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Background: Lung cancer rates are lower in Asians and Latinos than in whites. Ethnic differences in nicotine metabolism might explain, in part, ethnic differences in cigarette consumption and/or nicotine intake per cigarette and resultant tobacco-related cancer risk. We compared the rate of nicotine metabolism and the intake of nicotine per cigarette smoked among smokers of different ethnicities. Methods: Healthy volunteer smokers, including 37 Chinese-Americans, 40 Latinos, and 54 whites, received simultaneous infusions of deuterium-labeled nicotine and cotinine, a metabolite of nicotine. From blood and urine measurements, the disposition kinetics and daily intake of nicotine from smoking were determined. All statistical tests were two-sided. Results: Total and nonrenal clearance of nicotine and cotinine and metabolic clearance of nicotine via the cotinine pathway were similar in Latinos and whites and statistically significantly lower in Chinese-Americans. Intake of nicotine per cigarette by Chinese-Americans (0.73 mg; 95% confidence interval [CI] = 0.53 to 0.94 mg) was statistically significantly lower than that by Latinos (1.05 mg; 95% CI = 0.85 to 1.25 mg) or whites (1.10 mg; 95% CI = 0.91 to 1.30 mg; P = .039). Among all of the participants, there was a statistically significant positive correlation between nicotine clearance and daily intake of nicotine from cigarette smoking and between nicotine clearance and nicotine intake per cigarette (r = .41 and r = .39, respectively) (P

A new study investigates the effects of sex, time and age at diagnosis on the incidence of lung cancer in New South Wales.

Background: Adenocarcinoma of the lung, once considered minimally related to cigarette smoking, has become the most common type of lung cancer in the United States. The increased incidence of this cancer might be explained by advances in diagnostic technology (i.e., increased ability to perform biopsies on tumors in smaller, more distal airways), changes in cigarette design (e.g., the adoption of filtertips), or changes in smoking practices. We examined data from the Connecticut Tumor Registry and two American Cancer Society studies to explore these possibilities. Methods: Connecticut Tumor Registry data from 1959 through 1991 were analyzed to determine whether the increase in lung adenocarcinoma observed during that period could be best described by birth cohort effects (i.e., generational changes in cigarette smoking) or calendar period effects (i.e., diagnostic advances). Associations between cigarette smoking and death from specific types of lung cancer during the first 2 years of follow-up in Cancer Prevention Study I (CPS-I), initiated in 1959) and Cancer Prevention Study II (CPS-II, initiated in 1982) were also examined. Results: Adenocarcinoma incidence in Connecticut increased nearly 17-fold in women and nearly 10-fold in men from 1959 through 1991. The increases followed a clear birth cohort pattern, paralleling gender and generational changes in smoking more than diagnostic advances. Cigarette smoking became more strongly associated with death from lung adenocarcinoma in CPS-II compared with CPS-I, with relative risks of 19.0 (95% confidence interval [CI] = 8.3-47.7) for men and 8.1 (95% CI = 4.5-14.6) for women in CPS-II and 4.6 (95% CI = 1.7-12.6) for men and 1.5 (0.3-7.7) for women in CPS-I. Conclusions: The increase in lung adenocarcinoma since the 1950s is more consistent with changes in smoking behavior and cigarette design than with diagnostic advances. [J Natl Cancer Inst 1997;89:1580-6]

The prevalence of cigarette smoking is higher among African Americans than among whites. African Americans have higher rates of lung cancer than whites, although they smoke fewer cigarettes. To explore this black-white difference in lung cancer rates, I examine various aspects of tobacco use in African-American smokers, including the age of initiation of smoking, quantity of cigarettes smoked, quit rates, level of nicotine dependence, biochemical differences, and brand preferences, specifically menthol brand cigarettes. I also review briefly the sequelae of patterns of tobacco use, including rates of lung and other tobacco-related cancers. A preference for mentholated cigarettes by African Americans is well documented and is one of the most striking differences between African-American and white smokers. Menthol brand preference has been investigated in an attempt to explain the black-white differences in rates of cancers of the lungs and the upper respiratory and digestive tracts. Also, studies have evaluated smoking behavior both with and without menthol and have explicitly examined the question of whether menthol use helps explain the black-white difference in lung cancer rates. The results of these studies are so far inconclusive with regard to the use of menthol and the risk of lung cancer developing. I provide practical suggestions for clinicians in counseling African-American smokers to quit smoking and to maintain a nonsmoking status., (Richardson TL. African-American smokers and cancers of the lung and of the upper respiratory and digestive tracts: is menthol part of the puzzle? West J Med 1997 Mar; 166:189-194) Among [...]