Tobacco Documents Online

SMOKING AND HEALTH 1987 Proceedings of the 6th World Conference on Smoking and Health, Tokyo, 9-12 November 1987 Editors: Mssskzzu Aold Tuberculosis Iattitute, Kiyose, Tokyo, Japan Sk*rn Hisamk6[ Tohoku University School of Medicine, Sendai, Japan Saketaml TomLesa Aichi Cancer Center Research Institute, Nagoya, Japan 1988 EXCERPTA MEDICA, Amsterdam - Nrw York - Oxford © ~ ~ ~ Y ~ .co

Oc1988 Elsevier Science Publishers B.V'. (Biomedical Division) All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. Elsevier Science Publishers B.V., Biomedical Division, P.O. Box 1527, 1000 BM Amsterdam, The Netherlands. No responsibility is assumed by the Publisher for any injury and/or damage to per- sons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any method's, products, instructions or ideas contained in the material herein. Because of rapid advances in the medical' sciences, the Publisher recommends that independent verification of diagnoses and drug dosages should be made. Special regulations for readers in the USA - This publication has been registered with the Copyright Clearance Center Inc. (CCC), 27 Congress Street, Salem. MA 01970, USA. Information can be obtained from the CCC about conditions under which photocopies of paru of this publication may be made in the USA. All other copyright questions, including photocopying outside the USA, should be referred to the copyright owner, Elsevier Science Publishers B.V., unless otherwise specified.. International Congress Series No. 780 ISBN' 0 444 80994 5 Published by: Elsevier Science Publishers B.V. (Biomedical Division) P.O. Box 21' 1 1000 AE Amsterdam The Netherlands Sole disrributors Jor the USA and Caaoda: Elsevier Science Publishia= Company Inc. 52 Vanderbilt Avenue New York, NY 10017 USA Li6rory of CatVW Cot.loZutl in PublJcaQtioR Uaa: rao hNarw. . s..lq w.../.f I•e. ,. 1.n , T..r.. ..w1 IyM ny. 1M W I" 1M :.. P ft Nr 1"@ M. tM M.Mr /t OMHrMIff •`rt/y W 1M/M. TMLw. F1! IINftMr Ir7 / Mls&n. ftMtaA Am1. 5/perv N/Nl/M/;. MItM1TNli~:. R. •. - 1LQ0Mf/eM1,SowtoN Mtss /. •. 1M/ tm /edemsi. tY.9.) ~. >}~I~~~Vl~ ir1. MMaiw. tt. MNMN~t, •Ie". Z<I'.t. Tr{MM. YMMU. 1'1).. TTtN.•. tW /«0 t~A, . /. /•aIes ad so s.er-.ewuMs. !. arRtq--~rt.~.rt.. • ~MMS.h ...rs.... M Q~1~ .f. 7M ~ M t!f tlt7 N~1' MIJ1it.TIM /r7 •N.~'i--w1o O~.1v/zC fr /.qrsry N. ~IIK6 r-1M1 Printed in Zbe Nesheriands UP

