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Chapter 5 Annex: Health Effects Evidence Tables
Chapter 5 Annex: Health Effects Evidence Tables
Pages 279-312
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From page 279... ...
Chapter 5 Annex Health Effects Evidence Tables These tables provide descriptive and methodological information on the studies cited in Chapter 5 that studied primary cigar smokers for all-cause mortality, cardiovascular disease, lung cancer and respiratory illness, oral health and head/neck cancer, and other cancers. The findings and results are discussed in the chapter proper (see Chapter 5 reference list for full citations)
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From page 280... ...
Outcomes Factors Results Definition Intensity Chang et al., Seven studies Systematic All-cause and All studies Primary cigar smoking associ- Current Intensity (cigars 2015 contained review cause-specific adjusted for ated with all-cause mortal- cigar use.
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From page 281... ...
mortality among current 2005, and primary cigar smokers. Risk 2010 and of mortality associated with followed to current primary cigar smoking 2015 was lower than observed for cigarettes; it increased sig nificantly with more frequent cigar smoking (daily versus nondaily)
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From page 282... ...
Outcomes Factors Results Definition Intensity Rodu and N = 14,657 Pooled Mortality as- Age, race/ Increased risk of mortal- Never cigar Lack of information Plurphan- deaths, 176 analysis sociated with ethnicity, ity among current primary smokers de- about frequency swat, 2021 exclusive cigar from the cigar use marital status, cigar smokers, not statistically fined as and duration of PMID: user deaths Integrated educational significant (IRR: 1.02; 95% CI: never smoked consumption for 33413424 Public attainment, 0.86–1.23) at least 50 current smokers and Use Micro- family in- cigars in the number of years data Series come, region their lifetime.
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From page 283... ...
Thomson N = 109,395, Prospective Cause-specific Age (in 5-year Compared to never-smokers, Ever cigar Cigars smoked et al., 2020 2,535 primary study mortality groups of age primary cigar smoking was smokers per day in the past PMID: cigar smokers at risk, 30–69 associated with increased all- month 32446350 (Cuba) Study years)
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From page 284... ...
Outcomes Adjusted Factors Results Definition Intensity Chang et al., Seven stud- Systematic All-cause and All studies ad- Slight and generally Current cigar Intensity (cigars 2015 ies contained review cause-specific justed for age nonsignificant increased use. Cigar type per day)
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From page 285... ...
daily and 531 Partici- circulatory, cigar smokers compared to daily. Seventy- pants were cardiovas- never-tobacco users -- ef two CVD deaths identified cular, and fects became nonsignificant in former cigar in 1985, cerebrovascu- in multivariable analysis users, 53 in cur- 1992, 1995, lar causes controlling for sex, race and rent.
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From page 286... ...
Outcomes Adjusted Factors Results Definition Intensity Iribarren et N = 17,774 men Prospective CVD, both Age adjusted for Cigar smoking was associ- No data were None al., 1999 30–85 years old, cohort nonfatal and all study out- ated with a significantly available on PMID: followed for fatal, was comes; Covari- increased risk of coronary type of cigar, 10362820 25 years; 1,546 Kaiser determined ates included heart disease compared to but it was esti male current Health from hospital in multivariate never smokers (RR: 1.27; mated that 21% cigar users system in discharge analyses of the 1.12–1.45)
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From page 287... ...
Multivariable analysis: Current cigar Statistical power 1999 men, 2,508 cohort coronary age, race, marital rate ratio for coronary heart smokers had was limited so duPMID: deaths heart disease status, education, disease mortality: 1.30 (95% never smoked ration, frequency, 10665889 Study Pe- alcohol use, BMI, CI: 1.05–1.62) for current ci- cigarettes, and and inhalation riod: 1982 exercise level, gar smokers aged 30–74 but the majority patterns could to 1991 self-reported not significantly increased smoked at least not be measured hypertension, for those 75+.
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From page 288... ...
