DOI QR코드

DOI QR Code

Ethnic Variation in Consumption of Traditional Tobacco Products and Lung Cancer Risk in Nepal

  • Raspanti, Greg A (Maryland Institute for Applied Environmental Health, University of Maryland College Park School of Public Health) ;
  • Hashibe, Mia (Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine) ;
  • Siwakoti, Bhola (B.P. Koirala Memorial Cancer Hospital) ;
  • Wei, Mei (Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine) ;
  • Thakur, Binay Kumar (B.P. Koirala Memorial Cancer Hospital) ;
  • Pun, Chin Bahadur (B.P. Koirala Memorial Cancer Hospital) ;
  • Milrod, Charles (Maryland Institute for Applied Environmental Health, University of Maryland College Park School of Public Health) ;
  • Adhikari, Subodh (Maryland Institute for Applied Environmental Health, University of Maryland College Park School of Public Health) ;
  • Lee, Yuan-Chin Amy (Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine) ;
  • Sapkota, Amir (Maryland Institute for Applied Environmental Health, University of Maryland College Park School of Public Health)
  • Published : 2015.09.02

Abstract

Lung cancer is the leading contributor to cancer deaths in the developing world. Within countries, significant variability exists in the prevalence of lung cancer risk, yet limited information is available whether some of the observed variability is associated with differences in the consumption pattern of local tobacco products with differing potency. We recruited 606 lung cancer cases and 606 controls from the B.P. Koirala Memorial Cancer Hospital in Nepal from 2009-2012. We estimated odds ratios (ORs) and 95% confidence intervals (CI) for lung cancer risk associated with different tobacco products, using unconditional logistic regression. Unfiltered cigarettes tended to be the most frequently used products across ethnic subgroup with about 53.7% of Brahmins, 60.1% of Chettris, and 52.3% of Rai/Limbu/Magar/others. In contrast, about 39.9% of Madishe/Tharu smokers reported using bidi compared with only 27.7% who smoked unfiltered cigarettes. Among those who only smoked one type of product, choor/kankat smokers had the highest lung cancer risk (OR 10.2; 95% CI 6.2-16.6), followed by bidi smokers (OR 5.6; 95% CI 3.6-8.7), unfiltered cigarettes (OR 4.9; 95% CI 3.4-7.2), and filtered cigarettes (OR 3.4; 95% CI 2.2-5.3). A clear dose-response relationship was observed between increased frequency of smoking and lung cancer risk across all ethnic subgroups. These results highlight the important role of traditional tobacco products on lung cancer risk in the low income countries.