NCT: C E This materia; may, be protected "y r,op~,r~3ht iaw (Ttle 17 U.S. Code). ` 1988 E11c,,er S, en.e PuI+.Ilshen BV iB omedi¢al Dnitionl Smokmyand heal(ti,l98' M . Aoki ei al. editors CF --r R?LAT:C'h~_J :_ „N: r.. Lt'~.1 ":1N^_^-,3 483 ;. a'"-YI :,'.Y.•Lh:; ,, Y _.F4,." ., ;.L.',2, lerartment of rride^iolo,ry.°ianjin ?!edicall ^.ollege,Tian;in(F..11.China)i "here io still controversy about the relationstiip between cigarette snoYing an3 fe=e1e lung cancer.The rortal~it!y rate of female lung can- cer in Ti'anjin is the highest in ^hina(28.3/105)'.'^he feraale s^~osing rate in "ianjin is nlso the highast in ^hine.^herefore we hed' con- ducted a ease-control study of female lung cancer to illlustrate it. !SA'":RI::L AND r'rTT?C7S Ne conducted a i:t pair matched caae-control study. 7.Oeses:157, femal~e lung cwicer cases all resi'dent in :ian;ir. r:cre than 10 years. SquaWoue cell carcizoa.a 35(22.'±%);Small cell carcincra 31(t9.7%);Adenocareinoma 58(36•9:);Large cell carcinosa 4(2.50.);^e111 type 'inkr.owr: 29(1t8.51). ^ases were 3dagr.osed:i33(64.70.) his:ologica-- Iy or c-,ytologically;17(T0.e%) by ^T;7(4.5%) clinically or by Y-ray. 2.".or.trols:t:57,matched with _-.x,race,age(t2 years)a:d marital sta- Vis. nrg^L:S 1.,he case group is a qui*.e representative of the '"iar.jin female lung cancer. The age group structure and distribution of residents of the luna_ cancer group is quite sinlLar vi*.'s those of 1983 Tianjin fe- male lun¢_ cincer. Srroking rate of the control group(40.8!'.) is quite s1milar with that of the Tianjin adult female population(39.5% a58 11,) . 2.The age,education,occupation,race.marital statusrbirth place.resi- dent place of the case and control groups have no significant dif- ference (P>0.05) . 3•Pemale lung cancer and sctivs smoking #OR of active smoking is 3•05,PAR% is 57.4%.-(Table 1) . TABL? 1•0!t 0° SMC+%ING f aasee: gzpo9ure rVt0 o on ro s 45'~'65`" Smoker Nonsmoker 157 •656(3•05 -1') Smoker 45 58 FA~•656( 3•05-1 1 ~57.4~i CasesNon- smoker 19 35 Th.re ia qnite,.obvrioua. dose-effect ` OR-3•05, 957`CI-1 .77-5•30 ralat~anship between.lm6 vaacrr Adyuated 0R-2.6,95% CI-t.4-4.6, risk and-amnbel;of cl.6siettae smoked P<0.001 tpor day ead year of amoking(Teble 2).

484 OR is higher of those sTaoking deeper than those s-okc superficially or non-smoking (Table 3). OR is higher among those start smoking ear- lier (Table 4). .TABL? 2.L`"tw C1.NC:R' RISK. AND N0.O? TABLL: 3. OR AND D?GRr? 0F IN- CI3ARST:'rS AND YEAR OF SMOKiNG HALATIOh (!S-H M?THOD), ,lo•ciga OR 951i CI of OR No Occasional Deep rettes/day 0- 1 Case 54 37 66 Control 98 33 26 1- t.81 1.40-2.33 11- 3.27 2.28-4.68 OR 1 2.03 4.61 21- 5.90 3.79-9•18 p <0.01 Year of smokiug 0 1 1- 1.73 1.38-2'.18 20- 3.00 2.17-4.16 40- 5.20 3.49-7.75 TABLp 4. CR AND AG'g ONS?T Op SMC'KING (M.-H MpTHOD)' Age Group Non-smoking 211 16-20 15 P <44 Case 8 11 3 0 > 0.05 Control 12 0 1 0 45-Case 16 8 17 14 G O.Oti Control 29 9 14 3 5 5-c)ase• 24 13 13 15 <0.01 Control 35 18 6 5 65-Case 6 6 6 7 <0..01 ("on trol 17 4 2 2 OR 1 1.59 3.10 6.3 N.01 4.Pemalt lung cancer and paasive smoking. Ve had celcaLated the OR of passive smoking from husbaid,father,mo- ther and coll.agues,dnly that from husbaad is quita signifidmt.' f Tbe noa-asoking fesasle cases and controls with amokiag or non-smok- ing husband is as table 5. The OR is 2.16 (P s 0.05)t T1ffiS 5• OR OF S1q7EING R439A1(D TO 'ON-3KOYIN3 MIrE B:posure rate of cases 34 4 us ~ .63 20 - 3moker lton-mmoker -42'2%f pAM%- Case 34 20 .63{2.t6-1 .t Control 41 52 OR of fesale lung oe>ncer in- P 0R-2.16.95% CI-1.o3-4.53. cre:es with the numbor of ci4sr- p< 0.05 ettea smoked p.r day by her hns-

