Christopher Kim1, Robert S Chapman2, Wei Hu3, Xingzhou He4, H Dean Hosgood5, Larry Z Liu6, Hong Lai7, Wei Chen8, Debra T Silverman3, Roel Vermeulen9, Linwei Tian10, Bryan Bassig11, Min Shen12, Yawei Zhang13, Shuangge Ma13, Nathaniel Rothman3, Qing Lan3. 1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892, United States; School of Public Health, Yale University, New Haven, CT 06520, United States. Electronic address: Christopher.kim@nih.gov. 2. College of Public Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand. 3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892, United States. 4. Institute of Environmental Health and Engineering, Chinese Center for Disease Control and Prevention, Beijing 102206, China. 5. Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892, United States; Albert Einstein College of Medicine, Bronx, NY 10461, United States. 6. Weill Medical College of Cornell University, New York, NY 10021, United States. 7. Department of Radiology and Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21287, United States. 8. Forest Laboratories, Inc., Jersey City, NJ 07311, United States. 9. Institute for Risk Assessment, Utrecht University, Utrecht, The Netherlands. 10. School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. 11. Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892, United States; School of Public Health, Yale University, New Haven, CT 06520, United States. 12. Interfaith Medical Center, Brooklyn, NY 11213, United States. 13. School of Public Health, Yale University, New Haven, CT 06520, United States.
Abstract
OBJECTIVES: Lung cancer rates in Xuanwei are the highest in China. In-home use of smoky coal has been associated with lung cancer risk, and the association of smoking and lung cancer risk strengthened after stove improvement. Here, we explored the differential association of tobacco use and lung cancer risk by the intensity, duration, and type of coal used. MATERIALS AND METHODS: We conducted a population-based case-control study of 260 male lung cancer cases and 260 age-matched male controls. Odds ratios (OR) and 95% confidence interval (CI) for tobacco use was calculated by conditional logistic regression. RESULTS: Use of smoky coal was significantly associated with an increased risk of lung cancer, and tobacco use was weakly and non-significantly associated with lung cancer risk. When the association was assessed by coal use, the cigarette-lung cancer risk association was null in hazardous coal users and elevated in less hazardous smoky coal users and non-smoky coal users. The risk of lung cancer per cigarette per day decreased as annual use of coal increased (>0-3 tons: OR: 1.09; 95% CI: 1.03-1.17; >3 tons: OR: 0.99; 95% CI: 0.95-1.03). Among more hazardous coal users, attenuation occurred at even low levels of usage (>0-3 tons: OR: 1.02; 95% CI: 0.91-1.14; >3 tons: OR: 0.94; 95% CI: 0.97-1.03). CONCLUSION: We found evidence that smoky coal attenuated the tobacco and lung cancer risk association in males that lived in Xuanwei, particularly among users of hazardous coal where even low levels of smoky coal attenuated the association. Our results suggest that the adverse effects of tobacco may become more apparent as China's population continues to switch to cleaner fuels for the home, underscoring the urgent need for smoking cessation in China and elsewhere. Published by Elsevier Ireland Ltd.
