title: Tobacco smoking and chewing as risk factors for multiple human papillomavirus infections and cervical squamous intraepithelial lesions in two countries (Côte d'Ivoire and Finland) with different tobacco exposure.
abstract: Our objective was to compare the association between tobacco smoking and chewing and the risk of multiple human papillomavirus (HPV) infections and cervical squamous intraepithelial lesions (SILs) in two populations with different tobacco exposure. We studied 2,162 women from Côte d'Ivoire, West Africa, and 419 women from Finland, Northern Europe, with baseline data on cervical screening, HPV DNA status and smoking and chewing habits. The proportion of women who smoked and/or chewed tobacco was higher in Finland (36.8%) than in Côte d'Ivoire (3.7%), where tobacco chewing (2.6%) was more common than tobacco smoking (1.4%). Having multiple HPV infections was common in HPV16 and/or 18-infected women (60.4% in Finland and 47.2% in Côte d'Ivoire). There was no increased risk of multiple HPV infections among tobacco consumers. We found that women >or=30 years of age exposed to tobacco through smoking in Finland (OR: 2.2, 95% CI: 0.5-8.7) and chewing in Côte d'Ivoire (OR: 5.5, 95% CI: 2.1-14) had a moderately or highly increased risk of high-grade SIL, respectively. In the latter, the risk was statistically significant. Our findings emphasize the need for health initiatives targeted to prevent tobacco smoking or chewing among women especially in less industrialized countries.
authors.affiliation: Department of Child and Adolescent Health, National Public Health Institute, P.O. Box 310, Oulu, 90101, Finland. kapeu_aline@yahoo.fr
authors.forename: Aline
authors.initials: A
authors.lastname: Simen-Kapeu
authors.forename: Guy
authors.initials: G
authors.lastname: La Ruche
authors.forename: Vesa
authors.initials: V
authors.lastname: Kataja
authors.forename: Merja
authors.initials: M
authors.lastname: Yliskoski
authors.forename: Christine
authors.initials: C
authors.lastname: Bergeron
authors.forename: Apollinaire
authors.initials: A
authors.lastname: Horo
authors.forename: Kari
authors.initials: K
authors.lastname: Syrjänen
authors.forename: Seppo
authors.initials: S
authors.lastname: Saarikoski
authors.forename: Matti
authors.initials: M
authors.lastname: Lehtinen
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.forename: Annie J
authors.initials: AJ
authors.lastname: Sasco
mesh_terms: D000328:Adult; D007560:Cote d'Ivoire; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006801:Humans; D018307:Neoplasms, Squamous Cell / Q000821:virology*; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D002583:Uterine Cervical Neoplasms / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000821:virology*