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British Journal of Cancer logoLink to British Journal of Cancer
. 1997;75(11):1690–1693. doi: 10.1038/bjc.1997.287

The dose-response relationship between cigarette consumption, biochemical markers and risk of lung cancer.

M R Law 1, J K Morris 1, H C Watt 1, N J Wald 1
PMCID: PMC2223525  PMID: 9184188

Abstract

The relationship between the number of cigarettes smoked per day and the incidence of lung cancer is linear but, from the multistage model of carcinogenesis, it should be quadratic (upwards curving). We investigated this anomaly in a study of 11,403 male never smokers and current smokers in whom carboxyhaemoglobin (COHb) was measured in all and serum cotinine in 1175. The relationship between the biochemical markers and the reported number of cigarettes per day was approximately linear up to 20 cigarettes per day as expected. But above 20 cigarettes per day the marker levels increased less steeply and were 35% lower than expected in men who smoked more than 40 cigarettes per day. Less smoke is inhaled from each cigarette by men with high daily cigarette consumption than by men with lower consumption. Allowance for this transforms the observed linear dose-response relationship into one consistent with the expected quadratic relationship. The anomaly is explained by the observation that heavier smokers inhale less smoke from each cigarette.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Coburn R. F., Forster R. E., Kane P. B. Considerations of the physiological variables that determine the blood carboxyhemoglobin concentration in man. J Clin Invest. 1965 Nov;44(11):1899–1910. doi: 10.1172/JCI105296. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Day N. E., Brown C. C. Multistage models and primary prevention of cancer. J Natl Cancer Inst. 1980 Apr;64(4):977–989. [PubMed] [Google Scholar]
  3. Doll R., Peto R. Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and lifelong non-smokers. J Epidemiol Community Health. 1978 Dec;32(4):303–313. doi: 10.1136/jech.32.4.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hammond E. C. Smoking in relation to the death rates of one million men and women. Natl Cancer Inst Monogr. 1966 Jan;19:127–204. [PubMed] [Google Scholar]
  6. Hill P., Haley N. J., Wynder E. L. Cigarette smoking: carboxyhemoglobin, plasma nicotine, cotinine and thiocyanate vs self-reported smoking data and cardiovascular disease. J Chronic Dis. 1983;36(6):439–449. doi: 10.1016/0021-9681(83)90136-4. [DOI] [PubMed] [Google Scholar]
  7. Kahn H. A. The Dorn study of smoking and mortality among U.S. veterans: report on eight and one-half years of observation. Natl Cancer Inst Monogr. 1966 Jan;19:1–125. [PubMed] [Google Scholar]
  8. Kuller L. H., Ockene J. K., Meilahn E., Wentworth D. N., Svendsen K. H., Neaton J. D. Cigarette smoking and mortality. MRFIT Research Group. Prev Med. 1991 Sep;20(5):638–654. doi: 10.1016/0091-7435(91)90060-h. [DOI] [PubMed] [Google Scholar]
  9. Lawther P. J. Carbon monoxide. Br Med Bull. 1975 Sep;31(3):256–260. doi: 10.1093/oxfordjournals.bmb.a071296. [DOI] [PubMed] [Google Scholar]
  10. Parish S., Collins R., Peto R., Youngman L., Barton J., Jayne K., Clarke R., Appleby P., Lyon V., Cederholm-Williams S. Cigarette smoking, tar yields, and non-fatal myocardial infarction: 14,000 cases and 32,000 controls in the United Kingdom. The International Studies of Infarct Survival (ISIS) Collaborators. BMJ. 1995 Aug 19;311(7003):471–477. doi: 10.1136/bmj.311.7003.471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Rees P. J., Chilvers C., Clark T. J. Evaluation of methods used to estimate inhaled dose of carbon monoxide. Thorax. 1980 Jan;35(1):47–51. doi: 10.1136/thx.35.1.47. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Vesey C. J., Saloojee Y., Cole P. V., Russell M. A. Blood carboxyhaemoglobin, plasma thiocyanate, and cigarette consumption: implications for epidemiological studies in smokers. Br Med J (Clin Res Ed) 1982 May 22;284(6328):1516–1518. doi: 10.1136/bmj.284.6328.1516. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Vogt T. M., Selvin S., Hulley S. B. Comparison of biochemical and questionnaire estimates of tobacco exposure. Prev Med. 1979 Jan;8(1):23–33. doi: 10.1016/0091-7435(79)90026-4. [DOI] [PubMed] [Google Scholar]
  14. Wald N. J., Law M., Watt H. C., Wu T., Bailey A., Johnson A. M., Craig W. Y., Ledue T. B., Haddow J. E. Apolipoproteins and ischaemic heart disease: implications for screening. Lancet. 1994 Jan 8;343(8889):75–79. doi: 10.1016/s0140-6736(94)90814-1. [DOI] [PubMed] [Google Scholar]
  15. Wald N., Howard S., Smith P. G., Bailey A. Use of carboxyhaemoglobin levels to predict the development of diseases associated with cigarette smoking. Thorax. 1975 Apr;30(2):133–140. doi: 10.1136/thx.30.2.133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Wald N., Idle M., Bailey A. Carboxyhaemoglobin levels and inhaling habits in cigarette smokers. Thorax. 1978 Apr;33(2):201–206. doi: 10.1136/thx.33.2.201. [DOI] [PMC free article] [PubMed] [Google Scholar]

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