Changing cigarette habits and bladder cancer risk: a case-control study.

With the use of data from the 8,764 subjects in the National Bladder Cancer Study, the separate contribution of various aspects of a person's cigarette smoking history to his increased risk of bladder cancer was estimated. These estimates have not been previously available, owing to the smaller sizes of earlier studies. Our data indicated that people who have only smoked unfiltered cigarettes have higher risks than those who have only smoked filtered cigarettes but that people who have switched from unfiltered to filtered have experienced no reduction in risk. Our data also indicated that smoking cessation substantially reduced the risk. The former smoker appeared to benefit both because he stopped adding to the burden of irreversible damage and because he ceased being exposed to some reversible hazard. Thus the former smoker had a lower risk than the current smoker even though they had smoked the same number of cigarettes daily for the same number of years, but the former smoker's risk remained higher than the risk of a person who never smoked. Our data suggest that one-half of the bladder cancer occurring among men in the United States and one-third of that among women is caused by cigarette smoking.