{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:17:03Z","timestamp":1788844623414,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T00:00:00Z","timestamp":1647475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The objective of this study was to investigate the effects of reduction, cessation, and resumption of smoking on cancer development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors identified 893,582 participants who currently smoked, had undergone a health screening in 2009, and had a follow\u2010up screening in 2011. Among them, 682,996 participated in a third screening in 2013. Participants were categorized as quitters, reducers I (\u226550% reduction), reducers II (&lt;50% reduction), sustainers (referent), or increasers (\u226520% increase). Outcome data were obtained through December 31, 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Reducers I exhibited a decreased risk of all cancers (adjusted hazard ratio [aHR], 0.96; 95% confidence interval [CI], 0.93\u20100.99), smoking\u2010related cancers (aHR, 0.95; 95% CI, 0.92\u20100.99), and lung cancer (aHR, 0.83; 95% CI, 0.77\u20100.88). Quitters had the lowest risk of all cancers (aHR, 0.94; 95% CI, 0.92\u20100.96), smoking\u2010related cancers (aHR, 0.91; 95% CI, 0.89\u20100.93), and lung cancer (aHR, 0.79; 95% CI, 0.76\u20100.83). In further analysis with 3 consecutive screenings, additional smoking reduction (from reducers II to reducers I) lowered the risk of lung cancer (aHR, 0.74; 95% CI, 0.58\u20100.94) in comparison with sustainers. Quitting among reducers I further decreased the risk of all cancers (aHR, 0.90; 95% CI, 0.80\u20101.00), smoking\u2010related cancers (aHR, 0.81; 95% CI, 0.81\u20100.92), and lung cancer (aHR, 0.66; 95% CI, 0.52\u20100.84) in comparison with sustainers. Smoking resumption after quitting, even at a lower level, increased the risk of smoking\u2010related cancers (aHR, 1.19; 95% CI, 1.06\u20101.33) and lung cancer (aHR, 1.48; 95% CI, 1.21\u20101.80) in comparison with sustained quitting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Smoking cessation and, to a lesser extent, smoking reduction decreased the risks of cancer. Smoking resumption increased cancer risks in comparison with sustained quitting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay Summary<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Worldwide, tobacco use is the single leading preventable risk factor for cancer and cancer death.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This study examined the effects of reduction, cessation, and resumption of smoking on cancer development by measuring smoking behavior repetitively.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Although smoking reduction has a substantial cancer prevention benefit for those who cannot quit, cessation should be encouraged whenever possible. Quitters should be monitored to ensure that they do not resume smoking.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.34172","type":"journal-article","created":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T10:10:18Z","timestamp":1647511818000},"page":"2126-2137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Effect of smoking reduction, cessation, and resumption on cancer risk: A nationwide cohort study"],"prefix":"10.1002","volume":"128","author":[{"given":"Jung Eun","family":"Yoo","sequence":"first","affiliation":[{"name":"Department of Family Medicine Healthcare System Gangnam Center Seoul National University Hospital Seoul Republic of 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