Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Jun 18, 2023; 11(5): 228-252
Published online Jun 18, 2023. doi: 10.13105/wjma.v11.i5.228
Evidence relating cigarette, cigar and pipe smoking to lung cancer and chronic obstructive pulmonary disease: Meta-analysis of recent data from three regions
Peter Nicholas Lee, Katharine J Coombs, Jan S Hamling
Peter Nicholas Lee, Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
Katharine J Coombs, Statistics, P.N.Lee Statistics and Computing Ltd, Sutton SM2 5DA, Surrey, United Kingdom
Jan S Hamling, Statistics, RoeLee Statistics Ltd, Sutton SM2 5DA, United Kingdom
Author contributions: Lee PN planned the study; Literature searches were carried out by Coombs KJ and by Lee PN; Statistical analyses were carried out by Hamling JS and checked by Lee PN; Lee PN drafted the text, which was checked by Coombs KJ and Hamling JS.
Conflict-of-interest statement: The authors have carried out consultancy work for many tobacco organizations.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peter Nicholas Lee, MA, Senior Statistician, Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd., 17 Cedar Road, Sutton SM2 5DA, Surrey, United Kingdom. peterlee@pnlee.co.uk
Received: March 13, 2023
Peer-review started: March 13, 2023
First decision: April 28, 2023
Revised: May 10, 2023
Accepted: May 30, 2023
Article in press: May 30, 2023
Published online: June 18, 2023
Processing time: 94 Days and 12.6 Hours
Core Tip

Core Tip: For lung cancer, recent North American and European studies indicate current cigarette smoking increases risk > 10-fold in each sex. Limited evidence suggests cigars increase risk about 3-fold, but is variable for pipes. For Japanese studies the risk increase from cigarettes is much less than in Western regions. For chronic obstructive pulmonary disease, cigarettes increase risk about 9-fold, with little sex or regional variation. One North American study reports a lower increase for cigars and pipes. Smoking markedly increases risk of both diseases. While quitting reduces risk most effectively, available evidence suggests switching to nicotine products that are not smoked could potentially reduce these risks.