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A prospective cohort study on the association between waterpipe tobacco smoking and gastric cancer mortality in Northern Vietnam
Dung Thi Thuy Truong, Long Bao Tran, Phuoc Hong Le, Binh Uyen Duong Pham, Koji Wada, Shunya Ikeda, Ariuntuul Garidkhuu, Can Van Phan, Ngoan Tran Le
Tobacco consumption, as a worldwide problem, is a risk factor for several types of cancer. In Vietnam, tobacco consumption in the form of waterpipe tobacco smoking is common. This prospective cohort study aimed to study the association between waterpipe tobacco smoking and gastric cancer mortality in Northern Vietnam. A total of 25,619 eligible participants were followed up between 2008 and 2019. Waterpipe tobacco and cigarette smoking data were collected; semi-quantitative food frequency and lifestyle questionnaires were also utilized. Gastric cancer mortality was determined via medical records available at the state health facilities. A Cox proportional hazards model was used to estimate hazard ratios (HR) and 95% confdence intervals (95% CI). During 314,992.8 person-years of followup, 55 men and 25 women deaths due to gastric cancer were identifed. With never-smokers as the reference, the risk of gastric cancer mortality was signifcantly increased in participants who were ever-smoking (HR=2.43, 95% CI=1.35–4.36). The positive risk was also observed in men but was not signifcantly increased in women. By types of tobacco use, exclusive waterpipe smokers showed a signifcantly increased risk of gastric cancer mortality (HR=3.22, 95% CI=1.67–6.21) but that was not signifcantly increased in exclusive cigarette smokers (HR=1.90, 95% CI=0.88– 4.07). There was a signifcant positive association between tobacco smoking and gastric cancer death for indicators of longer smoking duration, higher frequency per day, and cumulative frequency of both waterpipe and cigarette smoking. Waterpipe tobacco smoking would signifcantly increase the risk of gastric cancer mortality in the Vietnamese population. Further studies are required to understand the waterpipe tobacco smoking-driven gastric cancer burden and promote necessary interventions.
2022
11p
eng
BMC Cancer
1-11
22
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