Abstract
Aim
To investigate the association between smoking, environmental tobacco smoke (ETS), and lung cancer risk.
Methods
This case–control study included 1622 newly diagnosed cases of lung cancer and 1622 healthy frequency-, age-, and gender-matched control participants. Epidemiological data were collected by in-person interviews using a standard questionnaire.
Results
Smoking was a risk factor for lung cancer in men (odds ratio (OR) = 4.486, 95% confidence interval (95%CI) 3.586–5.611). In addition, decreased starting age, increased number of cigarettes smoked per day, duration of smoking, pack–years, and depth of inhalation were all risk factors that met the dose–response relationship (P < 0.001). The risk of lung cancer was lower among men who had quit smoking for more than 10 years compared to current smokers. Additionally, male smokers with lung squamous cell carcinoma were at a higher risk of lung cancer than male smokers with lung adenocarcinoma. Workplace ETS increased the risk for lung cancer for male nonsmokers (OR = 2.452, 95%CI 1.534–3.920). In contrast, household ETS increased the risk for lung cancer for female nonsmokers (OR = 2.224, 95%CI 1.644–3.009). Approximately 65.93% cases of lung cancer in men could be attributed to smoking, whereas approximately 31.03% cases of lung cancer among nonsmokers could be attributed to ETS.
Conclusions
Smoking is the main risk factor for lung cancer. Workplace ETS is associated with increased lung cancer risk in male nonsmokers, while household ETS is associated with increased lung cancer risk in nonsmoking women. Thus, smoking and ETS increase the risk of lung cancer and are major public health concerns.
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Acknowledgments
We thank all the staff from the Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University. We also would like to express our appreciation to the patients who participated in our study.
Funding
This study was supported by the National Natural Science Foundation of China [grant number 81402738].
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FH and LC conceived and designed the experiments; ZQL, QPX, and WMX did the survey; FH, ZQL, JMZ, and RDX analyzed the data; RDX and XL contributed materials; JMZ and RDX wrote the paper.
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This study was approved by the Ethical Review Committee of Fujian Medical University (Fuzhou, China).
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All of the participants consented to complete the questionnaire.
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Zhuang, J., Liu, Z.q., Xiao, R. et al. Association between smoking and environmental tobacco smoke with lung cancer risk: a case–control study in the Fujian Chinese population. J Public Health (Berl.) 30, 2047–2057 (2022). https://doi.org/10.1007/s10389-021-01573-3
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DOI: https://doi.org/10.1007/s10389-021-01573-3