Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis

Julien Berthiller, Kurt Straif, A. Agudo, W. Ahrens, A. Bezerra Dos Santos, S. Boccia, Gabriella Cadoni, Cristina Canova, X. Castellsague, C. Chen, Daniel Conway, Maria Paula Curado, L. Dal Maso, Alexander W. Daudt, Eleonora Fabianova, L. Fernandez, Silvia Franceschi, Erica E Fukuyama, R. B. Hayes, C. HealyR. Herrero, I. Holcatova, K. Kelsey, Kristina Kjaerheim, S. Koifman, Pagona Lagiou, C. L. Vecchia, Philip Lazarus, F. Levi, Jolanta Lissowska, T. V. Macfarlane, D. Mates, M. McClean, A. Menezes, F Merletti, Hal Morgenstern, J. Muscat, Andrew F. Olshan, Mark P. Purdue, H. Ramroth, Peter Rudnai, Stephen M. Schwartz, D. Serraino, Oxana Shangina, E. Smith, Erich M. Sturgis, Neonilia Szeszenia-Dabrowska, P. Thomson, Thomas L. Vaughan, Marta Vilensky, Eric Q. Wei, D. M. Winn, V. Wunsch-Filho, Z. F. Zhang, Ariana Znaor, G. Ferro, P. J. Brennan, P. Boffetta, Mia Hashibe, C. Y. Lee

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Cigarette smoking is a major risk factor for head and neck cancer (HNC). To our knowledge, low cigarette smoking (0-3, >3-5, >5-10 cigarettes per day. RESULTS: Smoking >0-3 cigarettes per day was associated with a 50% increased risk of HNC in the study population [odds ratio (OR) = 1.52, 95% confidence interval (CI): (1.21, 1.90). Smoking >3-5 cigarettes per day was associated in each subgroup from OR = 2.01 (95% CI: 1.22, 3.31) among never alcohol drinkers to OR = 2.74 (95% CI: 2.01, 3.74) among women and in each cancer site, particularly laryngeal cancer (OR = 3.48, 95% CI: 2.40, 5.05). However, the observed increased risk of HNC for low smoking frequency was not found among smokers with smoking duration shorter than 20 years. CONCLUSION: Our results suggest a public health message that low frequency of cigarette consumption contributes to the development of HNC. However, smoking duration seems to play at least an equal or a stronger role in the development of HNC.
Original languageEnglish
Pages (from-to)835-845
Number of pages11
JournalInternational Journal of Epidemiology
Issue number3
Publication statusPublished - Jun 1 2016


  • Head and neck cancer
  • low frequency cigarette smoking
  • pooled analysis
  • risk factors


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