[Tobacco, lung cancer and chronic obstructive lung disease. Results from the Osterbro study]

Data from The Copenhagen City Heart Study, a prospective population study, were analysed to investigate the influence of the type of tobacco and inhalation on mortality from lung cancer and chronic obstructive pulmonary disease (COPD). The study sample comprised 2986 plain cigarette smokers, 3222 filter cigarette smokers, 1578 smokers of cheroots/cigars, 433 male pipe smokers and 773 smokers smoking more than one type of tobacco. From 1976 to the end of 1989 we observed 268 deaths from lung cancer and 195 deaths, where COPD was considered as either the main or the contributory cause of death. Current smokers of all types of tobacco had a significantly higher risk of mortality from the investigated diseases than never-smokers. In both sexes the risks of death from both lung cancer and COPD were lower in cheroot/cigar smokers and in pipe smokers than in cigarette smokers, but these differences were markedly diminished after an adjustment for the inhalation habit. The present study substantiates that tobacco smoking increases pulmonary mortality. The small differences between the various types of tobacco are probably caused by different inhalation patterns.