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Table 1

Results reported by studies evaluating the effect of total alcohol consumption on lung cancer risk

Study and locationStudy sizea and locationSmoking adjustmentComparisonOR/RR (95% CI or P)
Case control studies     
Kabat and Wynder, 1984 (10) 37/37 M NAb (Never smokers) No difference in alcohol consumption found Not presented 
 97/97 F    
 (U.S.)    
Koo, 1988 (37) 88/137 F (China) NA (Never smokers) Drinking ≥1 times/wk (yes/no) 1.8 (0.9–3.7) 
Restrepo et al., 1989 (16) 102/181 M and F (Colombia) Cigarettes/day Nondrinker 1.0 
   Former drinker 0.6 (P > 0.05) 
   Occasional drinker 0.9 (P > 0.05) 
   Habitual drinker 1.1 (P > 0.05) 
Pierce et al., 1989 (15) 71/71 M (Australia) “Smoking pattern” (smoking prevalence, time since cessation of smoking and cigarettes/day) Drinks/wk (continuous variable) 1.0 (0.99–1.01) 
   Duration, yr (continuous variable) 1.0 (0.96, 1.03) 
Bandera et al., 1992 (20) 280/564 white M (U.S.) Smoking history (pack-yr) >22 drinks/mo vs. drinking less (>40 pack-yr cigarette smoking) 
    1.6 (1.0–2.5) (No association for light smokers) 
De Stefani et al., 1993 (24) 327/350 M (Uruguay) Pack-yr in four categories Nondrinker vs. ml of pure ethanol/dayc  
   1–60 ml 1.4 (0.9–2.0) 
   61–176 1.6 (0.9–2.0) 
   >176 2.2 (1.3–3.0) 
    P for trend: 0.002 
Dosemeci et al., 1997 (29) 1,210/829 M (Turkey) Smoking categories (never, <20 pack-yr, 20–29 pack-yr, >29 pack-yr) vs. nondrinker  
   Amount (cl/wk)  
   1–35 1.6 (0.8–2.9) 
   36–140 1.7 (1.1–2.7) 
   >141 1.7 (1.7–2.9) 
    P for trend <0.001 
Carpenter et al., 1998 (31) 261/615 M and F (U.S.) Indicator variables for pack-yr and yr since quitting smoking Never-3 drinks/mo vs. >3 drinks/day 1.1 (0.5–2.4) 
Cohort studies     
Kvale et al., 1983 (9) 116/10,602 M Never-, ex- and current smokers of 1–9, 10–19, and ≥20 cigarettes/day Highest tertile of alcohol consumption vs. lowest All subjects: 1.3 (P = 0.37) 
 11.5 follow-up (Norway)   Low vitamin A consumers: 3.6 (P = 0.03) 
Gordon and Kannel, 1984 (40) 42/2,106 M Cigarettes/day oz/mo as continuous variable 1.0 (P > 0.05) M 
 9/2,641 F   0.7 (P > 0.05) F 
 22 yr follow-up (Framingham Study, U.S.)    
Pollack et al., 1984 (11) 89/7,837 M Smoking status (oz/mo based on usual consumption during 1 mo at baseline) (CI or P not shown) 
 14-yr follow-up (Japan-Hawaii Cancer Study, Hawaii) Adjustment for amount smoked did not change estimates   
   None 1.0 
   <5 0.7 
   5–14 1.3 
   15–39 1.7 
   >39 (or >1.18 l./mo) 1.9 
    P for trend: 0.003 
Kono et al., 1986, 1987 (12, 41) 74/5,477 M Non, ex- and current smokers of <10, 10–19, ≥20 cigarettes day Nondrinker 1.0 
 19-yr follow-up (Japanese Physicians Study, Japan)  Ex-drinker 0.6 (0.2–1.5) 
   Occasional drinker 0.4 (0.2–0.8) 
   Daily drinker of  
   <54 ml of alcohol 0.8 (0.4–1.4) 
   ≥54 ml of alcohol 0.9 (0.5–1.7) 
Stemmermann et al., 1990 (18) 209/8,006 M Current smoking status, age started smoking and no. of cigarettes/day (current smokers), ex-smoker status, maximum no. of cigarettes/day and yr smoking maximum amount (ex-smokers) (oz/mo based on 24-h recall)  