Outcomes Adjusted Factors Results Definition Intensity Inoue-Choi N = 165,335 Prospective All-cause and Adjusted for sex, Risk of coronary heart Former, current, Daily versus et al., 2019 adults; 1,595 cohort cause-specific education level disease mortality was current daily, nondaily users; PMID: exclusive cigar mortality, in- ( |
From page 289... ...
However, former primary defined as hav 2005, 2010, or stroke cigar smoking was associ- ing smoked at and 2015 ated with an increased risk least 50 cigars of heart conditions (aPR: but currently 1.33; 95% CI: 1.03–1.72) not smoking and stroke (aPR: 2.42; 95% at all.
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From page 290... ...
Outcomes Adjusted Factors Results Definition Intensity Wald and N = 21,520 men Prospective Risk of dy- Adjusted for age 1) Carboxyhemoglobin Compared None Watt, 1997 cohort ing from at entry of the levels: secondary cigar primary to PMID: lung cancer, study smokers had higher levels secondary 9224127 Study ischemic heart than primary smokers (1.0% cigar smokers period: disease, ob- versus 0.9%)
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From page 291... ...
. NOTE: aPR = adjusted prevalence ratio; BMI = body mass index; CI = confidence interval; CPS-II = Cancer Prevention Study II; CVD = cardiovascular disease; g = gram; HR = hazard ratio; RR = relative risk.
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Outcomes Factors Results Definition Intensity Boffetta et N = 120 (43 cases Pooled case Lung cancer Adjusted for 1) Adjusted OR for smoking Smokers (exclu- Intensity (consumpal., 1999 and 77 controls)
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From page 293... ...
, nondaily users 30 days riod: Partici- school, some 2) 1.87 (95% CI: 0.53–6.55 of any cigar pants were college or for current cigar smokers, enrolled in associated de- 3)
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From page 294... ...
For lung cancer, the Exclusive Inhalation, duration, et al., 2010 sive cigar users cohort BMI, alcohol adjusted HR among current cigar and pipe cigars per week, PMID: with 22 lung history, exclusive cigar smokers smoking and cigar size 20162568 cancer cases Study Period: and educa- was significant at 3.9 and in combination 1991–1998 to tional level, 2.4 (95% CI: 0.7–8.2) among with cigarettes 2003–2006 stratified by every cigar smokers.
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. NOTE: BMI = body mass index; CI = confidence interval; COPD = chronic obstructive pulmonary disease; HR = hazard ratio; OR = odds ratio.
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From page 296... ...
Outcomes Factors Results Definition Intensity Iribarren et N = 17,774; 1,546 Prospective Cancers Age, race, 1) Cancer of the orophar- Never smoked Did not assess al., 1999 exclusive current cohort study of UADT BMI, diabetes ynx: Current exclusive cigar cigarettes and duration of cigar PMID: cigar smokers (oropharynx, status, smoking: age-adjusted rate: did not cur- smoking; unable to 10362820 Study nose, larynx, alcohol con- 2.0 per 10,000 person-years rently smoke a separate occasional Period: and esopha- sumption, (adjusted RR: 2.61; 95% CI: pipe; cigar type cigar smokers (those 1971–1996 gus)
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From page 297... ...
Malhotra N = 6,622 cigar Pooled anal- Cancers of Adjusted for Subgroup analysis that Ever and exclu- None et al., 2017 smokers across ysis of five head and age at enroll- included the two cohort sive use of any PMID: five studies prospective neck ment, BMI, studies with the most cigar 28972007 cohort stud- race/ethnic- detailed data on frequency ies from the ity, SES, race/ and duration of tobacco NCI Cohort ethnicity, use, exclusive cigar smok Consortium alcohol use, ers with no history of family history cigarette smoking had an Study of cancer elevated risk of head and Period: Five neck cancer (HR: 2.59; 95% studies with CI: 1.21–5.58) different enrollment dates (and median duration of follow-up)
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From page 298... ...
were too sparse for 10675383 cigar smokers Study Pe- or chewing among current cigar detailed analysis by riod: 1982 to tobacco smokers and 2.4 (95% CI: number of cigars per 1994 0.8–7.3) among former cigar day)
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From page 299... ...
and all other sites. NOTE: BMI = body mass index; CI = confidence interval; HR = hazard ratio; INHANCE = International Head and Neck Cancer Epidemiology; IRR = incidence rate ratio; NCI = National Cancer Institute; OR = odds ratio; RR = relative risk; SES = socioeconomic status; UADT = upper 299 aerodigestive tract.
