Tobacco type and risk of squamous cell cancer of the oesophagus in males: a French multicentre case-control study

Background The association between tobacco smoking and oesophageal cancer i s well established. However, some major questions remain unanswered such as the importance of kind of tobacco and smoke inhalation. The aim of this st udy was to investigate the effect of each kind of tobacco on the risk of sq uamous cell cancer of the oesophagus in men and to test whether the effect of kind of tobacco is similar whatever the sub-site of cancer. Tobacco cons umption was assessed by the number of years of consumption and time since q uitting. Methods We conducted a multicentre case-control study in three university h ospitals in France (Caen, Dijon, and Toulouse). From 1991 to 1994, 208 case s and 399 controls, all male, were selected. During the interview, the subj ect's entire tobacco history was recalled, noting each type of tobacco cons umed throughout life. Results Strong tobacco, dark tobacco and non-filter-tipped cigarettes were - associated - with an increase in risk whatever the adjustments, whilst li ght, filter-tipped cigarettes and mild tobacco were not. Hand-rolled cigare ttes were more strongly associated with risk than manufactured cigarettes. The effect of hand-rolled cigarettes appeared stronger for the lower third whilst those of strong cigarettes and dark tobacco appeared stronger for th e upper third of the oesophagus. The effect of inhaling was confined to the upper third. Conclusions Our results, emphasizing the role of dark tobacco, hand-rolled cigarettes, strong cigarettes and non-filter-tipped cigarettes are in line with previous publications. Moreover, they suggest that the mechanism under lying the tobacco effect could be different according to the sub-site of ca ncer.