Cancer Res Treat.  2018 Oct;50(4):1114-1120. 10.4143/crt.2017.326.

Effect of Smoking Cessation and Reduction on the Risk of Cancer in Korean Men: A Population Based Study

Affiliations
  • 1Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.
  • 2Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Family Medicine, Seoul National University Hospital, Seoul, Korea. keyhoney@gmail.com
  • 4Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

PURPOSE
The purpose of this study was to investigate the effect of smoking habit change on the risk of cancer.
MATERIALS AND METHODS
From the Korean National Health Insurance Service database, we determined the change in smoking habit between the first (2002 and 2003) and second (2004 and 2005) health examination periods. A total of 143,071 men were categorized into baseline heavy (≥ 20 cigarettes per day), moderate (10-19 cigarettes per day), light (< 10 cigarettes per day) smokers, quitters, and never smokers, after which the change in smoking status was determined during the second health examination. The participants were then followed up from 2006 to 2013 for all cancer, smoking related cancer, and lung cancer.
RESULTS
Compared to heavy continual smokers, heavy smokers who quit had reduced risk of smoking related cancer (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.56 to 0.97) and tended to have reduced risk of all cancer (HR, 0.87; 95% CI, 0.75 to 1.00). Moderate smokers who reduced the amount of smoking to light levels had decreased risk of all cancer (HR, 0.82; 95% CI, 0.72 to 0.94), smoking related cancer (HR, 0.74; 95% CI, 0.59 to 0.93), and lung cancer (HR, 0.55; 95% CI, 0.38 to 0.79) compared to heavy continual smokers.
CONCLUSION
Smoking reduction decreases the risk of all cancer, smoking related cancer, and lung cancer. While smoking cessation should be the treatment of choice for smokers, smoking reduction may serve as an alternative strategy for those who cannot quit.

Keyword

Smoking cessation; Smoking reduction; Neoplasms

MeSH Terms

Humans
Lung Neoplasms
Male
National Health Programs
Smoke*
Smoking Cessation*
Smoking*
Tobacco Products
Smoke

Reference

References

1. Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol. 2004; 43:1731–7.
2. Wolf PA, D'Agostino RB, Kannel WB, Bonita R, Belanger AJ. Cigarette smoking as a risk factor for stroke. The Framingham Study. JAMA. 1988; 259:1025–9.
Article
3. Sasco AJ, Secretan MB, Straif K. Tobacco smoking and cancer: a brief review of recent epidemiological evidence. Lung Cancer. 2004; 45 Suppl 2:S3–9.
Article
4. Jung KW, Won YJ, Oh CM, Kong HJ, Lee DH, Lee KH, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer Res Treat. 2017; 49:292–305.
Article
5. Ebbert JO, Yang P, Vachon CM, Vierkant RA, Cerhan JR, Folsom AR, et al. Lung cancer risk reduction after smoking cessation: observations from a prospective cohort of women. J Clin Oncol. 2003; 21:921–6.
Article
6. Altieri A, Bosetti C, Talamini R, Gallus S, Franceschi S, Levi F, et al. Cessation of smoking and drinking and the risk of laryngeal cancer. Br J Cancer. 2002; 87:1227–9.
Article
7. Mulder I, Hoogenveen RT, van Genugten ML, Lankisch PG, Lowenfels AB, de Hollander AE, et al. Smoking cessation would substantially reduce the future incidence of pancreatic cancer in the European Union. Eur J Gastroenterol Hepatol. 2002; 14:1343–53.
Article
8. Hughes JR, Carpenter MJ. Does smoking reduction increase future cessation and decrease disease risk? A qualitative review. Nicotine Tob Res. 2006; 8:739–49.
Article
9. Shiffman S, Gitchell JG, Warner KE, Slade J, Henningfield JE, Pinney JM. Tobacco harm reduction: conceptual structure and nomenclature for analysis and research. Nicotine Tob Res. 2002; 4 Suppl 2:S113–29.
Article
10. Godtfredsen NS, Prescott E, Osler M. Effect of smoking reduction on lung cancer risk. JAMA. 2005; 294:1505–10.
Article
11. Song YM, Sung J, Cho HJ. Reduction and cessation of cigarette smoking and risk of cancer: a cohort study of Korean men. J Clin Oncol. 2008; 26:5101–6.
Article
12. Seong SC, Kim YY, Khang YH, Park JH, Kang HJ, Lee H, et al. Data resource profile: The National Health Information Database of the National Health Insurance Service in South Korea. Int J Epidemiol. 2017; 46:799–800.
13. Lee J, Lee JS, Park SH, Shin SA, Kim K. Cohort profile: The National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea. Int J Epidemiol. 2017; 46:e15.
Article
14. Kwon S. Payment system reform for health care providers in Korea. Health Policy Plan. 2003; 18:84–92.
Article
15. Korean National Health Insurance Corporation. Analysis of 2009 national health screening program. Wonju: Korean National Health Insurance Corporation;2010.
16. Park SM, Yun YH, Kim YA, Jo M, Won YJ, Back JH, et al. Prediagnosis body mass index and risk of secondary primary cancer in male cancer survivors: a large cohort study. J Clin Oncol. 2016; 34:4116–24.
Article
17. Seong SC, Kim YY, Park SK, Khang YH, Kim HC, Park JH, et al. Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea. BMJ Open. 2017; 7:e016640.
Article
18. Warren GW, Alberg AJ, Kraft AS, Cummings KM. The 2014 Surgeon General's report: "The health consequences of smoking: 50 years of progress": a paradigm shift in cancer care. Cancer. 2014; 120:1914–6.
19. Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA. New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol. 2004; 57:1288–94.
Article
20. Godtfredsen NS, Holst C, Prescott E, Vestbo J, Osler M. Smoking reduction, smoking cessation, and mortality: a 16-year follow-up of 19,732 men and women from The Copenhagen Centre for Prospective Population Studies. Am J Epidemiol. 2002; 156:994–1001.
Article
21. Hurt RD, Croghan GA, Wolter TD, Croghan IT, Offord KP, Williams GM, et al. Does smoking reduction result in reduction of biomarkers associated with harm? A pilot study using a nicotine inhaler. Nicotine Tob Res. 2000; 2:327–36.
Article
22. Hatsukami DK, Kotlyar M, Allen S, Jensen J, Li S, Le C, et al. Effects of cigarette reduction on cardiovascular risk factors and subjective measures. Chest. 2005; 128:2528–37.
Article
23. Seo HJ, Oh IH, Yoon SJ. A comparison of the cancer incidence rates between the national cancer registry and insurance claims data in Korea. Asian Pac J Cancer Prev. 2012; 13:6163–8.
Article
24. Sato I, Yagata H, Ohashi Y. The accuracy of Japanese claims data in identifying breast cancer cases. Biol Pharm Bull. 2015; 38:53–7.
Article
Full Text Links
  • CRT
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr