Impact of tobacco smoking on the risk of developing 25 different cancers in the UK: a retrospective study of 422,010 patients followed for up to 30 years

Abstract

BackgroundThe aim of this study was to analyze the impact of tobacco smoking on the risk of developing 25 different cancers in patients followed for up to 30 years in general practices in the UK.MethodsThis study included all individuals with at least one visit to one of 196 general practitioners’ offices in the UK between January 1988 and December 2008 (index date). Only individuals with documented smoking status were included. Smokers and non-smokers were matched (1:1) by age, gender, index year, body mass index, and physician. The main outcome of the study was the risk of cancer as a function of smoking status. Data regarding a total of 25 cancers were available for the present analysis. The risk of cancer was analyzed using Cox’s regression model.ResultsThe present retrospective study included 211,005 smokers and 211,005 non-smokers. The mean age was 36.5 years (SD = 12.5 years) in men and 34.3 years (SD = 13.1 years) in women. There was a slightly positive association between smoking and any cancer in both men (HR = 1.07) and women (HR = 1.03). Smoking was further found to be positively associated with several cancers, such as liver cancer, bladder and kidney cancers, pancreas cancer, and lymphoma. By contrast, the use of tobacco was negatively associated with the risk of developing skin cancer, prostate cancer, multiple myeloma, endometrial carcinoma, or breast cancer.ConclusionsSmoking increased the overall risk of cancer in primary care practices in the UK. In addition, smoking was predominantly positively and less frequently negatively associated with numerous specific cancers.

Patient-Level Factors Associated with Oncology Provider-Delivered Brief Tobacco Treatment Among Recently Diagnosed Cancer Patients

“…The first multivariable logistic regression model examined associations with receipt of Ask, with the final model significant, X 2 (1) = 4.16, P = .041, –2 Log likelihood (–2LL) = 239.27, Cox and Snell R 2 = .014. Based on univariate analyses, only a diagnosis of a smoking-related cancer was included in the model (odds ratio [OR], 1.97, 95% confidence interval [CI], 1.03-3.79, P = .042), such that patients diagnosed with smoking-related cancers were significantly more likely to report being asked about their smoking.…”

“…7 The important role of clinicians in the tobacco cessation process is highlighted in the United States Preventive Services Task Force's Clinical Practice Guidelines 8 for smoking cessation. Guidelines recommend that healthcare clinicians follow the 5As model of brief tobacco intervention for every visit they have with the patient: (1) ask all patients about their tobacco use, (2) advise all smokers to quit, (3) assess willingness to quit, (4) assist smokers with cessation, including counseling and pharmacotherapy, and (5) arrange follow-up contact for relapse prevention. 8 Despite accumulation of evidence supporting the need for smoking cessation in the context of cancer care, historically, tobacco use has been poorly addressed and cessation assistance infrequently delivered in oncology clinics, with clinician adherence to the 5As sub-optimal.…”

“…Approximately 40% of all cancer diagnoses are smoking-related, and less than half of patients attempt to quit smoking post-diagnosis. 1 – 3 Prevalence estimates of continued smoking among cancer patients range from 12.7% to 16.4%, with rates as high as 31.1% among some cancer types. 4 , 5 These high rates of continued smoking among cancer patients are cause for concern, since persistent smoking post-diagnosis is associated with numerous adverse outcomes, including decreased treatment effectiveness, increased risk of recurrence, and decreased survival.…”

Current and former smokers among adolescents aged 12–17 years in Iran: a systematic review and meta-analysis

“…Smoking is considered as a serious public health concern worldwide and many healthcare planners are making serious efforts in order to reduce cigarette consumption by designing and implementing appropriate strategies in order to control one of the most important factors associated with increased mortality [1,2]. Smoking leads, indeed, to a higher risk of cardiovascular disease, lung disorders as well as several malignancies, including lung, throat, stomach, and bladder cancers [3].…”

Association between smoking and cancers among women: results from the FRiCaM multisite cohort study

“…Cancer accounted for 26% of all deaths in 2013 1 . Tobacco smoke has been recognised as an important risk factor for various human cancers and other chronic diseases, in female population, for several decades [2][3][4] and is considered one of the largest threats to public health worldwide. According to the World Health Organization (WHO), tobacco causes more than seven million deaths each year, of which roughly six million are due to the direct use of tobacco and just below one million are associated with exposure to second-hand smoke 5 .…”