BMJ  2004;328:72 (10 January), doi:10.1136/bmj.37936.585382.44

Paper

Cigarette tar yields in relation to mortality from lung cancer in the cancer prevention study II prospective cohort, 1982-8

Jeffrey E Harris, professor1, Michael J Thun, vice president for epidemiology and surveillance research2, Alison M Mondul, research analyst2, Eugenia E Calle, director, analytic epidemiology2

1 Department of Economics, Massachusetts Institute of Technology, Cambridge MA 02139, USA, 2 Epidemiology and Surveillance Research, American Cancer Society, 1599 Clifton Road NE, Atlanta GA 30329, USA

Correspondence to: J E Harris Internal Medicine Associates, Massachusetts General Hospital, Boston MA 02114 USA jeharris{at}partners.org

Objective To assess the risk of lung cancer in smokers of medium tar filter cigarettes compared with smokers of low tar and very low tar filter cigarettes.

Design Analysis of the association between the tar rating of the brand of cigarette smoked in 1982 and mortality from lung cancer over the next six years. Multivariate proportional hazards analyses used to assess hazard ratios, with adjustment for age at enrolment, race, educational level, marital status, blue collar employment, occupational exposure to asbestos, intake of vegetables, citrus fruits, and vitamins, and, in analyses of current and former smokers, for age when they started to smoke and number of cigarettes smoked per day.

Setting Cancer prevention study II (CPS-II).

Participants 364 239 men and 576 535 women, aged >= 30 years, who had either never smoked, were former smokers, or were currently smoking a specific brand of cigarette when they were enrolled in the cancer prevention study.

Main outcome measure Death from primary cancer of the lung among participants who had never smoked, former smokers, smokers of very low tar (<= 7 mg tar/cigarette) filter, low tar (8-14 mg) filter, high tar (>= 22 mg) non-filter brands and medium tar conventional filter brands (15-21 mg).

Results Irrespective of the tar level of their current brand, all current smokers had a far greater risk of lung cancer than people who had stopped smoking or had never smoked. Compared with smokers of medium tar (15-21 mg) filter cigarettes, risk was higher among men and women who smoked high tar (>= 22 mg) non-filter brands (hazard ratio 1.44, 95% confidence interval 1.20 to 1.73, and 1.64, 1.26 to 2.15, respectively). There was no difference in risk among men who smoked brands rated as very low tar (1.17, 0.95 to 1.45) or low tar (1.02, 0.90 to 1.16) compared with those who smoked medium tar brands. The same was seen for women (0.98, 0.80 to 1.21, and 0.95, 0.82 to 1.11, respectively).

Conclusion The increase in lung cancer risk is similar in people who smoke medium tar cigarettes (15-21 mg), low tar cigarettes (8-14 mg), or very low tar cigarettes (<= 7 mg). Men and women who smoke non-filtered cigarettes with tar ratings >= 22 mg have an even higher risk of lung cancer.


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Lower tar makes no difference
BMJ 2004 328: 0. [Full Text] [PDF]

This article has been cited by other articles:

