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The relationship is likely confounded by smoking, complicating the interpretation of previous studies. We examined the association of alcohol consumption and lung cancer risk in a large pooled international sample, minimizing potential confounding of tobacco consumption by restricting analyses to never smokers. Our study included 22 case\u2010control and cohort studies with a total of 2548 never\u2010smoking lung cancer patients and 9362 never\u2010smoking controls from North America, Europe and Asia within the International Lung Cancer Consortium (ILCCO) and SYNERGY Consortium. Alcohol consumption was categorized into amounts consumed (grams per day) and also modelled as a continuous variable using restricted cubic splines for potential non\u2010linearity. Analyses by histologic sub\u2010type were included. Associations by type of alcohol consumed (wine, beer and liquor) were also investigated. Alcohol consumption was inversely associated with lung cancer risk with evidence most strongly supporting lower risk for light and moderate drinkers relative to non\u2010drinkers (&gt;0\u20134.9 g per day: OR\u2009=\u20090.80, 95% CI\u2009=\u20090.70\u20130.90; 5\u20139.9 g per day: OR\u2009=\u20090.82, 95% CI\u2009=\u20090.69\u20130.99; 10\u201319.9 g per day: OR\u2009=\u20090.79, 95% CI\u2009=\u20090.65\u20130.96). Inverse associations were found for consumption of wine and liquor, but not beer. The results indicate that alcohol consumption is inversely associated with lung cancer risk, particularly among subjects with low to moderate consumption levels, and among wine and liquor drinkers, but not beer drinkers. Although our results should have no relevant bias from the confounding effect of smoking we cannot preclude that confounding by other factors contributed to the observed associations. Confounding in relation to the non\u2010drinker reference category may be of particular importance.<\/jats:p>","DOI":"10.1002\/ijc.30618","type":"journal-article","created":{"date-parts":[[2017,1,25]],"date-time":"2017-01-25T03:22:43Z","timestamp":1485314563000},"page":"1976-1984","source":"Crossref","is-referenced-by-count":41,"title":["Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study"],"prefix":"10.1002","volume":"140","author":[{"given":"Gordon","family":"Fehringer","sequence":"first","affiliation":[{"name":"Lunenfeld\u2010Tanenbaum Research Institute, Sinai Health System Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren R.","family":"Brenner","sequence":"additional","affiliation":[{"name":"Lunenfeld\u2010Tanenbaum Research Institute, Sinai Health System Toronto Canada"},{"name":"International Agency for Research on Cancer Lyon France"},{"name":"Department of Cancer Epidemiology and Prevention Research Alberta Health Services Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuo\u2010Feng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology School of Public Health, UCLA Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan\u2010Chin Amy","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family and Preventive Medicine School of Medicine, University of Utah Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keitaro","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Division of Molecular Medicine Aichi Cancer Center Research Institute Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemi","family":"Ito","sequence":"additional","affiliation":[{"name":"Division Epidemiology and Prevention Aichi Cancer Center Research Institute Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Lan","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Vineis","sequence":"additional","affiliation":[{"name":"Division of Epidemiology Public Health and Primary Care, Faculty of Medicine, Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Johansson","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Overvad","sequence":"additional","affiliation":[{"name":"Department of Public Health Section for Epidemiology, Aarhus University  Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elio","family":"Riboli","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Imperial College London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Trichopoulou","sequence":"additional","affiliation":[{"name":"Hellenic Health Foundation Athens Greece"},{"name":"World Health Organization Collaborating Center for Food and Nutrition Policies Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Sacerdote","sequence":"additional","affiliation":[{"name":"Unit of Cancer Epidemiology Piedmont Children Cancer Registry, Citt\u00e0 della Salute e della Scienza di Torino Hospital and CPO Piemonte Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Stucker","sequence":"additional","affiliation":[{"name":"Department of Environmental Epidemiology INSERM Villejuif U170 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Boffetta","sequence":"additional","affiliation":[{"name":"Mount Sinai School of Medicine The Tisch Cancer Institute New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Brennan","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David. 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