 22-yr follow-up (Japan-Hawaii Cancer Study, Hawaii)  1.0 
   <5 0.7 (0.5–1.2) 
   5–14 0.9 (0.6–1.5) 
   15–39 1.4 (1.0–2.1) 
   >39 1.1 (0.7–1.6) 
    P for trend 0.09 
Bandera et al., 1997 (28) 395/27,544 M Cigarettes/day and yr smoking Highest vs. lowest tertile of consumption  
 130/20,456 F   1.1 (0.9–1.4) M 
 8 yr   P for trend: 0.001 
 (New York State Cohort Study, U.S.)   1.0 (0.6–1.6) F 
    P for trend: 0.8 
    (Squamous cell carcinoma cases) 
    1.5 (0.97–2.3) 
Cohort studies (cont’d)     
Prescott et al., 1999 (32) 480/15,107 M Six categories of present smoking and eight categories of duration of smoking (Best fit based on likelihood ratio test) No. of drinks/wk: (M) 
 194/13,053 F  <1 1.0 
 (Copenhagen City Heart Study, the Centre of Preventive Medicine, and the Copenhagen Male Study, Denmark)  1–6 0.8 (0.6–1.2) 
   7–13 1.0 (0.7–1.4) 
   14–20 0.9 (0.6–1.3) 
   21–41 1.2 (0.9–1.7) 
   >41 1.6 (1.1–2.3) 
    P for trend: 0.002 
    (No relationship for F) 
Woodson et al., 1999 (33) 1059/27,111 M smokers Cigarettes smoked per day and total yr smoked Nondrinker vs. drinker 1.2 (0.9–1.4) 
 7.7 yr (ATBC Study, Finland)  Highest quartile of drinking vs. lowest quartile of g/day) 1.0 (0.8–1.2) 
    (Adenocarcinoma) 
    1.7 (1.0–2.8) 
Breslow et al., 2000 (34) 158/20,004 M and F 8.5 yr (U.S.) Packs/day and duration of smoking as continuous variables Highest quartile of alcohol intake compared with lowest 1.3 (0.8–2.0) 
    (Nonsmokers) 
    2.3 (1.1–4.6) 
Study and locationStudy sizea and locationSmoking adjustmentComparisonOR/RR (95% CI or P)
Case control studies     
Kabat and Wynder, 1984 (10) 37/37 M NAb (Never smokers) No difference in alcohol consumption found Not presented 
 97/97 F    
 (U.S.)    
Koo, 1988 (37) 88/137 F (China) NA (Never smokers) Drinking ≥1 times/wk (yes/no) 1.8 (0.9–3.7) 
Restrepo et al., 1989 (16) 102/181 M and F (Colombia) Cigarettes/day Nondrinker 1.0 
   Former drinker 0.6 (P > 0.05) 
   Occasional drinker 0.9 (P > 0.05) 
   Habitual drinker 1.1 (P > 0.05) 
Pierce et al., 1989 (15) 71/71 M (Australia) “Smoking pattern” (smoking prevalence, time since cessation of smoking and cigarettes/day) Drinks/wk (continuous variable) 1.0 (0.99–1.01) 
   Duration, yr (continuous variable) 1.0 (0.96, 1.03) 
Bandera et al., 1992 (20) 280/564 white M (U.S.) Smoking history (pack-yr) >22 drinks/mo vs. drinking less (>40 pack-yr cigarette smoking) 
    1.6 (1.0–2.5) (No association for light smokers) 
De Stefani et al., 1993 (24) 327/350 M (Uruguay) Pack-yr in four categories Nondrinker vs. ml of pure ethanol/dayc  
   1–60 ml 1.4 (0.9–2.0) 
   61–176 1.6 (0.9–2.0) 
   >176 2.2 (1.3–3.0) 
    P for trend: 0.002 
Dosemeci et al., 1997 (29) 1,210/829 M (Turkey) Smoking categories (never, <20 pack-yr, 20–29 pack-yr, >29 pack-yr) vs. nondrinker  
   Amount (cl/wk)  
   1–35 1.6 (0.8–2.9) 
   36–140 1.7 (1.1–2.7) 
   >141 1.7 (1.7–2.9) 
    P for trend <0.001 
Carpenter et al., 1998 (31) 261/615 M and F (U.S.) Indicator variables for pack-yr and yr since quitting smoking Never-3 drinks/mo vs. >3 drinks/day 1.1 (0.5–2.4) 
Cohort studies     
