The relationship between cigarettes with varying tar yields and the risk of oesophageal cancer was evaluated using data from a hospital-based case-control study conducted in Northern Italy on 129 histologically confirmed cases and 426 controls with acute, non-neoplastic of digestive diseases unrelated to tobacco or alcohol consumption. Compared with never-smokers, the relative risks of developing cancer of the oesophagus were 2.9 for subjects who smoked mainly middle- or low-tar (less than 22 mg) cigarettes and 8.9 for those smoking high-tar cigarettes (greater than or equal to 22 mg). The difference between the two categories was evident among ever-smokers and only current smokers, was not explained by adjustment for the major covariates of interest (social class, alcohol consumption and dietary indicators), and persisted when allowance was made for duration of smoking and number of cigarettes smoked per day by means of multiple regression analysis. The present findings suggest that the relation between tar deliveries of cigarettes and risk may be even more marked for oesophageal than for lung cancer. Further, they have important public health implications, in consideration of the current relatively high tar yields of Italian cigarettes, particularly in a few areas of north-eastern Italy where death certification rates from cancer of the oesophagus are among the highest in Europe. Nonetheless, in this study, smokers of prevalently low- to mid-tar cigarettes still did experience a significantly higher oesophageal cancer risk than life-long non-smokers.
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