485 band +tad the iuratiorn of exposure to her husband's smoking(':able 6)., 5•CR of either active or rassi•e and combina:ion of sc'i've and ras- sive snoking,is as table 7. "A°_'' 6,C? C' ~,',Lr D1'27:, '"ABLr 7.CR OT' A77I'1s ANJ 'ASSIY= 3T!CKIS: '.,;:i'?3 C' .i. Ci:."-; i^._?3:;I:7 ?'f?OM ?iT'S&1ID :3A~_, C~ GCe'1I C° OR A..-:•r-. S.",'L'7".(':1;'TS) tiC Y='S : ".A? ". . ' ' -rR ~A ! S3Ah~ M(' H' 1 .G 2.61 (;1 .4-4.6) 0 1 SN'OKINO Yrs 1i.66(1.04- 4.90(1.8-9•5) 1- 1.40 1.12-1.76 3•5) 10- 1.97 1.42-2.72 20- 2.76 1.85-4.10 If a smoking vorr,an with smoking hus- Y'A~~ C° band,the OR of lung cancer is 4.g .expo- 0 1 sure rate is 610, (83/103). 1- 1.49 T.t5-1.94 a o 6 20- 2.23 1.54-3.22 _ . t t ;=75•95%. aC- 3.';2 2.11 -5.22 A non-smoking woman with smoking husband.the CR of lung cancer is 1.86,exFosure rate is 63% (34/54) • PA?t, .63C,1.86-1) « =35•17~• according to 103 smoking female linwr cancer cases about 78.23(103 X .7595) are due to smoking,xhil^ :he 54 non-smoking female lung cancer cases about 16.95(54 X.351') are due to ~~yd, That is '8,2'*18. 5s61,0,% of female lung cancer in Ti9n3in may at- tribute to active smoking and passive s.^ioking from their husbands. 6. OR of female lung cancer due to other causes. Occupational exposure: Textile sorkers.rorkers eTpose to asc.:tos,, benzene,etc. CR=3•1.A5% CI=1.58-6.02. OR of history of lung diseases (lnelu^i pulmonary '"BC.chron2c bron- ctiitis,pulmonary infeetion,etc.)is 2.64.Adjusted with conditioaal re- gression model.DR=2.72,95!iCI of OR=1.23-3.63. Oit of lung cancer and cooking with coal is shown in table 8. 7. Joint :.'fect of the Risk ?actors. Hultifactor analysis by conditional regression method demonstrate that the combination of active emoking,passive smoking from husbends. occupational expoeure.history of lung diseases and 4 XtA a hours cook- iag with coal makes the OR being about 50 in comparisor -ith those

486 . rithou: the above risk f3cto^s and cooking wi'th coal less than 3X1G" hours. 050. :I o.` OR-13.7-tB5.3. ^' 3L'' 8. OR OF LLt:7 AITO MC}:I:+3 WI"'i ^OkL m23"':^i? 07 :OCL:';,(hrs)1 OR o5IG ^T of OR tx10 (1.5 hr/day.20, yrs)' 1.54 1.20-1 .q6 2X104(1i.5 hr/dey.40, yrs): 2.36 t.66-3.34 3X104(2 hrs/day.42 yrs) 3.62' 2.36-5.55 4X104(3 hrs/lay.37 yre) 5.56 3.40-9.10, CnNCL^'';I()x '-t. Both active amoking and passive smokinr, :.u^ Mir husband are the moat i!nportaat risk factors of lsmale.lung cancer in Tisnjin. :, oout a ,~.. ~ _.. 60c~ of female lung cancer in$Tianjin may be attributed to s^.oY.ing. 2. There ii joint effect of.a:noking:vith occupational exposnre.his- tory of lung diseases and cooking vith coal. R"-?,u,?WC?S t. Hirayama T (1981) Brit Med J 282:183 2. Xu ttH.;eng GY (1983) Chinese J°pideni^1 4:193-197' 3. Ter,,q 'rY (1980) In: :,eng CY (eds) ?pidemiolo+3y-'eople's ;fedical Fublishing House.3ei,j,ing. vol I. pp 153-1:56.188-191