Kvale et al., 1983 (9) 116/10,602 M Never-, ex- and current smokers of 1–9, 10–19, and ≥20 cigarettes/day Highest tertile of alcohol consumption vs. lowest All subjects: 1.3 (P = 0.37) 
 11.5 follow-up (Norway)   Low vitamin A consumers: 3.6 (P = 0.03) 
Gordon and Kannel, 1984 (40) 42/2,106 M Cigarettes/day oz/mo as continuous variable 1.0 (P > 0.05) M 
 9/2,641 F   0.7 (P > 0.05) F 
 22 yr follow-up (Framingham Study, U.S.)    
Pollack et al., 1984 (11) 89/7,837 M Smoking status (oz/mo based on usual consumption during 1 mo at baseline) (CI or P not shown) 
 14-yr follow-up (Japan-Hawaii Cancer Study, Hawaii) Adjustment for amount smoked did not change estimates   
   None 1.0 
   <5 0.7 
   5–14 1.3 
   15–39 1.7 
   >39 (or >1.18 l./mo) 1.9 
    P for trend: 0.003 
Kono et al., 1986, 1987 (12, 41) 74/5,477 M Non, ex- and current smokers of <10, 10–19, ≥20 cigarettes day Nondrinker 1.0 
 19-yr follow-up (Japanese Physicians Study, Japan)  Ex-drinker 0.6 (0.2–1.5) 
   Occasional drinker 0.4 (0.2–0.8) 
   Daily drinker of  
   <54 ml of alcohol 0.8 (0.4–1.4) 
   ≥54 ml of alcohol 0.9 (0.5–1.7) 
Stemmermann et al., 1990 (18) 209/8,006 M Current smoking status, age started smoking and no. of cigarettes/day (current smokers), ex-smoker status, maximum no. of cigarettes/day and yr smoking maximum amount (ex-smokers) (oz/mo based on 24-h recall)  
 22-yr follow-up (Japan-Hawaii Cancer Study, Hawaii)  1.0 
   <5 0.7 (0.5–1.2) 
   5–14 0.9 (0.6–1.5) 
   15–39 1.4 (1.0–2.1) 
   >39 1.1 (0.7–1.6) 
    P for trend 0.09 
Bandera et al., 1997 (28) 395/27,544 M Cigarettes/day and yr smoking Highest vs. lowest tertile of consumption  
 130/20,456 F   1.1 (0.9–1.4) M 
 8 yr   P for trend: 0.001 
 (New York State Cohort Study, U.S.)   1.0 (0.6–1.6) F 
    P for trend: 0.8 
    (Squamous cell carcinoma cases) 
    1.5 (0.97–2.3) 
Cohort studies (cont’d)     
Prescott et al., 1999 (32) 480/15,107 M Six categories of present smoking and eight categories of duration of smoking (Best fit based on likelihood ratio test) No. of drinks/wk: (M) 
 194/13,053 F  <1 1.0 
 (Copenhagen City Heart Study, the Centre of Preventive Medicine, and the Copenhagen Male Study, Denmark)  1–6 0.8 (0.6–1.2) 
   7–13 1.0 (0.7–1.4) 
   14–20 0.9 (0.6–1.3) 
   21–41 1.2 (0.9–1.7) 
   >41 1.6 (1.1–2.3) 
    P for trend: 0.002 
    (No relationship for F) 
Woodson et al., 1999 (33) 1059/27,111 M smokers Cigarettes smoked per day and total yr smoked Nondrinker vs. drinker 1.2 (0.9–1.4) 
 7.7 yr (ATBC Study, Finland)  Highest quartile of drinking vs. lowest quartile of g/day) 1.0 (0.8–1.2) 
    (Adenocarcinoma) 
    1.7 (1.0–2.8) 
Breslow et al., 2000 (34) 158/20,004 M and F 8.5 yr (U.S.) Packs/day and duration of smoking as continuous variables Highest quartile of alcohol intake compared with lowest 1.3 (0.8–2.0) 
    (Nonsmokers) 
    2.3 (1.1–4.6) 
a

Study size refers to no. of cases and controls in case-control studies and no. of cases and total subjects in cohort studies.

b

NA, not applicable.

c

Beer: 60 ml of pure ethanol/liter; wine: 120 ml/liter; hard liquor: 460 ml/liter.

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