ASPO Abstracts
Tobacco smoking, chewing habits, alcohol drinking and the risk of head and neck cancer in Nepal
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2019
Abstract Body:
Purpose of the study. Several local types of tobacco smoking, chewing products and alcoholic beverages are frequently consumed in Nepal. Even though tobacco smoking and alcohol drinking are important risk factors for head and neck cancer (HNC), there are no studies that have evaluated these local habits and their influence on the risk of HNC in Nepal, to our knowledge. This study aimed to investigate the impact of tobacco smoking, chewing habits and alcohol drinking on HNC risk in Nepal. Methods. A case-control study was conducted at B.P. Koirala Memorial Cancer Hospital, the main cancer hospital in Nepal. We included 551 incident HNC cases and 599 controls, from 2016 through 2018, frequency matched by age (±5 years), sex, race/ethnicity and residence area. Information on tobacco smoking, chewing and alcohol drinking habits were collected using a standardized questionnaire. The types of tobacco smoking included cigarette, bidi and choor/hankat. The types of chewing habits included pan (with and without tobacco), pan masala (with and without tobacco), khaini, surti, zarda, zarda and kiwam, supari, and lwang. The types of alcoholic beverages included beer, whisky, rakshi, jaand/chayang, thongha, and wine. The odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression adjusting for potential confounders, such as age, sex, education, race/ethnicity, family monthly income, area of residence, duration and frequency of tobacco smoking, chewing habits and alcohol drinking where appropriate.Results. We observed increased HNC risks for ever tobacco smoking (OR, 95% CI: 1.50, 1.10-2.01), ever chewing habits (OR, 95% CI: 2.36, 1.75-3.18) and ever alcohol drinking (OR, 95% CI: 1.61, 1.17-2.23) after adjusting for potential confounding factors. When combining three habits, people who smoked, chewed and drank had a 11.94 fold increase (95% CI: 6.49-21.98) in the risk of HNC compared to people who did not have those habits. The joint effect between tobacco smoking and alcohol drinking was greater than multiplicative (ratio of ORs, 95% CI: 3.07, 1.05-8.99) on HNC risk among non-chewers. Conclusions. Local products for tobacco smoking, chewing habits and alcohol drinking were independently associated with the risk of HNC. High
Keywords: alcohol; chewing; head and neck cancer; Nepal; tobacco