title: Passive smoking and the use of noncigarette tobacco products in association with risk for pancreatic cancer: a case-control study.
abstract: BACKGROUND
  The associations between passive smoking and the use of noncigarette tobacco products with pancreatic cancer are not clear.
  
  
  METHODS
  In this case-control study, the authors collected information on passive smoking and the use of noncigarette tobacco products in 808 patients with pancreatic adenocarcinoma and 808 healthy controls by personal interview. Multivariable logistic regression was performed to estimate the adjusted odds ratio (AOR) and 95% confidence interval (95% CI).
  
  
  RESULTS
  The results confirmed the previously reported association between active smoking and increased risk for pancreatic cancer. The AOR was 1.7 (95% CI, 1.4-2.2) for regular smokers, 1.8 (95% CI, 1.4-2.4) for long-term smokers, and 3.1 (95% CI, 2.2-4.3) for former smokers. Although passive smoking showed a nonsignificantly elevated risk for pancreatic cancer in the entire study population (AOR, 1.3; 95% CI, 0.9-1.7), the association was present among ever smokers (AOR, 1.7; 95% CI, 1.03-2.6) but was absent among never smokers (AOR, 1.1; 95% CI, 0.8-1.6). Neither intensity nor duration of passive smoking modified the risk of pancreatic cancer among never smokers. The use of chewing tobacco, snuff, and pipes showed no significant risk elevation for pancreatic cancer after controlling for the confounding effects of demographics and other known risk factors. The use of cigars in never smokers showed a borderline significant increase of risk for pancreatic cancer (AOR, 2.2; 95% CI, 1.0-4.7; P = .05).
  
  
  CONCLUSIONS
  The current observations did not support a role for passive smoking or the use of noncigarette tobacco products in the etiology of pancreatic cancer. The association between cigar use and the risk of pancreatic cancer needs to be confirmed in other study populations.
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Manal M
authors.initials: MM
authors.lastname: Hassan
authors.forename: James L
authors.initials: JL
authors.lastname: Abbruzzese
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Bondy
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wolff
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Vauthey
authors.forename: Peter W
authors.initials: PW
authors.lastname: Pisters
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Evans
authors.forename: Rabia
authors.initials: R
authors.lastname: Khan
authors.forename: Renato
authors.initials: R
authors.lastname: Lenzi
authors.forename: Li
authors.initials: L
authors.lastname: Jiao
authors.forename: Donghui
authors.initials: D
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
chemical_list: D014028:Tobacco Smoke Pollution