Time to smoke first morning cigarette and lung cancer in a case-control study

Fangyi Gu, Sholom Wacholder, Stephanie Kovalchik, Orestis A. Panagiotou, Carolyn Reyes-Guzman, Neal D. Freedman, Sara De Matteis, Dario Consonni, Pier Alberto Bertazzi, Andrew W. Bergen, Maria Teresa Landi, Neil E. Caporaso

Research output: Contribution to journalArticlepeer-review


Background Targeting smokers at higher lung cancer risk can improve efficiency and reduce false-positive detection in lung cancer screening. We evaluated whether time to first cigarette after waking (TTFC), a single-item measure of nicotine dependency, could improve stratification of lung cancer risk beyond standard smoking metrics (intensity, duration, and pack-years). Methods In 3249 ever-smokers (n = 1812 case subjects; n = 1437 control subjects) from a population-based case-control study in Italy, we examined the association between TTFC and lung cancer using logistic regression and estimated lung cancer incidence by levels of TTFC, and intensity, duration, and pack-years using absolute risk regression. Significance tests were two-sided. Results Compared with smokers with TTFC greater than 60 minutes, the lung cancer odds ratios for TTFC of 31 to 60 minutes, 6 to 30 minutes, and 5 or fewer minutes (by increasing dependency) were 2.57 (95% confidence interval [CI] = 2.03 to 3.26), 2.27 (95% CI = 1.79 to 2.88), and 3.50 (95% CI = 2.64 to 4.64), respectively (P trend interaction

Original languageEnglish
JournalJournal of the National Cancer Institute
Issue number6
Publication statusPublished - Jun 11 2014

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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