Lung cancer among cigar and pipe smokers.

The effect of pipe and cigar smoking on lung cancer risk is reviewed using data from an ongoing hospital-based, case-control study of smoking-related cancers. Data from 2,085 patients with histologically defined lung cancer and 3,948 matched controls interviewed between 1977 and 1984 were analyzed. Cigar and pipe smokers experienced much lower lung cancer risks than cigarette smokers. Risk, expressed as the odds ratio in current smokers of cigarettes only, was 16.0 times that of never smokers (95% confidence intervals, 12.2 to 20.9), 3.1 times that of cigars only (1.8 to 5.6), 1.9 times that of pipes only (0.8 to 4.3), and 2.5 times that of cigars and pipes (1.0 to 6.1). Risks were high in mixed smokers of cigars, pipes, or cigars and pipes, who also smoked cigarettes, odds ratio 10.5 (7.7 to 14.4). Among pipe and/or cigar smokers only, patients with lung cancer were more likely than controls to have been long-time smokers of 5 or more cigars or 5 or more pipefuls per day and to have inhaled. The odds ratio for those smoking 5 to 9 cigars or pipes per day was 3.2 and for those smoking 10 or more units 6.7. The odds ratio of those cigar or pipe smokers who inhaled was 12.3. The proportion of Kreyberg I cancers was higher in cigar and pipe smokers than in cigarette smokers.