ArticleAmerican journal of epidemiology2016
Smokeless Tobacco Use and the Risk of Head and Neck Cancer: Pooled Analysis of US Studies in the INHANCE Consortium.
Article in American journal of epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- Comparative disease risks associated with cigarette smoking and use of moist smokeless tobacco and snus: an umbrella review of epidemiological evidence from the United States and Western Europe.BMC public health · 2025Pooled it
- Health effects associated with chewing tobacco: a Burden of Proof study.Nature communications · 2024Pooled it
- The health impact of smokeless tobacco products: a systematic review.Harm reduction journal · 2021Pooled it
- Relationship between type of smokeless tobacco & risk of cancer: A systematic review.The Indian journal of medical research · 2018Pooled it
- Randomized Controlled Trial of a Text-Based Smokeless Tobacco Cessation Intervention for Rural and Medically Underserved Communities.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Trial
- Effects of a Reduced Risk Claim on Adolescents' Smokeless Tobacco Perceptions and Willingness to Use.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2023Trial
- Developing Messages to Prevent Smokeless Tobacco and Nicotine Pouch Uptake Among Early Career Rural Firefighters in California: A Qualitative Study.Behavioral sciences (Basel, Switzerland) · 2026Article
- Nicotiana tabacum: From a Beneficial Plant to Harmful Products-A Comprehensive Review of Smokeless Tobacco and Its Adverse Health Effects.TheScientificWorldJournal · 2026Review
- Cellular Senescence as a Risk Factor in Head and Neck Cancer-Diagnostic and Therapeutic Perspective.Cancers · 2025Review
- Rural-Urban Patterns in Household Rules Limiting Combustible Tobacco, Noncombustible Tobacco, and E-Cigarette Use.Annals of the American Thoracic Society · 2025Article
- Heavy Metals, Active Ingredients, and Adulteration Smokeless Tobacco Varieties: a Chemometrics Based on Principal Components and Hierarchical Cluster Analysis.Biological trace element research · 2025Article
- Liquid Biopsies in Head and Neck Cancers: Recent Developments Across Biofluids, Analytes, and Molecular Features.Head & neck · 2025Review
- Molecular and Genetic Pathogenesis of Oral Cancer: A Basis for Customized Diagnosis and Treatment.Biology · 2025Review
- Examining the role of freebase nicotine in the harm reduction potential of oral nicotine pouches versus moist snuff: A randomized crossover trial.Addiction (Abingdon, England) · 2025Article
- The Relationship Between Smokeless Tobacco and the Incidence of Oral Cancer: A Systematic Review Study.Addiction & health · 2025Review
- Prevalence and predictors of chronic disease among rural and medically underserved populations using smokeless tobacco.Frontiers in public health · 2025Article
- The global, regional, and national impact of laryngeal cancer from 1990 to 2021, along with forecasts for 2050: a comprehensive analysis for the Global Burden of Disease 2021 research.Frontiers in oncology · 2025Article
- Oncogenic HRAS Induces Metformin Resistance in Head and Neck Cancer by Promoting Glycolytic Metabolism.Cancer prevention research (Philadelphia, Pa.) · 2024Article
- Oral Cancer Incidence Among Adult Males With Current or Former Use of Cigarettes or Smokeless Tobacco: Population-Based Study.JMIR cancer · 2024Article
- Matricellular proteins: Potential biomarkers in head and neck cancer.Journal of cell communication and signaling · 2024Review
Corrections and comments
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Authors and funding
21 authors.
Funding
Abstract
Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95% confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95% CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95% CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95% CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.