Cigarette smoking and male lung cancer risk with special regard to type oftobacco

Background The mortality rate from lung cancer (LC) increased sharply in Sp ain between 1957 and 1986. This increase has been related to a previous inc rease in cigarette smoking. Certain features of cigarette smoking which wer e frequent among Spanish smokers (use of black tobacco and use of cigarette s 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 structur ed questionnaire. The LC odds ratios (OR) and 95% CI were estimated with mu ltiple logistic regression. Results Lung cancer risk increased with cigarette consumption and duration of the habit. After adjusting for lifetime cigarette consumption and for so cioeconomic level, LC risk was greater among black tobacco smelters than am ong exclusive blond tobacco smokers (OR = 5.0, 95% CI : 2.0-12.7); LC risk among long-term (greater than or equal to 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 tob acco users than in exclusive blond tobacco users, and a lower LC risk among long-term filter-tipped cigarette smokers than all other smokers) have bee n consistent with previous case-control studies and with ecologic studies w hich took into account past exposure levels.