Dietary Differences among Light vs. Heavy Smokers from the Alpha-Tocopherol, Beta-Carotene Cancer (ATBC) Prevention Study Cohort

Abstract

Background: Smokers tend to have a poorer diet as compared to non-smokers. Less is known about dietary differences between light vs. heavy smokers. The purpose of this study is to evaluate reported dietary intake by the level of smoking and its link to cancer mortality. Methods: Using data from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, we evaluated dietary intake among light vs. heavy smokers in Finnish male smokers, aged 50 - 69 years. We analyzed the association of these dietary intakes with cancer mortality and survival for the cohort participants. Out of 27,111 participants, 17,300 (63.8%) reported smoking ≥ 20 cigarettes/day and were classified as heavy-smokers, and 9,811 (36.2%) reported smoking ˂ 20 cigarettes/day and were classified as light-smokers. Dietary data were collected at the baseline using a detailed Food Frequency Questionnaire. Cancer deaths were ascertained until 2016 using the Finland Cancer Registry. Results: Reported intakes of cereal (212.13 ± 0.67 vs. 221.78 ± 0.84 g/day; p ˂ 0.00001), vegetables (110.91 ± 0.54 vs. 118.29 ± 0.71 g/day; p ˂ 0.00001), fruits (209.91 ± 1.48 vs. 232.44 ± 1.98 g/day; p ˂ 0.00001), and total dietary fiber (18.44 ± 19.29 g/day; p ˂ 0.00001) were significantly lower among heavy-smokers as compared to light-smokers. Reported intakes of red meat (73.14 ± 0.27 vs. 68.04 ± 0.32 g/day; p ˂0.00001), processed meat (78.10 ± 0.47 vs. 69.44 ± 0.54 g/day; p ˂ 0.00001), dairy products (737.23 ± 3.06 vs. 719.42 ± 3.74 g/day; p ˂ 0.0001), coffee (640.56 ± 2.80 vs. 549.23 ± 3.13 g/day; p ˂ 0.00001), and alcohol (20.55 ± 0.18 vs. 13.50 g/day; p ˂ 0.00001) were significantly higher among heavy-smokers as compared to light-smokers. Conclusions: Dietary intake varies significantly by the level of smoking and heavy-smokers have poorer intakes as compared to light-smokers. The observed dietary differences have important implications for cancer prevention and control efforts, suggesting a need to incorporate dietary components into tobacco cessation interventions. Funding: This research was supported in part by the Intramural Research Program of the NIH and the National Cancer Institute. Additionally, this research was supported by U.S. Public Health Service contracts N01-CN-45165, N01-RC-45035, N01-RC-37004, HHSN261201000006C, and HHSN261201500005C from the National Cancer Institute, Department of Health and Human Services. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.