Differential effects of smoking on lung cancer mortality before and after household stove improvement in Xuanwei, China.
BACKGROUND
In Xuanwei County, Yunnan Province, China, lung cancer mortality rates in both males and females are among the highest in China.


METHODS
We evaluated differential effects of smoking on lung cancer mortality before and after household stove improvement with chimney to reduce exposure to smoky coal emissions in the unique cohort in Xuanwei, China. Effects of independent variables on lung cancer mortality were measured as hazard ratios and 95% confidence intervals using a multivariable Cox regression model that included separate time-dependent variables for smoking duration (years) before and after stove improvement.


CONCLUSIONS
We found that the effect of smoking on lung cancer risk becomes considerably stronger after chimney installation and consequent reduction of indoor coal smoke exposure.
Lee
K-M
KM
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. kmlee92@snu.ac.kr
Chapman
R S
RS
Shen
M
M
Lubin
J H
JH
Silverman
D T
DT
He
X
X
Hosgood
H D
HD
Chen
B E
BE
Rajaraman
P
P
Caporaso
N E
NE
Fraumeni
J F
JF
Blair
A
A
Lan
Q
Q
D016902:Air Pollution, Indoor; D002681:China; D003031:Coal; D008175:Lung Neoplasms / Q000401:mortality*; D012907:Smoking
D003031:Coal