  • Cropsey, K., Eldridge, G., Weaver, M., Villalobos, G., Stitzer, M., Best, A. (2008). Smoking Cessation Intervention for Female Prisoners: Addressing an Urgent Public Health Need. AJPH 98: 1894-1901 [Abstract] [Full text]  
  • O'Connor, R J, Hammond, D, McNeill, A, King, B, Kozlowski, L T, Giovino, G A, Cummings, K M (2008). How do different cigarette design features influence the standard tar yields of popular cigarette brands sold in different countries?. Tobacco Control 17: i1-i5 [Abstract] [Full text]  
  • O'Connor, R J, Hurley, P J (2008). Existing technologies to reduce specific toxicant emissions in cigarette smoke. Tobacco Control 17: i39-i48 [Abstract] [Full text]  
  • Melikian, A. A., Djordjevic, M. V., Chen, S., Richie, J. Jr., Stellman, S. D. (2007). Effect of Delivered Dosage of Cigarette Smoke Toxins on the Levels of Urinary Biomarkers of Exposure. Cancer Epidemiol. Biomarkers Prev. 16: 1408-1415 [Abstract] [Full text]  
  • Brennan, P., Crispo, A., Zaridze, D., Szeszenia-Dabrowska, N., Rudnai, P., Lissowska, J., Fabianova, E., Mates, D., Bencko, V., Foretova, L., Janout, V., Fletcher, T., Boffetta, P. (2006). High Cumulative Risk of Lung Cancer Death among Smokers and Nonsmokers in Central and Eastern Europe. Am J Epidemiol 164: 1233-1241 [Abstract] [Full text]  
  • Tindle, H. A., Rigotti, N. A., Davis, R. B., Barbeau, E. M., Kawachi, I., Shiffman, S. (2006). Cessation Among Smokers of "Light" Cigarettes: Results From the 2000 National Health Interview Survey. AJPH 96: 1498-1504 [Abstract] [Full text]  
  • Sassen, A. W., Richter, E., Semmler, M. P., Harreus, U. A., Gamarra, F., Kleinsasser, N. H. (2005). Genotoxicity of Nicotine in Mini-Organ Cultures of Human Upper Aerodigestive Tract Epithelia. Toxicol Sci 88: 134-141 [Abstract] [Full text]  
  • Godtfredsen, N. S., Prescott, E., Osler, M. (2005). Effect of Smoking Reduction on Lung Cancer Risk. JAMA 294: 1505-1510 [Abstract] [Full text]  
  • Hecht, S. S. (2005). Carcinogenicity studies of inhaled cigarette smoke in laboratory animals: old and new. Carcinogenesis 26: 1488-1492 [Abstract] [Full text]  
  • Kleinsasser, N. H., Sassen, A. W., Semmler, M. P., Harreus, U. A., Licht, A.-K., Richter, E. (2005). The Tobacco Alkaloid Nicotine Demonstrates Genotoxicity in Human Tonsillar Tissue and Lymphocytes. Toxicol Sci 86: 309-317 [Abstract] [Full text]  
  • Lewis, S, Arnott, D, Godfrey, C, Britton, J (2005). Public health measures to reduce smoking prevalence in the UK: how many lives could be saved?. Tobacco Control 14: 251-254 [Abstract] [Full text]  
  • Hammond, D., Fong, G. T., Cummings, K. M., Hyland, A. (2005). Smoking Topography, Brand Switching, and Nicotine Delivery: Results from an In vivo Study. Cancer Epidemiol. Biomarkers Prev. 14: 1370-1375 [Abstract] [Full text]  
  • Hecht, S. S., Murphy, S. E., Carmella, S. G., Li, S., Jensen, J., Le, C., Joseph, A. M., Hatsukami, D. K. (2005). Similar Uptake of Lung Carcinogens by Smokers of Regular, Light, and Ultralight Cigarettes. Cancer Epidemiol. Biomarkers Prev. 14: 693-698 [Abstract] [Full text]  
  • Stewart, B. W., Coates, A. S. (2005). Cancer Prevention: A Global Perspective. JCO 23: 392-403 [Abstract] [Full text]  
  • Doll, R., Peto, R., Boreham, J., Sutherland, I. (2004). Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ 328: 1519- [Abstract] [Full text]  
  • Davies, H E (2004). Non-linear relationship between lung cancer risk and cigarette tar yield. Thorax 59: 354-354 [Full text]  
  • (2004). From the library. Br J Ophthalmol 88: 600-600 [Full text]  
  • (2004). Hit Parade. BMJ 328: 774-774 [Full text]  
  • (2004). Low Tar Doesn't Mean Low Risk. Journal Watch Cardiology 2004: 4-4 [Full text]  
  • (2004). Low Tar Doesn't Mean Low Risk. JWatch General 2004: 3-3 [Full text]  

Rapid Responses:

Read all Rapid Responses

DNA Adducts in Smokers
John M McLaren Howard
bmj.com, 14 Jan 2004 [Full text]
The answer to a quandary?
Alfred P J Lake
bmj.com, 18 Jan 2004 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