the oral cavity and pharynx, 235 of the larynx, and 404 of the oesophagus and gastric cardia. 724 controls were selected by random digit dialing. Personal interviews ascertained information on lifetime job histories, cigarette use, alcohol consumption, and other potential risk factors. The probability and level of exposure to PCE were estimated from the scientific literature. RESULTS: People who worked in dry cleaning tended to consume less alcohol and cigarettes than the general population. The adjusted odds ratio (OR) associated with ever having worked in dry cleaning was 1.6 (95% confidence interval (95% CI) = 0.6 to 4.4) for all cancer types together. The strongest associations were with laryngeal (OR 2.7; 95% CI 0.6 to 10.9) and oesophageal squamous cell carcinomas (OR 3.6; 95% CI 0.5 to 27.0). For laryngeal cancer, the relative risk increased with number of years employed in the dry cleaning industry (P = 0.14. The two cases of oesophageal squamous cell carcinomas had worked in dry cleaning for only a short time. Analyses of subsites showed higher risks for supraglottic laryngeal cancer (OR 5.7; 95% CI 1.0 to 32.1) and cancer of the tongue (OR 2.3; 95% CI 0.4 to 12.6). Analyses of exposure to PCE yielded similar results. CONCLUSIONS: These findings could easily be explained by chance; nevertheless, they are consistent with previous reports of excess risk of oesophageal, laryngeal, and tongue cancer, and suggest that previous studies of dry cleaners that could not control for alcohol and cigarette use may have underestimated the relative risks of such cancers.     

Maternal smoking and congenital heart defects

The Swedish Child Cardiology Registry (CCR) and the Swedish Medical Birth Registry (MBR) were used to investigate a possible association between maternal smoking during pregnancy and congenital heart defects. Among 1,413,811 infants born in 1983–1996 with known smoking exposure in early pregnancy, 3384 infants with congenital heart defects were selected (458 term infants with persistent ductus arteriosus (PDA) identified from MBR or CCR, and 2926 infants with other heart defects, identified from CCR). After controlling for year of birth, maternal age, parity, and educational level, a weak, statistically significant association between all heart defects and maternal smoking was found (odds ratio (OR): 1.09; 95% confidence interval (CI): 1.01–1.19). When infants with isolated PDA were removed from the case group the significance disappeared (OR: 1.07; 95% CI: 0.98–1.17). For truncus abnormalities (OR: 1.23; 95% CI: 1.02–1.49), atrial septal defects (OR: 1.63; 95% CI: 1.04–2.57), and PDA (OR: 1.30; 95% CI: 1.05–1.62), a rather strong effect of maternal smoking was indicated. The increased OR for PDA remained when gestational duration and intrauterine growth was also controlled for. Further research based on independent data sets is needed to conclude whether the risk estimates for maternal smoking are true and truly differ between the groups. The classification system used (with 24 classes) is described in enough detail to permit a repetition of the study.     

Occupational exposure and lung cancer risk in a coastal area of Northeastern Italy

Summary A case-control study of lung cancer and occupational exposure was conducted in a coastal area of Northeastern Italy where metallurgical and mechanical industries, docks and shipyards are located. Cases comprised 756 men who died of primary lung cancer in a 5-year period. Controls comprised 756 male subjects dying from other causes during the same period. Occupational exposures to lung carcinogens were assessed according to a job title-based approach, using two separate lists of industries/occupations recognized as being causally associated (list A) or suspected of being causally associated (list B) with lung cancer in humans. Exposure to asbestos was classified as absent, possible, or definite. After adjustment for cigarette smoking and place of residence, a significant association was found between lung cancer and occupations in both list A [relative risk (RR) = 2.25, 95% confidence interval (CI) = 1.68–3.03] and list B (RR = 1.33, 95% CI = 1.03–1.71). A significant excess risk was found for workers with definite exposure to asbestos as compared to those with no exposure to lung carcinogens (RR = 1.98, 95% CI = 1.42–2.75). Among occupations with recognized exposure to lung carcinogens other than asbestos, a significant excess risk for lung cancer was observed in iron and metalware workers. In occupational groups with definite exposure to asbestos, elevated risk estimates were found for shipyard workers, dockworkers, carpenters, and electricians. The combined effect of smoking and asbestos was found to be compatible with that expected under a multiplicative model. The overall population-attributable risk (ARp) for cigarette smoking was found to be 87.5%. The ARp estimate for occupations in list A was 16.0%. The estimate increased to 25.3% (95% CI = 16.2–34.4) when occupations in list B were included. The ARp estimate for possible or definite exposure to asbestos was 20.0% (95% CI = 11.5–28.5). With regard to the histologic types of lung cancer, significant associations were found between definite exposure to asbestos and squamous cell carcinoma (RR = 2.00, 95% CI = 1.28-–3.11), small cell carcinoma (RR = 2.11, 95% CI = 1.31–3.39), and adenocarcinoma (RR = 2.16, 95% CI = 1.32–3.53).     