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Outcomes Factors Results Definition Intensity Krall et al., N = 690 (50 cigar Prospective Radiographic Age, educa- 1) Cigar smokers had Exclusive cigar None 1999 smokers)
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NOTE: CI = confidence interval; OR = odds ratio; RR = relative risk.
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Outcomes Factors Results Definition Duration, Intensity Alguacil N = 46 (9 cases Case control Pancreatic Adjusted by Adjusted OR for cigar-only Regular cigar None and and 37 controls) cancer risk race, gender, smokers was 1.9 (95% CI: use of any cigar Silverman, Study geographic 0.8–4.3)
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From page 303... ...
leukemia, na sal and sinus, oral cavity, pancreas, pharynx, rectum, stom ach, tongue, ureter, and uterus Bracci and N = 9 patients, Case control NHL Adjusted for 1) The age-adjusted OR Ever use of any None Holly, 2005 15 controls incidence, age for NHL was 1.3 (95% CI: cigar PMID: Study overall and by 0.54–3.0)
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From page 304... ...
Outcomes Factors Results Definition Duration, Intensity Chang Two studies con- Systematic Mortality All studies Esophageal: Current cigar Intensity (cigars et al., 2015 tained primary review from adjusted for 1) The adjusted IRR for cigar- use; cigar type per day)
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Mortality ratios for BC were 0.94–1.9 for current cigar smoking. 305 continued
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Outcomes Factors Results Definition Duration, Intensity Christensen N = 3,537 exclu- Prospective Tobacco-re- Adjusted for 1) The adjusted HR for current Current or Intensity (daily et al., 2018 sive cigar with cohort lated cancers age, sex, race/ cigar smokers was 1.61 (95% former use of versus nondaily PMID: 32 deaths from (bladder, ethnicity, edu- CI: 1.11–2.32)
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From page 307... ...
included 83 ity; renal cell authors ex- incident BC was similar for studies on cancer (not tracted the es- pipe smokers (RR: 1.49; 95% BC between reported here, timates from CI: 1.18–1.88) but lower than 1987 and as no primary the maximally the risk for cigarette smokers August cigar smokers adjusted (RR: 3.37; 95% CI: 3.01–3.78)
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From page 308... ...
Outcomes Factors Results Definition Duration, Intensity Inoue-Choi N = 165,335 Prospective BC mortality Adjusted for Compared to never-tobacco Former, current, Daily versus et al., 2019 adults; 1,595 cohort sex, education users, HRs for BC mortality current daily, nondaily users; PMID: exclusive cigar level, race or were 5.68 (95% CI: 0.74–43.69) current non- number of days 31321380 users Study ethnicity, and for current exclusive cigar daily, nondaily, smoked last 30 Period: survey year smokers, 4.65 (2.65–8.17)
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From page 309... ...
HRs for incidence of BC were 1.14 (95% CI: 0.88–1.48) for ever cigar smokers only and 1.40 (95% CI: 1.07–1.84)
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From page 310... ...
for exclusive in combination cases, 33 upper Period: creas, kidney, tional level, cigar smokers. The study found with cigarettes aerodigestive Recruitment colorectal stratified by no significant associations for tract (UADT)
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was controls ies from exposure and 3.5 (95% CI: 2.9–4.2) for ascertained in all Denmark, primary cigarette smoking studies.
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From page 312... ...
A slight trend for cigars per day and duration may exist. NOTE: BC = bladder cancer; BMI = body mass index; CI = confidence interval; COPD = chronic obstructive pulmonary disease; HR = hazard ratio; IRR = incidence rate ratio; NCI = National Cancer Institute; NHL = non-Hodgkin lymphoma; OR = odds ratio; RR = relative risk; SES = socioeconomic status; UADT = upper aerodigestive tract.
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