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Study of the relationship between smoking, as a lifestyle factor, and lung cancer in the Beijing area of China. Fan, R.L., et al. Beijing Tuberculosis and Thoracic Tumor Research Institute of The People's Republic of China (PRC), Beijing, China In a case-control study, 403 (252 male and 151 female) primary lung cancer patients and 1,151 (734 male and 417 female) population- based controls from the WHO-MONICA Project (involving about 750,000 residents) were interviewed. The results of the study suggest that smoking is a dominant cause of lung cancer among men. The overall Odds Ratio (OR) was 2.65 (95% CI 2.04-3.44) for all patients. The Odds Ratios were 2.84 (95% CI 1.90-4.28) for males and 3.92 (95% CI 2.59-5.94) for females. The reason for the lower OR for males (2.84) than for females (3.92) should be studied further. The Attributable Risk (AR) was 64.8% for males and 74.5% for females (62.3% overall). The Population Attributable Risk (PAR) was 55.5% for males and 40.5% for females (46.0% overall). There was a trend for an increased risk with increased smoking (number of cigarettes per day), the duration, and the degree of "deep" smoking (inhaling). The risk varied for different cell types, measured by OR, AR and PAR. The figures for squamous cell carcinoma (79.0% males and

21.0% females) were 12.18, 91.8% and 87.3%, respectively; for adenocarcinoma, 1.39, 28.1% and 14.3% (51.8% male and 48.2% female); and for small cell lung cancer (SCLC), 2.48, 59.7% and 44.5%. The strongest association between smoking, as a lifestyle factor, and lung cancer was for squamous cell carcinoma; SCLC ranked second. The correlation between smoking and adenocarcinoma was not statistically significant (P>0.05).