Tobacco use and non-Hodgkin lymphoma: results from a population-based case-control study in the San Francisco Bay Area, California.

OBJECTIVE

Investigate the association between tobacco use and non-Hodgkin lymphoma (NHL).

METHODS

Tobacco-use data were collected during in-person interviews in a population-based case-control study of NHL (N=1593 patients, N=2515 controls) conducted in the San Francisco Bay Area between 1988 and 1995. Odds ratios (ORs) for HIV-negative participants were obtained from adjusted unconditional logistic regression models stratified by sex.

RESULTS

NHL was not associated with overall tobacco use, intensity or duration of cigarette smoking in women or men. However, ORs were increased for NHL among men who used any non-cigarette tobacco alone (OR=1.7), non-cigarette tobacco and cigarettes (OR=1.4), multiple types of non-cigarette tobacco alone (OR=2.1) and smokeless tobacco alone (OR=4.0). In analyses stratified by sex and age, ORs for NHL associated with cigarette smoking in general were above unity among those aged > or =60 years. ORs for follicular lymphoma were increased in men who used cigarettes and other tobacco, cigars alone and smokeless tobacco alone. Diffuse large-cell lymphoma in men was associated with use of cigarettes and other tobacco, and multiple types of non-cigarette tobacco.

CONCLUSIONS

Our data do not support an association between overall tobacco use and all NHL in women or men. Further analyses are warranted in larger studies to evaluate non-cigarette tobacco use, tobacco-related biologic markers and genetic factors in the development of NHL.