title: Smoking addiction and the risk of upper-aerodigestive-tract cancer in a multicenter case-control study.
abstract: Although previous studies on tobacco and alcohol and the risk of upper-aerodigestive-tract (UADT) cancers have clearly shown dose-response relations with the frequency and duration of tobacco and alcohol, studies on addiction to tobacco smoking itself as a risk factor for UADT cancer have not been published, to our knowledge. The aim of this report is to assess whether smoking addiction is an independent risk factor or a refinement to smoking variables (intensity and duration) for UADT squamous cell carcinoma (SCC) risk in the multicenter case-control study (ARCAGE) in Western Europe. The analyses included 1,586 ever smoking UADT SCC cases and 1,260 ever smoking controls. Addiction was measured by a modified Fagerström score (first cigarette after waking up, difficulty refraining from smoking in places where it is forbidden and cigarettes per day). Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for UADT cancers with addiction variables were estimated with unconditional logistic regression. Among current smokers, the participants who smoked their first cigarette within 5 min of waking up were two times more likely to develop UADT SCC than those who smoked 60 min after waking up. Greater tobacco smoking addiction was associated with an increased risk of UADT SCC among current smokers (OR = 3.83, 95% CI: 2.56-5.73 for score of 3-7 vs. 0) but not among former smokers. These results may be consistent with a residual effect of smoking that was not captured by the questionnaire responses (smoking intensity and smoking duration) alone, suggesting addiction a refinement to smoking variables.
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Yuan-Chin Amy
authors.initials: YC
authors.lastname: Lee
authors.forename: Daniela
authors.initials: D
authors.lastname: Zugna
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Richiardi
authors.forename: Franco
authors.initials: F
authors.lastname: Merletti
authors.forename: Manuela
authors.initials: M
authors.lastname: Marron
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Ahrens
authors.forename: Hermann
authors.initials: H
authors.lastname: Pohlabeln
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Antonio
authors.initials: A
authors.lastname: Agudo
authors.forename: Xavier
authors.initials: X
authors.lastname: Castellsague
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Betka
authors.forename: Ivana
authors.initials: I
authors.lastname: Holcatova
authors.forename: Kristina
authors.initials: K
authors.lastname: Kjaerheim
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Macfarlane
authors.forename: Tatiana V
authors.initials: TV
authors.lastname: Macfarlane
authors.forename: Renato
authors.initials: R
authors.lastname: Talamini
authors.forename: Luigi
authors.initials: L
authors.lastname: Barzan
authors.forename: Cristina
authors.initials: C
authors.lastname: Canova
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Simonato
authors.forename: David I
authors.initials: DI
authors.lastname: Conway
authors.forename: Patricia A
authors.initials: PA
authors.lastname: McKinney
authors.forename: Peter
authors.initials: P
authors.lastname: Thomson
authors.forename: Ariana
authors.initials: A
authors.lastname: Znaor
authors.forename: Claire M
authors.initials: CM
authors.lastname: Healy
authors.forename: Bernard E
authors.initials: BE
authors.lastname: McCartan
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.forename: Mia
authors.initials: M
authors.lastname: Hashibe
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D005060:Europe; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires
keywords: Fagerström; smoking addiction; upper-aerodigestive-tract cancer