title: Relation between smoking and skin cancer.
abstract: OBJECTIVE
  Tobacco smoking is a risk factor for several cancers. The risk of cutaneous malignancies related to smoking, however, is relatively unknown. We investigated the possible association between smoking and skin cancer.
  
  
  METHODS
  A hospital-based case-control study was performed that included 161 patients with squamous cell carcinoma, 301 with nodular basal cell carcinoma, 153 with superficial multifocal basal cell carcinoma, 125 with malignant melanoma, and 386 controls. Information on smoking history was collected in personal interviews. Relative risks were estimated using exposure odds ratios from cross-tabulation and logistic regression.
  
  
  RESULTS
  An association between smoking and squamous cell carcinoma of the skin was found (relative risk, 2.3; 95% confidence interval, 1.5 to 3.6; P: = .0001), with a higher risk for current smokers (relative risk, 3.3; 95% confidence interval, 1.9 to 5.5) than for former smokers (relative risk, 1.9; 95% confidence interval, 1.2 to 3.0). After adjustment for age, sex, and sun exposure, the relative risk of squamous cell carcinoma was 2.0 (95% confidence interval, 1.2 to 3.2; P: = .008). There was a dose-response relationship with number of cigarettes and pipes smoked. No significant association was found between smoking and nodular basal cell carcinoma, superficial multifocal basal cell carcinoma, or malignant melanoma.
  
  
  CONCLUSIONS
  Tobacco smoking is an independent risk factor for cutaneous squamous cell carcinoma.
authors.affiliation: Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.lastname: De Hertog SA
authors.forename: C A
authors.initials: CA
authors.lastname: Wensveen
authors.forename: M T
authors.initials: MT
authors.lastname: Bastiaens
authors.forename: C J
authors.initials: CJ
authors.lastname: Kielich
authors.forename: M J
authors.initials: MJ
authors.lastname: Berkhout
authors.forename: R G
authors.initials: RG
authors.lastname: Westendorp
authors.forename: B J
authors.initials: BJ
authors.lastname: Vermeer
authors.forename: J N
authors.initials: JN
authors.lastname: Bouwes Bavinck
mesh_terms: D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D012306:Risk; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects*