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Tobacco: A Major International Health Hazard. Cigarette Yield and Cancer Risk: Evidence From Case-Control and Prospective Studies

Stellman, Steven D.

INTRODUCTION; The belief that cancer risk can be reduced by lowering the tar yield of cigarettes has been developed from three basic observations: (1) many cancers exhibit a dose-response with respect to the number of cigarettes smoked per day, as shown in Figure 1 (Wynder & Stellman, 1977); (2) cancer risk decreases with number of years of smoking cessation (Fig. 2); (3) tumours can be produced quantitatively in animals using cigarette combustion products (Wynder & Hoffmann, 1967). Although quantitative relationships between cigarette smoking and cancer risk had been developed in both case-control and prospective studies in the 1950s and even earlier, epidemiological confirmation of a specific relationship with cigarette tar yield was not achieved consistently until the late 1960s. Since that time, differences in relative risk have been observed for at least four cancer sites: lung, larynx, oral cavity, and bladder. In this paper we review the data which have led to these conclusions, and discuss some of the similarities and differences in the studies.


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October 6, 2014