Abstract
In 1966, a cohort of White males aged 35 or over, who were policy-holders with the Lutheran Brotherhood Insurance Society (United States), completed a mail questionnaire on tobacco use, diet, and demographic characteristics. During the 20 years of follow-up, 219 lung cancer deaths occurred. Besides the strong relationship with cigarette smoking, we observed an effect on lung cancer risk among current users of cigars or pipes who were nonsmokers of cigarettes (relative risk [RR]=3.5, 95 percent confidence interval[CI]=1.0–12.6) or who were past/occasional users of cigarettes (RR=2.7, CI=1.4–5.3). In addition, elevated risks (from 1.5 to 2.6) of lung cancer were found among craftsmen and laborers, with the highest risks among subjects who worked in the mining or manufacturing industry. No association between current (as of 1966) use of beer or hard liquor and lung cancer was observed, although past users were at elevated risk. An inverse association between lung cancer and intake of fruits was observed, and risks of lung cancer were lower among persons in the highest dietary intake quintiles of vitamins A and C. Except for oranges, however, none of the inverse associations with fruits or dietary nutrients had statistically significant trends. The findings from this cohort study add to the evidence of an adverse effect of cigar/pipe smoking and possibly protective effect of dietary factors on lung cancer risk.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
American Cancer Society. Cancer Facts & Figures. Atlanta, GA: ACS, 1991.
US Department of Health, Education, and Welfare. Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. Bethesda, MD: Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1989; DHHS Pub. No. (CDC) 89–8411.
Higgins ITT, Mahan CM, Wynder EL. Lung cancer among cigar and pipe smokers. Prev Med 1988; 17: 116–28.
Lubin JH, Richter BS, Blot WJ. Lung cancer risk with cigar and pipe use. JNCI 1984; 73: 377–81.
Vineis P, Thomas T, Hayes RB, et al. Proportion of lung cancers in males, due to occupation, in different areas of the USA. Int J Cancer 1988; 42: 851–6.
Colditz GA, Stampfer MJ, Willett WC. Diet and lung cancer: a review of the epidemiologic evidence in humans. Arch Intern Med 1987; 147: 157–60.
Fontham ETH. Protective dietary factors and lung cancer. Int J Epidemiol 1990; 19 (Suppl 1): S32-S42.
Snowdon DA. Alcohol use and mortality from cancer and heart disease among members of the Lutheran Brotherhood cohort. PhD dissertation, University of Minnesota, 1981.
National Center for Health Statistics. Plan and operation of the second National Health and Nutrition Examination Survey, 1976–1980. Vital and Health Statistics. Programs and Collection Procedures. Series 1, No. 15. Hyattsville, MD: US Department of Health and Human Services, 1981.
United States Department of Agriculture. Composition of foods: raw, processed, prepared. Agriculture Handbook Nos 8–1 to 8–10. Washington, DC: US Government Printing Office, 1976–1983.
Preston DL, Kopecky KJ, Kato H. Analysis of mortality and disease incidence among atomic bomb survivors. In: Blot WJ, Hirayama Y, Hoel DG, eds. Statistical Methods in Cancer Epidemiology. Hiroshima, Japan: Radiation Effects Research Foundation, 1985.
Breslow NE, Day NE. Statistical Methods in Cancer Research, Vol. 2. Lyon, France: International Agency for Research on Cancer, 1987; IARC Sci. Pub. No. 82: 120–76.
Bjelke E, Schuman LS, Gart JJ. Dietary factors and lung cancer mortality. The Lutheran Brotherhood Study 1966–1977 (Abstract). Proceedings of the 13th International Cancer Congress. Seattle, Washington, September, 1982: 175.
Wynder EL, Higgins IT, Harris RE. The wish bias. J Clin Epidemiol 1990; 43: 619–21.
Fiore MC, Novotny TE, Pierce JP, et al. Trends in cigarette smoking in the United States. JAMA 1989; 261: 49–55.
Doll R, Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J 1976; 2: 1525–36.
Alderson M. Occupational Cancer. Boston: Butter-worths, 1986: 166–7.
Blot WJ, Fraumeni JF, Jr. The epidemiology of lung and pleural cancer. In: Schottenfeld D, Fraumeni JF Jr, eds. Cancer, Epidemiology, and Prevention. 2nd edn. Philadelphia, PA: W. B. Saunders (in press).
Saftlas AF, Blair A, Cantor KP, et al. Cancer and other causes of death among Wisconsin farmers. Am J Ind Med 1987; 11: 119–29.
Blair A, Malker H, Cantor KP, et al. Cancer among farmers: a review. Scand J Work Environ Health 1985; 11: 397–407.
Blair A, Zahm SH. Cancer among farmers. Occup Med: State of the Art Reviews 1991; 6: 335–54.
Blair A, Grauman DJ, Lubin JH, et al. Lung cancer and other causes of death among licensed pesticide applicatiors. JNCI 1983; 71: 31–7.
McDuffie HH, Klaassen DJ, Cockcroft DW, et al. Farming and exposure to chemicals in male lung cancer patients and their siblings. J Occup Med 1988; 30: 55–9.
