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Original Articles
Latency period of lung cancer in relation to tobacco smoking in Korea
Thi Tra Bui, Hee-Yeon Kang, Eunjung Park, Jin-Kyoung Oh
Epidemiol Health. 2026;48:e2026014.   Published online March 30, 2026
DOI: https://doi.org/10.4178/epih.e2026014
  • 7,183 View
  • 140 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This mixed-methods observational study aimed to examine the temporal relationship between trends in cigarette smoking prevalence and lung cancer mortality and incidence rates, and to estimate the latency period between smoking initiation and lung cancer diagnosis among smokers at the individual level.
METHODS
Smoking prevalence data for 1960–2022 were reconstructed using data from the Korea National Health and Nutrition Examination Survey (1998–2022). Lung cancer mortality data (1983–2022) and incidence data (1999–2022) were obtained from Statistics Korea and the Korea Central Cancer Registry. The population latency period was estimated using peak comparison and distributed lag non-linear models. The individual latency period was estimated as the average time interval between age at smoking initiation and age at lung cancer diagnosis using individual-level data from the National Health Insurance Service cohort.
RESULTS
In men, smoking prevalence peaked around 1985, whereas lung cancer mortality peaked around 2000 during 1960–2022, indicating a lag time of approximately 15 years. In women, lung cancer mortality peaked in 2002, while smoking prevalence peaked around the same time. The population-level latency period between smoking and lung cancer incidence was estimated to be 15 years after adjustment for age, gender, and year of outcome. The individual latency period was estimated to be 42.6 years (standard deviation [SD], 12.5) in men and 34.4 years (SD, 14.2) in women. Smoking intensity and age at initiation did not appear to shorten the individual latency period.
CONCLUSIONS
Estimates of the smoking-attributable lung cancer burden should account for historical smoking prevalence from approximately 15 years earlier.
Summary
Korean summary
한국의 흡연율과 폐암 사망률 및 발생률은 뚜렷한 시간적 추세를 보였으며, 특히 남성에서 인구집단 수준에서 약 15년의 시차가 관찰되었다. 개인 수준 분석에서는 흡연 시작부터 폐암 진단까지의 잠복기가 훨씬 더 길게 나타나 남성에서는 40년 이상, 여성에서는 30년 이상이었다. 이러한 결과는 인구 건강에 대한 흡연 기인 폐암 부담을 평가할 때 최소 15년 이전의 과거 흡연 패턴을 반영해야 함을 시사한다.
Key Message
Smoking prevalence and lung cancer mortality and incidence rates in Korea showed clear temporal trends, particularly among men, with an approximate 15-year lag at the population level. Individual-level analyses indicated much longer latency periods from smoking initiation to lung cancer diagnosisover 40 years in men and over 30 years in women. These findings suggest that assessments of the smoking-attributable lung cancer burden on population health should incorporate historical smoking patterns from at least 15 years earlier.
Smokeless tobacco consumption and its association with tobacco control factors in the Western Pacific Region: results from the Global Youth Tobacco Survey 2015-2019
Chandrashekhar T. Sreeramareddy, Anusha Manoharan
Epidemiol Health. 2022;44:e2022103.   Published online November 8, 2022
DOI: https://doi.org/10.4178/epih.e2022103
  • 20,177 View
  • 122 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We estimated the prevalence of smokeless tobacco (ST) consumption and its associations with tobacco control factors among school-going youth in 18 Western Pacific Region (WPR) countries.
METHODS
We analyzed school-based Global Youth Tobacco Survey (2014-2019) microdata from 18 WPR countries and estimated weighted prevalence rates of ST consumption, cigarette smoking, and dual use. We used multilevel binary logistic regression to examine the associations of ST consumption and dual use with demographic variables, exposure to pro-tobacco and anti-tobacco factors, national income, and MPOWER indicators.
RESULTS
Data from 58,263 school-going youth were analyzed. The prevalence of past 30-day ST consumption was highest in Kiribati (42.1%), the Marshall Islands (26.1%), Micronesia (21.3%), Palau (16.0%), and Papua New Guinea (15.2%). In adjusted multilevel models, ST consumption and dual use were significantly associated with sex, age, parental smoking, pro-tobacco factors, national income, and MPOWER score. For each unit increase in score for cessation programs, we observed approximately 1.4-fold increases in the odds of youth ST consumption (adjusted odds ratio [aOR], 1.38; 95% confidence interval [CI], 1.15 to 1.66) and dual use (aOR, 1.47; 95% CI, 1.16 to 1.86). Similarly, for each unit increase in score for health-related warnings, the odds of both ST consumption (aOR, 0.47; 95% CI, 0.42 to 0.53) and dual use (aOR, 0.35; 95% CI, 0.30 to 0.42) decreased by approximately 60%.
CONCLUSIONS
The prevalence of youth ST consumption was substantial in the Pacific Islands, exceeding that of cigarette smoking in some countries. Implementing MPOWER measures for ST products could help reduce ST consumption.
Summary
Key Message
The prevalence of smokeless tobacco consumption, and cigarette smoking is considerably high among the school going youth in five pacific island nations of Western Pacific Region. Exposure to pro-tobacco factors and parental smoking were positively associated with youth smokeless tobacco consumption as well as dual use (both smokeless tobacco and cigarettes smoking) Closer monitoring and strict tobacco control policies are needed to prevent further escalation of smokeless tobacco consumption.

Citations

Citations to this article as recorded by  
  • Single, Dual, and Poly Use of Tobacco Products, and Associated Factors Among Adults in 18 Global Adult Tobacco Survey Countries During 2015–2021
    Chandrashekhar T. Sreeramareddy, Kiran Acharya, N. RamakrishnaReddy
    International Journal of Mental Health and Addiction.2025; 23(5): 4118.     CrossRef
  • Impact of Smokeless Oral Nicotine Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment: A Policy Statement From the American Heart Association
    Cheryl R. Dennison Himmelfarb, Neal L. Benowitz, Melissa D. Blank, Aruni Bhatnagar, Paul J. Chase, Esa M. Davis, Jessica L. Fetterman, Brittney Keller-Hamilton, Oluwabunmi Ogungbe, Robert L. Page, Mary Rezk-Hanna, Rose Marie Robertson, Laurie P. Whitsel
    Circulation.2025;[Epub]     CrossRef
  • Regional Variations in the Prevalence of Risk Factors and Non-Communicable Diseases in Papua New Guinea: A Scoping Review
    Bobby Porykali, Ryley Gronau, Phyllis Tran, Juliana Chen, Margaret Allman-Farinelli, Anna Rangan, Shelina Porykali, Robin Oge, Hans Nogua, Alyse Davies
    International Journal of Environmental Research and Public Health.2025; 22(1): 102.     CrossRef
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