title: Cannabis, tobacco and domestic fumes intake are associated with nasopharyngeal carcinoma in North Africa.
abstract: BACKGROUND
  The lifestyle risk factors for nasopharyngeal carcinoma (NPC) in North Africa are not known.
  
  
  METHODS
  From 2002 to 2005, we interviewed 636 patients and 615 controls from Algeria, Morocco and Tunisia, frequency-matched by centre, age, sex, and childhood household type (urban/rural). Conditional logistic regression was used to evaluate the association of lifestyles with NPC risk, controlling for socioeconomic status and dietary risk factors.
  
  
  RESULTS
  Cigarette smoking and snuff (tobacco powder with additives) intake were significantly associated with differentiated NPC but not with undifferentiated carcinoma (UCNT), which is the major histological type of NPC in these populations. As demonstrated by a stratified permutation test and by conditional logistic regression, marijuana smoking significantly elevated NPC risk independently of cigarette smoking, suggesting dissimilar carcinogenic mechanisms between cannabis and tobacco. Domestic cooking fumes intake by using kanoun (compact charcoal oven) during childhood increased NPC risk, whereas exposure during adulthood had less effect. Neither alcohol nor shisha (water pipe) was associated with risk.
  
  
  CONCLUSIONS
  Tobacco, cannabis and domestic cooking fumes intake are risk factors for NPC in western North Africa.
authors.affiliation: Genetic Epidemiology Group, International Agency for Research on Cancer, 69372 Lyon, France. bingjian.feng@hsc.utah.edu
authors.forename: B-J
authors.initials: BJ
authors.lastname: Feng
authors.forename: M
authors.initials: M
authors.lastname: Khyatti
authors.forename: W
authors.initials: W
authors.lastname: Ben-Ayoub
authors.forename: S
authors.initials: S
authors.lastname: Dahmoul
authors.forename: M
authors.initials: M
authors.lastname: Ayad
authors.forename: F
authors.initials: F
authors.lastname: Maachi
authors.forename: W
authors.initials: W
authors.lastname: Bedadra
authors.forename: M
authors.initials: M
authors.lastname: Abdoun
authors.forename: S
authors.initials: S
authors.lastname: Mesli
authors.forename: H
authors.initials: H
authors.lastname: Bakkali
authors.forename: M
authors.initials: M
authors.lastname: Jalbout
authors.forename: M
authors.initials: M
authors.lastname: Hamdi-Cherif
authors.forename: K
authors.initials: K
authors.lastname: Boualga
authors.forename: N
authors.initials: N
authors.lastname: Bouaouina
authors.forename: L
authors.initials: L
authors.lastname: Chouchane
authors.forename: A
authors.initials: A
authors.lastname: Benider
authors.forename: F
authors.initials: F
authors.lastname: Ben-Ayed
authors.forename: D E
authors.initials: DE
authors.lastname: Goldgar
authors.forename: M
authors.initials: M
authors.lastname: Corbex
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D016022:Case-Control Studies; D003296:Cooking; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D015999:Multivariate Analysis; D009303:Nasopharyngeal Neoplasms / Q000209:etiology*; D012307:Risk Factors; D012906:Smoke; D012907:Smoking / Q000009:adverse effects*; D014030:Tobacco, Smokeless / Q000009:adverse effects
chemical_list: D012906:Smoke