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. 2022 Aug 26:20:71.
doi: 10.18332/tid/152137. eCollection 2022.

Smoking trajectory and cancer risk: A population-based cohort study

Minh N Luu  1   2 , Minji Han  1   3 , Tra T Bui  1 , Phuong Thao T Tran  1 , Min-Kyung Lim  4 , Jin K Oh  1   3
Affiliations

Smoking trajectory and cancer risk: A population-based cohort study

Minh N Luu et al. Tob Induc Dis. .

Abstract

Introduction: Smoking behavior can change with time and lead to different health outcomes. This study explored the trajectory of smoking and its relationship with cancer incidence and mortality among Korean male adults.

Methods: We used 2002-2018 data from the National Health Insurance Service (NHIS). Smoking status was repeatedly measured in four waves of general health examinations provided by the NHIS between 2002 and 2009. Cancer incidence and mortality were tracked from 2010 to 2018. Trajectory analysis was used to identify the patterns of smoking. The hazard ratio was calculated using Cox proportional regression models.

Results: For the 2448548 men (≥20 years), 137788 cases of cancers and 41146 cancer deaths were found. We identified six trajectory groups: never smokers, former smokers, new current smokers, decreasing light smokers, steady moderate smokers, and steady heavy smokers. All smoking groups had an increased risk of cancer. The steady heavy smokers showed higher cancer incidence and mortality rate than the steady non-smokers (hazard ratio, HR=1.53; 95% CI: 1.49-1.58 and HR=2.64; 95% CI: 2.50-2.79, respectively). The cancer-specific analysis showed that the larynx and lung cancer incidence and mortality rate of the smoking group were higher than in never smokers.

Conclusions: Smoking, even at low doses, increases the risk of most cancers in men. Quitting or reducing smoking, especially at a young age, can lower cancer incidence and mortality. This study may provide more objective results on the relationship between smoking and cancer, because smoking behavior was examined at multiple time points.

Keywords: cancer risk; population-based study; smoking trajectory.

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Conflict of interest statement

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.

Figures

Figure 1
Figure 1
Flow diagram of the selection of study participants
Figure 2
Figure 2
Smoking trajectory groups
See this image and copyright information in PMC

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