Secondhand Smoke Enhances Lung Cancer Risk in Male Smokers: An Interaction
Secondhand Smoke Enhances Lung Cancer Risk in Male Smokers: An Interaction
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DOI：
10.1093/ntr/ntw115
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发表时间：
2016-11-01
影响因子：
4.7
通讯作者：
Yu, Ignatius Tak-Sun
中科院分区：
文献类型：
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作者：
Li, Wentao;Tse, Lap Ah;Yu, Ignatius Tak-Sun
此前的研究表明，一些室内空气污染物和细颗粒物可能与主动吸烟相互作用，增加吸烟者患肺癌的风险。二手烟（SHS）与主动吸烟有显着差异，它对室内空气污染有显着影响，并产生大量细颗粒物，可能与主动吸烟产生类似的相互作用。在这项病例参考研究中，收集了有关终生二手烟以及主动吸烟和其他已确诊或疑似肺癌危险因素的信息。对不同 SHS 水平中吸烟状况的比值比和 95% 置信区间 (95% CI) 进行了评估。探讨了潜在的乘性和加性相互作用。与没有接受过 SHS 的从不吸烟者相比，暴露于高水平 SHS 的当前吸烟者表现出最高的比值比（15.13，95% CI：8.60，26.65），几乎是目前没有接受过 SHS 的吸烟者的两倍。对于所有肺癌（协同指数 = 1.80，95% CI：1.02，3.24）和鳞癌亚组，当前吸烟与高水平二手烟之间存在显着的相加相互作用。高水平二手烟暴露大大增加了当前吸烟者患肺癌的风险，这与相加相互作用一致；而这种相互作用在鳞状癌中占主导地位。研究结果为推动全球戒烟的合理性提供了新的证据。一些室内空气污染物可以与主动吸烟相互作用，产生协同作用，诱发肺癌。二手烟与主动吸烟有明显不同，它是室内空气污染的主要来源。然而，关于二手烟对吸烟者的影响以及二手烟和主动吸烟之间是否存在类似的相互作用，人们知之甚少。在这项研究中，我们评估了它们的单独和联合效应，确实发现它们之间的相互作用不仅仅是相加的。这一发现表明场地限制政策可能加剧聚集吸烟的潜在问题，并重新倡导戒烟政策。
Previous studies revealed that some indoor air pollutants and fine particle matter can interact with active smoking, enhancing lung cancer risk in smokers. Secondhand smoke (SHS), with remarkable differences from active smoking, contributes significantly to indoor air pollution and generates a considerable amount of fine particle matter, may cause a similar interaction with active smoking.Information on lifetime SHS along with active smoking and other confirmed or suspected risk factors for lung cancer was collected in this case-referent study. Odds ratios and the 95% confidence intervals (95% CIs) of smoking status in different levels of SHS were evaluated. Potential multiplicative and additive interactions were explored.Compared with never-smokers without SHS, current smokers who were exposed to a high level of SHS demonstrated the highest odds ratio (15.13, 95% CI: 8.60, 26.65), almost doubles the effect in the current smokers without SHS. Significant additive interactions between current smoking and high level of SHS were observed for all lung cancers (synergy index = 1.80, 95% CI: 1.02, 3.24) and the squamous carcinoma subgroup.High level of SHS exposure greatly enhanced lung cancer risk among current smokers, consistent with an additive interaction; while this interaction was predominant for the squamous carcinoma. The results provide new evidence to the rationale of promoting global smoking cessation.Some indoor air pollutants can interact with active smoking, yielding a synergistic effect on inducing lung cancer. SHS, with noticeable differences from active smoking, is a major source of indoor air pollution. However, little has been known about the effect of SHS in smokers and whether there is a similar interaction between SHS and active smoking. In this study, we evaluated their separate and joint effects and indeed found a more than additive interaction between them. This finding suggests a potential problem of gathering smoking aggravating by venue restriction policies and re-advocates policy efforts on smoking cessation.