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Lung cancer risk 40% greater in unfiltered cigarette smokers
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Smoking any type of cigarette is associated with an increased risk for lung cancer incidence and death, but unfiltered cigarettes pose the greatest risk, according to a study published in JAMA Internal Medicine.
Additionally, researchers found that “light” or “ultralight” cigarettes were associated with the same risk for lung cancer mortality as regular cigarettes.
Nichole T. Tanner, MD, MSCR, an associate professor in the department of medicine at the Medical University of South Carolina, and colleagues wrote that despite the creation of low-tar alternatives and filtered cigarettes, “smoking remains responsible for 80% to 90% of lung cancer diagnoses, and 5-year survival is 18%, highlighting the importance of prevention.”
Researchers conducted a secondary analysis of the National Lung Screening Trial. Specifically, they examined the association between baseline cigarette tar level, menthol flavor and filter status and lung cancer incidence and mortality.
Among the 14,123 patients included in the study, 88% smoked filtered cigarettes, 33% smoked light cigarettes and 11.1% smoked ultralight cigarettes. Participants had a history of smoking, on average, 60 packs of cigarettes each year.
Those who smoked unfiltered cigarettes were 40% more likely than those who smoked filtered cigarettes to develop lung cancer (HR = 1.37; 95% CI, 1.1-1.17) and almost twice as likely to die of lung cancer (HR = 1.96; 95% CI, 1.46-2.64).
All-cause mortality was nearly 30% (HR = 1.28; 95% CI, 1.09-1.5) higher among those who smoked unfiltered cigarettes compared with those who smoked filtered cigarettes.
Researchers noted that although the risk was greater in those who smoked unfiltered cigarettes, those who smoked filtered cigarettes are also at a great risk. The study demonstrated lung cancer deaths occur in 1,600 per 100,000 persons who smoked filtered cigarettes compared with just 34 per 100,000 persons who never smoked.
Mortality outcomes did not differ between those who smoked light, ultralight or flavored cigarettes and those who smoked regular cigarettes.
“This study confirms that smoking any type of cigarette conveys serious health risks,” Tanner and colleagues wrote. “Within the context of this study, unfiltered cigarettes are the most dangerous, and individuals who smoke them should be targeted for aggressive tobacco treatment interventions.”– by Erin Michael
Disclosures: Tanner reported grants from the American Cancer Institute during the conduct of the study and grants from Cook Medical, Exact Sciences, Olympus America, and Veracyte outside the submitted work. Please see study for all other authors’ relevant financial disclosures.