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

Research output: Contribution to journalArticle

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.

Details

Authors
  • Valerie A. McCormack
  • Antonio Agudo
  • Christina C. Dahm
  • Kim Overvad
  • Anja Olsen
  • Anne Tjonneland
  • Rudolf Kaaks
  • Heiner Boeing
  • Goran Hallmans
  • Ingegerd Johansson
  • Maria Dolores Chirlaque
  • Aurelio Barricarte
  • Miren Dorronsoro
  • Laudina Rodriguez
  • Maria Luisa Redondo
  • Kay-Tee Khaw
  • Nick Wareham
  • Naomi Allen
  • Tim Key
  • Elio Riboli
  • Paolo Boffetta
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology

Keywords

  • pipe, cancer, cigar, smoking
Original languageEnglish
Pages (from-to)2402-2411
JournalInternational Journal of Cancer
Volume127
Issue number10
Publication statusPublished - 2010
Publication categoryResearch
Peer-reviewedYes