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Online Program

325699
Interactions between lifestyle factors and active and passive exposure to tobacco smoke on the risk of lung cancer in a Chinese population


Monday, November 2, 2015 : 8:30 a.m. - 8:48 a.m.

Jin-Yi Zhou, Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Claire Kim, MPH, Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles (UCLA), Los Angeles, CA
Ren-Qiang Han, Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Zi-Yi Jin, Jiangyin City Center for Disease Control and Prevention, Jiangyin, China
Xiao-Feng Zhang, Ganyu County Center for Disease Control and Prevention, Lianyungang, China
Xu-Shan Wang, Ganyu County Center for Disease Control and Prevention, Lianyungang, China
Ai-Ming Liu, Dafeng County Center for Disease Control and Prevention, Yancheng, China
Li-Ming Li, MD, School of Public Health Science Studies, Peking University Health Science Center, Beijing, China
Qing-Yi Lu, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
Lina Mu, M.D., Ph.D., Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
Ming Wu, Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Jin-Kou Zhao, Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
Zuo-Feng Zhang, PhD MD, Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles (UCLA), Los Angeles, CA
Audio (mp3) recording Recorded Presentation (mp4)
Background     Exposure to tobacco smoke is the strongest risk factor for lung cancer. Other known or putative lifestyle factors associated with lung cancer include indoor air pollution, dietary habits, and other lifestyle factors. However, the relationships between lifestyle factors and active and passive exposures to tobacco smoke in the development of lung cancer are not well understood. The aim of this study was to investigate the interactions between various lifestyle factors and active and passive exposure to tobacco smoke on lung cancer development.

Methods           A population-based case-control study was conducted in Jiangsu Province of China from 2003 to 2010. There were 2,871 lung cancer cases and 8,019 healthy controls. We used multivariate unconditional logistic regression to estimate adjusted odds ratios (aOR) and their 95% confidence intervals (CI) and evaluated multiplicative and additive interactions.

Results             Active and passive smoking were each associated with increased odds of lung cancer (aOR=2.74, 95% CI: 2.46-3.06 and aOR=1.62, 95% CI: 1.27-2.06, respectively). Monotonic dose-response relations were observed for duration and intensity of passive smoking (aOR for passive smoking of at least 20 years=2.00, 95% CI: 1.54-2.59; aOR for heavy exposure=2.06, 95% CI: 1.55-2.74). Use of coal for cooking was positively associated with lung cancer (aOR=1.37, 95% CI: 1.23-1.53). Use of solid fuel for heating was associated with increased odds of lung cancer among smokers only (OR=1.25, 95% CI: 1.08-1.44) and showed multiplicative interaction with smoking status, with a ratio of ORs (ROR) of 1.24 (95% CI: 1.02-1.51). Fruit and vegetable intake was not significantly associated with lung cancer whereas raw garlic consumption showed an inversely relation (aOR=0.78, 95% CI: 0.78-0.91).  Inverse associations with lung cancer were also observed among never smokers for ethanol consumption of less than 250 ml/week (aOR=0.70, 95% CI: 0.51-0.96) and green tea consumption, which was more apparent among those ever exposed to passive smoking (aOR=0.52, 95% CI: 0.32-0.86) than among those never exposed (aOR=0.83, 95% CI: 0.53-1.31; ROR=2.02, 95% CI: 1.08-3.80).

Conclusions     Lifestyle factors may modify the effects of active and passive exposure to tobacco smoke on the development of lung cancer. Our findings offer new options for lung cancer prevention, especially among non-smokers in China.

Learning Areas:

Environmental health sciences
Epidemiology

Learning Objectives:
Assess the interactions between lifestyle factors and active and passive exposure to tobacco smoke on lung cancer development.

Keyword(s): Tobacco Use, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am writing a doctoral dissertation on the epidemiology of environmental tobacco smoke and lung cancer. I have published one paper on this topic as first author in the International Journal of Cancer.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3034.0: Recent Findings in Cancer Epidemiology