21PD_PR - Perception of lung cancer (LC) risk: Impact of smoking status and nicotine dependence

Date 17 April 2015
Event ELCC 2015
Session Epidemiology, early stage NSCLC and surgery
Topics Cancer Aetiology, Epidemiology, Prevention
Lung and other Thoracic Tumours
Presenter Laurent Greillier
Citation Annals of Oncology (2015) 0 (0): 1-8. 10.1093/annonc/mdv128
Authors L. Greillier1, S. Couraud2, C. Touboul3, J. Viguier4, F. Eisinger5, J. Morère6, X. Pivot7, J. Blay8, C. Lhomel9, A. Cortot10
  • 1Service D'oncologie Multidisciplinaire & Innovations Thérapeutiques, Hopital Nord, 13915 Marseille Cedex 20 - Marseille/FR
  • 2Pneumologie Aiguë Spécialisée & Cancérologie Thoracique, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Lyon/FR
  • 3Statistics, KantarHealth, Montrouge/FR
  • 4Centre De Coordination Des Dépistages Des Cancers, Hôpital Bretonneau, Tours/FR
  • 5Oncogénétique, Institute Paoli Calmettes, Marseille/FR
  • 6Department Of Onco-hematology, Hopital Paul Brousse, Villejuif/FR
  • 7Department Of Medical Oncology, CHU Besançon, Hôpital Jean Minjoz, Besançon/FR
  • 8University Claude Bernard Lyon I, Centre Léon Bérard, 69008 - Lyon/FR
  • 9Oncologie Hématologie, Roche SAS, Boulogne-Billancourt/FR
  • 10Pneumologie Et Oncologie Thoracique, Hôpital Calmette, Lille/FR



The general population is nowadays well aware that tobacco dramatically increases the risk of developing LC in the future. We hypothesized that personal smoking history, and the level of nicotine dependence in current smokers (CS), may affect the perception of this risk among healthy individuals.


The fourth French nationwide observational survey, EDIFICE 4, was conducted from June 12 to July 10, 2014 among a representative sample of 1602 individuals aged between 40 and 75 years, using the quota method. Individuals were questioned by phone about their smoking habits. Nicotine dependence was assessed in CS using the Fagerström Test (no dependence [group A]; low [group B]; moderate [group C] and high dependence [group D]). Risk perception was self-assessed: individually compared with the average-risk population, according to the effect of tobacco consumption, and to the effect of quitting.


Among the 1463 subjects with no history of cancer, 481 (33%) were former smokers (FS) and 330 (24%) were CS, with a mean daily consumption of 14.2 cigarettes. According to the Fagerström Test, 52% of CS belonged to group A, 21% to group B, 18% to group C and 9% to group D. Only half the CS considered themselves at higher risk of LC than the average-risk population, while 4% of never smokers (NS) and 14% of FS had the same perception (P < 0.05). Among CS, the majority of those with a dependence on nicotine (B, C, D groups) considered themselves to be at higher risk of LC, while only 37% of non-dependent subjects (A group) had the same perception (P < 0.05). Surprisingly, 34% of FS considered themselves to be at lower risk of LC, versus 7% among CS (P < 0.05). Of the whole sample population, 34% considered that a daily consumption of up to 10 cigarettes was not associated with any risk of LC. The daily number of cigarettes considered “non-dangerous” was 1.8 in FS and 2 in NS, versus 3.4 in CS (P < 0.05). Less than 40% of individuals questioned were aware that the risk of LC never disappears after smoking cessation, but neither the smoking status nor the level of nicotine dependence significantly influenced this perception.


The considerable number of individuals who consider low cigarette-consumption to be safe demonstrates the urgency of initiating campaigns to address this question.


All authors have declared no conflicts of interest.