title: Body mass index and smoking-related lung cancer risk in the Singapore Chinese Health Study.
abstract: BACKGROUND
  Smokers with low body mass index (BMI) may be more susceptible to lung cancer.
  
  
  METHODS
  We prospectively examined the association between baseline BMI and lung cancer risk in the Singapore Chinese Health Study, a cohort of 63 257 Chinese enrolled between 1993 and 1998.
  
  
  RESULTS
  After adjustment for smoking intensity and duration, BMI was inversely associated with risk of lung cancer among current smokers (P for trend=0.0004). Current smokers at different dosage of smoking with low BMI had significantly higher risk for lung cancer than those with high BMI. Hazard ratios (95% confidence intervals) of lung cancer for heavy smokers with BMI of > or =28, 24-<28, 20-<24, and <20 kg m(-2) were 6.37 (2.10-19.30), 9.01 (5.04-16.10), 8.53 (6.35-11.5), and 11.12 (6.60-18.70), respectively, as compared with nonsmokers. BMI had no modifying effects on lung cancer risk among nonsmokers and former smokers.
  
  
  CONCLUSIONS
  Smokers with lower BMI may experience an enhanced risk of lung cancer. The findings have significant public-health implication given the increase in smoking prevalence in developing countries, where people still have relatively low BMI.
authors.affiliation: Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. ephkwp@nus.edu.sg
authors.forename: W-P
authors.initials: WP
authors.lastname: Koh
authors.forename: J-M
authors.initials: JM
authors.lastname: Yuan
authors.forename: R
authors.initials: R
authors.lastname: Wang
authors.forename: H-P
authors.initials: HP
authors.lastname: Lee
authors.forename: M C
authors.initials: MC
authors.lastname: Yu
mesh_terms: D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012846:Singapore; D012907:Smoking / Q000009:adverse effects*