Black (air-cured) and blond (flue-cured) tobacco and cancer risk II: Pharynx and larynx cancer.

Two case-control studies have examined the relationship between black or blond tobacco smoking and the occurrence of pharynx or larynx cancer. The first study was carried out in several European countries. Tobacco smoking was found to be associated with higher risks for supraglottic and epilarynx cancer localisations than for pharynx, glottic and subglottic localisation. In all localisations, risk was twice as high again in users of black tobacco after adjusting for alcohol and for lifetime average daily dose of tobacco. The other study was carried out in Uruguay. After taking into account age, age at start of smoking, duration of smoking, years since stopping smoking and filter use, risks were found to be higher in black tobacco smokers than in blond tobacco smokers. All known studies which have been performed in countries where blond tobacco is generally smoked showed lower risks even when adjusted for alcohol. Use of black tobacco appears to be associated with higher risks of cancer of the pharynx and larynx than blond tobacco use.