CoChat
Sign Up
Cited by 104Antioxidant Activity and Oxidative StressSmoking Behavior and CessationLung Cancer Diagnosis and Treatment

The DOI matches its Crossref record; 28 of the 29 references it cites were found in a registry or an index.

β-Carotene Supplementation and Lung Cancer Incidence in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study: The Role of Tar and Nicotine

Open access
Middha, Pooja, Weinstein, Stephanie J, Männistö, Satu, Albanes, Demetrius, Mondul, Alison M·2019·Nicotine & Tobacco Research
DOI 10.1093/ntr/nty115PMC PMC6636175
Open this paper in CoChat — free accountOpen PDF

Abstract

Introduction: The Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study demonstrated that β-carotene supplementation increases lung cancer incidence in smokers. Further, cigarettes with higher tar and nicotine content are associated with a higher risk of lung cancer. However, no studies have examined whether the increased risk associated with β-carotene supplementation in smokers varies by the tar or nicotine content of cigarettes. Methods: The ATBC Study was a randomized, double-blind intervention trial conducted in southwest Finland. A total of 29 133 male smokers, aged 50–69 years, were enrolled and randomly assigned to one of four groups (α-tocopherol, β-carotene, both, or placebo). Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) of lung cancer risk by β-carotene trial assignment stratified by a priori categories of cigarette tar and nicotine content. Results: The β-carotene supplementation group had significantly higher risk of developing lung cancer in all categories of tar content (yes vs. no β-carotene supplementation—ultralight cigarettes [≤7 mg tar]: HR = 1.31, 95% CI = 0.91 to 1.89; nonfiltered cigarettes [≥21 mg tar]: HR = 1.22, 95% CI = 0.91 to 1.64; p for interaction = .91). Similarly, there was no interaction with nicotine content (yes vs. no β-carotene supplementation—ventilated cigarettes [≤0.8 µg nicotine]: HR = 1.23, 95% CI = 0.98 to 1.54; nonfiltered cigarettes [≥1.3 µg nicotine]: HR = 1.22, 95% CI = 0.91 to 1.64; p for interaction = .83). Conclusion: These findings support the conclusion that supplementation with β-carotene increases the risk of lung cancer in smokers regardless of the tar or nicotine content of cigarettes smoked. Our data suggest that all smokers should continue to avoid β-carotene supplementation. Implications: Previous studies demonstrated that β-carotene supplementation increases risk of lung cancer in smokers. This study moves the field forward by examining the potential for modification of risk of lung cancer with different levels of tar and nicotine in cigarettes smoked, as interaction with carcinogens in these components of cigarette smoke is hypothesized to be the mechanism by which β-carotene increases risk. Our study provides evidence that the increased risk of lung cancer in smokers who take β-carotene supplements is not dependent upon the tar or nicotine level of cigarettes smoked and suggests that all smokers should continue to avoid β-carotene supplementation.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1093/ntr/nty115

Cites

28 of 28 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 29 references

Research works printed but not linked: 2

  1. US Department of Health, Education and Welfare, 1979, Smoking and Health: A Report of the Surgeon General
  2. Benowitz, 2001, Compensatory smoking of low yield cigarettes, 39

Cited by

Sorted by citations

Related

See all

Metadata

Authors
Middha, P., Weinstein, S. J., Männistö, S., Albanes, D., & Mondul, A. M.
Affiliations
  • University of Michigan (US)
  • National Institutes of Health (US)
  • Finnish Institute for Health and Welfare (FI)
Corresponding author
Mondul, Alison M
ORCID
Venue
Nicotine & Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2018-06-08
Volume
21
Issue
8
Pages
1045-1050
ISSN
  • 1462-2203 (ISSN-L)
  • 1469-994X
DOI
10.1093/ntr/nty115
PMC
PMC6636175
OpenAlex
W2806458401
Cited by
104
References
29
Citations by year
2026: 10 · 2025: 9 · 2024: 19 · 2023: 14 · 2022: 21 · 2021: 16 · 2020: 6 · 2019: 6 · 2018: 3
FWCI
5.31
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Nicotine & Tobacco Research (publishedVersion, public-domain)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • US National Cancer Institute
  • National Institutes of Health
  • US Public Health Service (HHSN261201500005C)
Topics
  • Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
Keywords
beta-carotene supplementation, lung cancer incidence, smokers, filtered cigarettes, Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, vitamin supplementation, alpha-tocopherol, tobacco control, lung cancer screening
MeSH terms
Provitamins, Aged, Antioxidants, Double-Blind Method, Finland, Follow-Up Studies, Humans, Lung Neoplasms, Male, Middle Aged, Nicotine, Smoking, Tars, Incidence, beta Carotene, Dietary Supplements, alpha-Tocopherol

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review