Hand-rolled tobacco and laryngeal carcinoma : a case-control study in Thai patients

Abstract

Objectives : 1. To determine the association of hand-rolled tobacco smoking and laryngeal carcinoma 2. To compare the risk effect of hand-rolled tobacco and commercial cigarettes 3. To evaluate the joint effect of smoking and alcohol consumption in increasing the risk of laryngeal cancer. Design : An unmatched case-control study. Setting : Two tertially medical centers - Srinagarind hospital, Khon-Kaen and Siriraj hospital, Bangkok. Material and method : One hundred eighty patients were enrolled in this study, 60 patients as cases and 120 patients as controls. Cases were definded as newly diagnosed laryngeal cancer patients who had a histologically proven squamous cell carcinoma as primary tumor. Control subjects were male in-patients who were admitted to the same hospitals during the same periods as cases. Controls had no previous history of cancer in the respiratory tract, no tobacco related disease as principle illness and had a normal larynx visualized by qualified laryngologists. Both cases and controls were asked to answer) the same questions on their demographic background, smoking and alcohol [drinking behavior and some dietary factors by 2 well trained interviewers followed a standard questionnaire. Results : The odds ratio for laryngeal, cancer in relation to smoking was 8.9 with 95% C.I. = 2.8 - 28.6. Whereas hand-rolled tobacco smoking had a higher risk effect than commercial cigarettes.(adjusted OR were 15.6 vs 10.7) There was also a synergistic effect between cigarettes smoking and alcohol consumption in relation to laryngeal cancer in this study. However, occupation education, socioeconomic status, and some dietary factors showed a non association with this cancer. Conclusion : Tobacco smoking has a strong association with laryngeal cancer. Hand-rolled tobacco showed a higher risk effect for laryngeal cancer than commercial cigarettes in our study. Therefore, a smoking cessation campaign [and law reenforcement should be immediately and continuously exploited to minimize its harmful effect in our community.