中国人群吸烟与喉癌关系的Meta分析

目的综合评价中国人群吸烟与喉癌之间的关系及关联强度,为我国喉癌的防治策略提供依据。方法在CNKI、万方、维普、PubMed、ScienceDirect、SpringerLink、Wiley、ProQuest等数据库中系统检索截止2013年1月之前国内外发表的相关研究文献。所有文献检索、文献选取、文献信息的提取及文献质量评价均由两人独立进行。根据研究之间的异质性大小采用合适的方法来合并相关结果。结果纳入合格研究文献16篇,喉癌患者2730例,对照3224例。吸烟与喉癌发病关系的合并0尺值为4．08（95％CI：2．90—5．26;r=86．7％,P〈0．001）。很少吸烟者及经常吸烟者发生喉癌的OR值为分别为5．90（95％CI：3．05～11．41）及13．30（95％CI：8．03～22．03）。结合漏斗图的结果,尚不能认为目前纳入的研究存在发表偏倚（Egger,P=0．402;Begg,P=0．784）。结论在中国,吸烟会显著增加喉癌的发病风险,而且随着吸烟量的增加,喉癌的风险可能更高。     

Lifestyle-Related Determinants of Hookah and Cigarette Smoking in Iranian Adults

To identify lifestyle-related determinants of hookah and cigarette smoking in Iranian adults, a total of 12,514 men and women aged ≥19 years in three counties in central Iran (Isfahan, Najafabad, Arak) were selected in multistage random sampling. Data on socio-demographic characteristics and lifestyle were collected in interviewer-administered questionnaires, as part of the baseline survey of the Isfahan Healthy Heart Program. Unhealthy lifestyle-related factors independently associated with cigarette and hookah smoking, were identified in sex-specific multivariate logistic regression analyses. High stress levels (OR: 1.55; 95% CI: 1.35–1.78 for men; OR: 1.63; 95% CI: 1.17–2.27 for women), family member smoking (OR: 1.61; 95% CI: 1.27–4.92 for men; OR: 2.49; 95% CI: 2.20–2.95 for women), and short/long sleep duration (OR: 1.18; 95% CI: 1.01–1.39 for men; OR: 1.52; 95% CI: 1.10–2.35 for women) were associated with cigarette smoking in both men and women. Poor diet was also related to cigarette smoking in men (OR: 1.55; 95% CI: 1.62–1.89). Family member smoking was associated with hookah smoking in both men (OR: 1.16; 95% CI: 1.05–3.12) and women (OR: 1.56; 95% CI: 1.02–4.92), and in addition high stress levels (OR: 2.87; 95% CI: 1.14–5.83) and short/long sleep duration (OR: 1.07; 95% CI: 1.02–2.41) were associated with hookah smoking in women. Unhealthy lifestyle-related factors co-occur with cigarette and hookah smoking in Iranian adults, likely increasing the risk for chronic health problems. Sex differences in the determinants of hookah and cigarette smoking may need to be taken into account in planning tobacco control strategies.