Systematic review of the relation between smokeless tobacco and cancer in Europe and North America

Table 26 Overall cancer; individual effect (relative risk/odds ratio) estimates

	ST use				RR/OR
Source^a	Type^b	Exposure^c	Smoking	Sex	Id.	Cases^d	Estimate (95%CI)^d	Adjustment factors^e
Cohort studies
NHANES I: Accortt et al. 2005 [22]	ST	Ever	Never	M	1	38	0.80 (0.40–1.60)	age, pov, race
				F	2	26	1.20 (0.70–2.10)	age, pov, race
CPS-I: Henley et al. 2005 [23]	ST	Current	Never	M	3	357	1.07 (0.95–1.20)	age, alc, asp, bmi, diet, edu, exer, occ, race
CPS-II: Henley et al. 2005 [23]	ST	Current	Never	M	4	162	1.19 (1.02–1.40)	age, alc, asp, bmi, diet, edu, exer, occ, race
	ST	Former			5	57	1.04 (0.80–1.36)
	ST	Ever			6	219	1.15 (1.00–1.32)^f
	Chew only	Current			7	113	1.23 (1.02–1.49)
	Snuff only	Current			8	14	0.93 (0.55–1.57)
Swedish construction workers: Bolinder et al. 1994 [28]	Snuff	Current	Never	M	9	96	1.10 (0.90–1.40)	age, res
Uppsala County: Roosaar et al. 2008 [35]	Snuff	Ever	Any	M	10	237	1.00 (0.87–1.15)	age, alc, res, smok, time
			Never		11	138	1.10 (0.90–1.40)	age, alc, res, time
Case-control studies
Sterling et al. 1992 [89]	ST	Ever	Any	M+F	12	2,498^g	0.64 (0.53–0.78)^f	age, alc, occ, race, sex, smok

^a Fuller details of the studies are given in Tables 1 and 2.
^b ST implies smokeless tobacco unspecified, or combined snuff use or chewing.
^c Ever, former and current ST use were compared with never ST. Use indicates timing not given and comparison is with non use.
^d 'Id.' is the RR/OR identification number used in Table 27, and 'Cases' is the number of cases in ST users as defined.
^e Abbreviations used: alc = alcohol, asp = aspirin, bmi = body mass index, edu = education, exer = exercise, occ = occupation, pov = poverty, res = area of residence, smok = smoking.
^f RR/OR and/or 95% CI estimated from data provided in the source.
^g Number of cases estimated from data provided in the source.
CI = confidence interval; ST = smokeless tobacco; OR = odds ratio; RR = relative risk.

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