References

  1. Bhagabaty S, Kataki A, Kalita M, et al (2015). Community based intervention for tobacco cessation: a pilot study experience, north East India. Asian Pac J Cancer Prev, 16, 811-4. https://doi.org/10.7314/APJCP.2015.16.2.811
  2. Binu V, Chandrashekhar T, Subba S, et al (2007). Cancer pattern in Western Nepal: a hospital based retrospective study. Asian Pac J Cancer Prev, 8, 183-6.
  3. Chawla R, Sathian B, Mehra A, et al (2010). Awareness and assessment of risk factors for lung cancer in residents of pokhara valley, Nepal. Asian Pac J Cancer Prev, 11, 1789-93.
  4. D'Souza N, Murthy N, Aras R (2013). Projection of cancer incident cases for India -till 2026. Asian Pac J Cancer Prev, 14, 4379-86. https://doi.org/10.7314/APJCP.2013.14.7.4379
  5. Dikshit R, Kanhere S (2000). Tobacco habits and risk of lung, oropharyngeal and oral cavity cancer: a population-based case-control study in Bhopal, India. Int J Epidemiol, 29, 609-14. https://doi.org/10.1093/ije/29.4.609
  6. Ganesh B, Sushama S, Monika S, et al (2011). A case-control study of risk factors for lung cancer in Mumbai, India. Asian Pac J Cancer Prev, 12, 357-62.
  7. Ghosh A, Ghosh T (2009). Modification of Kuppuswamy's socioeconomic status scale in context to Nepal. Indian Pediatrics, 46, 1104-5.
  8. Gupta B, Johnson N (2014). Emerging and established global life-style risk factors for cancer of the upper aero-digestive tract. Asian Pac J Cancer Prev, 15, 5983-91. https://doi.org/10.7314/APJCP.2014.15.15.5983
  9. Gupta B and Kumar N (2014). A cross-country comparison of knowledge, attitudes and practices about tobacco use: findings from the global adult tobacco survey. Asian Pac J Cancer Prev, 15, 5035-42. https://doi.org/10.7314/APJCP.2014.15.12.5035
  10. Gupta D, Boffetta P, Gaborieau V, et al (2001). Risk factors of lung cancer in chandigarh, India. Indian J Med Res, 113, 142-50.
  11. Hashibe M, Siwakoti B, Wei M, et al (2011). Socioeconomic status and lung cancer risk in Nepal. Asian Pac J Cancer Prev, 12, 1083-8.
  12. IARC (2012). http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx
  13. ICF International (2012). Nepal demographic and health survey 2011. http://dhsprogram.com/pubs/pdf/FR257/FR257%5B13April2012%5D.pdf
  14. IOM (2007). Cancer control opportunities in low- and middleincome countries.
  15. Jayalekshmy P, Akiba S, Nair M, et al (2008). Bidi smoking and lung cancer incidence among males in karunagappally cohort in Kerala, India. Int J Cancer, 123, 1390-7. https://doi.org/10.1002/ijc.23618
  16. Jussawalla D and Jain D (1979). Lung cancer in greater bombay: correlations with religion and smoking habits. Br J Cancer, 40, 437-48. https://doi.org/10.1038/bjc.1979.199
  17. Noronha V, Dikshit R, Raut N, et al (2012). Epidemiology of lung cancer in India: focus on the differences between nonsmokers and smokers: a single-centre experience. Indian J Cancer, 49, 74-81. https://doi.org/10.4103/0019-509X.98925
  18. Notani P and Sanghvi L (1974). A retrospective study of lung cancer in Bombay. Br J Cancer, 29, 477-82. https://doi.org/10.1038/bjc.1974.100
  19. Notani P, Rao D, Sirsat M, et al (1977). A study of lung cancer in relation to bidi smoking in different religious communities in Bombay. Indian J Cancer, 14, 115-21.
  20. Pednekar M, Gupta P, Yeole B, et al (2011). Association of tobacco habits, including bidi smoking, with overall and site-specific cancer incidence: results from the mumbai cohort study. Cancer Causes Control, 22, 859-68. https://doi.org/10.1007/s10552-011-9756-1
  21. Peltzer K and Pengpid S (2014). Tobacco use, beliefs and risk awareness in university students from 24 low, middle and emerging economy countries. Asian Pac J Cancer Prev, 15, 10033-8. https://doi.org/10.7314/APJCP.2014.15.22.10033
  22. Pradhananga K, Baral M, Shrestha B (2009). Multi-institution hospital-based cancer incidence data for Nepal: an initial report. Asian Pac J Cancer Prev, 10, 259-62.
  23. Prasad R, Ahuja RC, Singhal S, et al (2010). A case-control study of bidi smoking and bronchogenic carcinoma. Ann Thorac Med, 5, 238-41. https://doi.org/10.4103/1817-1737.69116
  24. Prasad R, Singhal S, Garg R (2009). Bidi smoking and lung cancer. Biosci Trends, 3, 41-3.
  25. Sapkota A, Gajalakshmi V, Jetly D, et al (2008). Indoor air pollution from solid fuels and risk of hypopharyngeal/ laryngeal and lung cancers: a multicentric case-control study from India. Int J Epidemiol, 37, 321-8. https://doi.org/10.1093/ije/dym261
  26. Thapa B, Sayami P (2014). Low lung cancer resection rates in a tertiary level thoracic center in Nepal--where lies our problem? Asian Pac J Cancer Prev, 15, 175-8. https://doi.org/10.7314/APJCP.2014.15.1.175
  27. WHO (2012). http://www.who.int/mediacentre/factsheets/fs297/en/
  28. World Bank (2012). http://data.worldbank.org/country/nepal

Cited by

  1. Trend of Cancer Incidence in Nepal from 2003 to 2012 vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.2171
  2. Passing the “Torches of Freedom”: Smoking Behaviors of Women in Nepal vol.24, pp.3, 2018, https://doi.org/10.1080/13545701.2017.1406192