Incident cancers attributable to using opium and smoking cigarettes in the Golestan cohort study

BackgroundOpium consumption has recently been identified as a carcinogen, but the impact of opium use on cancer burden is unknown. We aimed to evaluate fraction cancers that could be attributed alone and in combination with cigarette smoking region where widely used.Methods50,045 Iranian adults were recruited this prospective cohort study between 2004 2008 followed through January 2022. assessed association using and/or various proportional hazards regression models. then calculated population attributable fractions (PAFs) for all groups causally linked smoking.FindingsOf total participants, 8% only used opium, 8.3% smoked cigarettes, 9% both substances. During median 14 years follow-up, 2195 individuals diagnosed cancer, including 215 opium-related (lung, larynx, bladder) 1609 tobacco-related (20 types). Opium was estimated cause 35% (95% CI: 26%–45%) cancers, while cigarettes (6%–12%) population. Using 13% (9%–16%) 58% (49%–66%) 15% (11%–18%) cancers. Moreover, joint exposure had greatest pharynx, lung, bladder, PAFs ranging from 50% 77%.InterpretationUsing account large proportion To reduce burden, prevention policies should aim decrease substances public awareness campaigns interventional efforts.FundingThe Golestan Cohort Study work funded by Tehran University Medical Sciences, Cancer Research UK, U.S. National Institute, International Agency Cancer. The presented analysis supported HundredK+ Cohorts Consortium (IHCC).