PT  - JOURNAL ARTICLE
AU  - Balte, Pallavi
AU  - Bhatt, Surya
AU  - Chaves, Paulo
AU  - Couper, David
AU  - Freedman, Neal
AU  - Jacobs Jr, David
AU  - Jones, Miranda
AU  - Kalhan, Ravi
AU  - Mathew, Amanda
AU  - Kronmal, Richard
AU  - Loehr, Laura
AU  - London, Stephanie
AU  - Newman, Anne
AU  - O'Connor, George
AU  - Schwartz, Joseph
AU  - Smith, Benjamin
AU  - Smith, Lewis
AU  - White, Wendy
AU  - Yende, Sachin
AU  - Oelsner, Elizabeth
TI  - Association of low-intensity smoking with respiratory and lung cancer mortality
AID  - 10.1183/13993003.congress-2020.4389
DP  - 2020 Sep 07
TA  - European Respiratory Journal
PG  - 4389
VI  - 56
IP  - suppl 64
4099  - http://erj.ersjournals.com/content/56/suppl_64/4389.short
4100  - http://erj.ersjournals.com/content/56/suppl_64/4389.full
SO  - Eur Respir J2020 Sep 07; 56
AB  - Background: The number of current smokers has reached its lowest level to date in the US but the proportion of smokers smoking <10 cigarettes per day (CPD) has increased from 16% to 27%, and many consider “light” smoking to be low risk.Aim: To assess relative risks of respiratory and lung cancer mortality in low-intensity smokers.Methods: Data from 4 US general population cohorts were harmonized and pooled. Current smokers were categorized by self-reported CPD (<10, 10-20, 20+). Adjudication/administrative criteria were used to classify respiratory and lung cancer deaths. Associations were tested via competing risk regression adjusted for sociodemographic factors.Results: Of 18,730 participants (mean age 61 yrs, 56% women, 69% white, 13% current smokers, 17 yrs median follow-up), 649 (IDR=20/10,000 person-years) died from respiratory causes while 560 (IDR=17) died from lung cancer. Compared to never smokers, those with <10CPD had higher risk of respiratory (HR=2.5,P=0.005) and lung cancer (HR=8.6,P=<.0001) mortality. The risks of respiratory and lung cancer mortality associated with <10CPD smoking were 49% and 71%, of the risks of 20+CPD smoking. Results were slightly attenuated after adjusting for smoking duration.Conclusions: Risk of respiratory and lung cancer deaths among low-intensity current smokers vs never smokers, is non-trivial: in this study, this risk was equivalent to at least half that seen in those with 20+CPD.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4389.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).