Jacobsen BK, Bjelke E, Kvale G, et al. Coffee drinking, mortality, and cancer incidence: results from a Norwegian prospective study. JNCI 1986; 76: 823–31.
Nomura A, Heilbrun LK, Stemmermann GN. Prospective study of coffee consumption and the risk of cancer. JNCI 1986; 76: 587–90.
Mettlin C. Milk drinking, other beverage habits, and lung cancer risk. Int J Cancer 1989; 43: 608–12.
Gibson R, Schuman L, Bjelke E. A prospective study of coffee consumption and mortality from cancer (Abstract). Am J Epidemiol 1985; 122: 520.
International Agency for Research on Cancer. Alcohol Drinking. Lyon, France: IARC, 1988; IARC Monogr Eval Carcinog Risk Humans vol. 44: 232–40.
Potter JD, Sellers TA, Folson AR. Beer and lung cancer in older women: the Iowa Women's Health Study (Abstract). Am J Epidemiol 1990; 132: 784.
Bandera EV, Graham S, Freudenheim JL, et al. Alcohol consumption and lung cancer (Abstract). Am J Epidemiol 1991; 134: 725.
Kolonel LN, Hankin JH, Lee J, et al. Nutrient intakes in relation to cancer incidence in Hawaii. Br J Cancer 1981; 44: 332–9.
Wynder EL, Hebert JR, Kabat GC. Association of dietary fat and lung cancer. JNCI 1987; 79: 631–7.
Xie J, Lesaffre E, Kesteloot H. The relationship between animal fat intake, cigarette smoking, and lung cancer. Cancer Causes Control 1991; 2: 79–83.
Jain M, Burch JD, Howe GR, et al. Dietary factors and risk of lung cancer: results from a case-control study, Toronto, 1981–1985. Int J Cancer 1990; 45: 287–93.
Goodman MT, Kolonel LN, Yoshizawa CN, et al. The effect of dietary cholesterol and fat on the risk of lung cancer in Hawaii. Am J Epidemiol 1988; 128: 1241–55.
Hinds MW, Kolonel LN, Hankin JH, et al. Dietary cholesterol and lung cancer risk in a multi-ethnic population in Hawaii. Int J Cancer 1983; 32: 727–32.
Byers TE, Graham S, Haughey BP, et al. Diet and lung cancer risk: findings from the Western New York Diet Study. Am J Epidemiol 1987; 125: 351–63.
Prentice RL, Sheppard L. Dietary fat and cancer: consistency of the epidemiologic data, and disease prevention that may follow from a practical reduction in fat consumption. Cancer Causes Control 1990; 1: 81–97.
Heilbrun LK, Nomura AMY, Stemmermann GN. Dietary cholesterol and lung cancer risk among Japanese men in Hawaii. Am J Clin Nutr 1984; 39: 375–9.
Shekelle RB, Rossof AH, Stamler J. Dietary cholesterol and incidence of lung cancer: the Western Electric Study. Am J Epidemiol 1991; 134: 480–4.
Bjelke E. Dietary vitamin A and human lung cancer. Int J Cancer 1975; 15: 561–5.
Ziegler RG. Epidemiologic studies of vitamins and cancer of the lung, esophagus, and cervix. Adv Exp Med Biol 1986; 206: 11–26.
Willett W. Vitamin A and lung cancer. In: Willett W. Nutritional Epidemiology. New York: Oxford University Press, 1990.
Ziegler RG, Mason TJ, Stemhagen A, et al. Carotenoid intake, vegetables, and the risk of lung cancer among White men in New Jersey. Am J Epidemiol 1986; 123: 1080–93.
Hinds MW, Kolonel LN, Hankin JH, et al. Dietary vitamin A, carotene, vitamin C, and risk of lung cancer incidence in Hawaii. Am J Epidemiol 1984; 119: 227–36.
Fontham ETH, Pickle LW, Haenszel W, et al. Dietary vitamins A and C and lung cancer risk in Louisiana. Cancer 1988; 62: 2267–73.
LeMarchand L, Yoshizawa CN, Kolonel LN, et al. Vegetable consumption and lung cancer risk: a population-based case-control study in Hawaii. JNCI 1989; 81: 1158–64.
Wu AH, Henderson BE, Pike MC, et al. Smoking and other risk factors for lung cancer in women. JNCI 1985; 74: 747–51.
Knekt P, Jarvinen R, Seppanen R, et al. Dietary antioxidants and the risk of lung cancer. Am J Epidemiol 1991; 134: 471–9.
Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control 1991; 2: 325–57.
Wang L, Hammond EC. Lung cancer, fruit, green salad and vitamin pills. Chinese Med J 1985; 98: 206–10.
Fraser GE, Beeson WL, Phillips RL. Diet and lung cancer in California Seventh-day Adventists. Am J Epidemiol 1991; 133: 683–93.
Henson DE, Block G, Levine M. Ascorbic acid: biologic functions and relation to cancer. JNCI 1991; 83: 547–50.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chow, WH., Schuman, L.M., McLaughlin, J.K. et al. A cohort study of tobacco use, diet, occupation, and lung cancer mortality. Cancer Causes Control 3, 247–254 (1992). https://doi.org/10.1007/BF00124258
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00124258