OBJECTIVES:Lung cancer rates in Xuanwei are the highest in China. In-home use of smoky coal has been associated with lung cancer risk, and the association of smoking and lung cancer risk strengthened after stove improvement. Here, we explored the differential association of tobacco use and lung cancer risk by the intensity, duration, and type of coal used. MATERIALS AND METHODS: We conducted a population-based case-control study of 260 male lung cancer cases and 260 age-matched male controls. Odds ratios (OR) and 95% confidence interval (CI) for tobacco use was calculated by conditional logistic regression. RESULTS: Use of smoky coal was significantly associated with an increased risk of lung cancer, and tobacco use was weakly and non-significantly associated with lung cancer risk. When the association was assessed by coal use, the cigarette-lung cancer risk association was null in hazardous coal users and elevated in less hazardous smoky coal users and non-smoky coal users. The risk of lung cancer per cigarette per day decreased as annual use of coal increased (>0-3 tons: OR: 1.09; 95% CI: 1.03-1.17; >3 tons: OR: 0.99; 95% CI: 0.95-1.03). Among more hazardous coal users, attenuation occurred at even low levels of usage (>0-3 tons: OR: 1.02; 95% CI: 0.91-1.14; >3 tons: OR: 0.94; 95% CI: 0.97-1.03). CONCLUSION: We found evidence that smoky coal attenuated the tobacco and lung cancer risk association in males that lived in Xuanwei, particularly among users of hazardous coal where even low levels of smoky coal attenuated the association. Our results suggest that the adverse effects of tobacco may become more apparent as China's population continues to switch to cleaner fuels for the home, underscoring the urgent need for smoking cessation in China and elsewhere. Published by Elsevier Ireland Ltd.
Entities:
Keywords:
China; Coal; Epidemiology; Global health; Indoor air pollution; Lung cancer; Tobacco
Authors: J H Lubin; J Y Li; X Z Xuan; S K Cai; Q S Luo; L F Yang; J Z Wang; L Yang; W J Blot Journal: Int J Cancer Date: 1992-05-28 Impact factor: 7.396
Authors: Qing Lan; Xingzhou He; Min Shen; Linwei Tian; Larry Z Liu; Hong Lai; Wei Chen; Sonja I Berndt; Howard Dean Hosgood; Kyoung-Mu Lee; Tongzhang Zheng; Aaron Blair; Robert S Chapman Journal: Int J Cancer Date: 2008-11-01 Impact factor: 7.396
Authors: Jason Y Y Wong; Wei Hu; George S Downward; Wei Jie Seow; Bryan A Bassig; Bu-Tian Ji; Fusheng Wei; Guoping Wu; Jihua Li; Jun He; Chin-San Liu; Wen-Ling Cheng; Yunchao Huang; Kaiyun Yang; Ying Chen; Nathaniel Rothman; Roel C Vermeulen; Qing Lan Journal: Carcinogenesis Date: 2017-09-01 Impact factor: 4.944
Authors: Teresa W Wang; Roel C H Vermeulen; Wei Hu; Gang Liu; Xiaohui Xiao; Yuriy Alekseyev; Jun Xu; Boris Reiss; Katrina Steiling; George S Downward; Debra T Silverman; Fusheng Wei; Guoping Wu; Jihua Li; Marc E Lenburg; Nathaniel Rothman; Avrum Spira; Qing Lan Journal: Carcinogenesis Date: 2015-10-14 Impact factor: 4.944
Authors: E Drizik; S Corbett; Y Zheng; R Vermeulen; Y Dai; W Hu; D Ren; H Duan; Y Niu; J Xu; W Fu; K Meliefste; B Zhou; Xiaohui Zhang; J Yang; Bryan Bassig; Hanqiao Liu; M Ye; Gang Liu; X Jia; T Meng; P Bin; J Zhang; D Silverman; A Spira; N Rothman; M E Lenburg; Q Lan Journal: Environ Int Date: 2020-02-07 Impact factor: 9.621
Authors: Jason Y Y Wong; Roel Vermeulen; Yufei Dai; Wei Hu; W Kyle Martin; Sarah H Warren; Hannah K Liberatore; Dianzhi Ren; Huawei Duan; Yong Niu; Jun Xu; Wei Fu; Kees Meliefste; Jufang Yang; Meng Ye; Xiaowei Jia; Tao Meng; Bryan A Bassig; H Dean Hosgood; Jiyeon Choi; Mohammad L Rahman; Douglas I Walker; Yuxin Zheng; Judy Mumford; Debra T Silverman; Nathaniel Rothman; David M DeMarini; Qing Lan Journal: Environ Mol Mutagen Date: 2021-08-16 Impact factor: 3.579