{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T19:59:08Z","timestamp":1783627148891,"version":"3.55.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012155","name":"National Institute for Medical Research Development","doi-asserted-by":"publisher","award":["940045"],"award-info":[{"award-number":["940045"]}],"id":[{"id":"10.13039\/501100012155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Despite the implementation of the WHO Framework Convention on Tobacco Control (FCTC) program in Iran, the regulation of second-hand smoke (SHS) exposure\u2014an often-overlooked hazard\u2014, still requires improvement. We employed a multi-center case-control study to investigate the association between exposure to secondhand smoke (SHS) from various tobacco products (cigarettes, water-pipes, pipes, and chopogh), opium use, and the risk of lung cancer.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>We included 627 lung cancer cases and 3477 controls. Exposure to SHS tobacco and SHS opium was collected through a questionnaire. We used mixed-model logistic regressions to estimate odds ratios (ORs) and 95% confidence intervals (CI).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Result<\/jats:title>\n<jats:p>Among the overall population exposed to second-hand tobacco smoke (SHTS), the odds ratio (OR) compared to those never exposed was 1.35 (95% CI: 1.08\u20131.71). Never smokers who were ever exposed to second-hand tobacco smoke (SHTS) had 1.69-fold risk of lung cancer compared to those who were never exposed (95% CI: 1.13\u20132.52). Exposure to SHTS between 2\u20133 per day (OR = 2.27, 95% CI: 1.13\u20134.53) and more than three hours per day (OR = 2.29, 95% CI: 1.20\u20134.37) can increase the risk of lung cancer compared with the no exposure group (P-trend &lt;0.01). We did not observe any association between exposure to second-hand opium smoke (SHOS) and the risk of lung cancer, either in the overall population or among never-smokers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our study estimates the impact of second-hand tobacco smoke (SHTS) on lung cancer risk in both the overall population and never-smokers. Additional studies are required to evaluate the association between exposure to second-hand smoke from opium and other type of tobacco, including water-pipe and the risk of lung cancer.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0306517","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T17:30:05Z","timestamp":1720632605000},"page":"e0306517","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Exposure to second-hand smoke and risk of lung cancer among Iranian population: A multicenter case-control study"],"prefix":"10.1371","volume":"19","author":[{"given":"Fereshte","family":"Lotfi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamideh","family":"Rashidian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Hadji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0868-4067","authenticated-orcid":true,"given":"Elham","family":"Mohebbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Marzban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Naghibzadeh-Tahami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eero","family":"Pukkala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Boffetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Etemadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0269-4945","authenticated-orcid":true,"given":"Kazem","family":"Zendehdel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"issue":"1","key":"pone.0306517.ref001","first-page":"31","article-title":"Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States","volume":"68","author":"F Islami","year":"2018","journal-title":"CA: a cancer journal for clinicians"},{"issue":"3","key":"pone.0306517.ref002","first-page":"E540","article-title":"Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results","volume":"5","author":"A Grundy","year":"2017","journal-title":"Canadian Medical Association Open Access Journal"},{"issue":"18","key":"pone.0306517.ref003","doi-asserted-by":"crossref","first-page":"4220","DOI":"10.1002\/cncr.33078","article-title":"Global, regional, and national burden of lung cancer and its attributable risk factors, 1990 to 2017","volume":"126","author":"N Wang","year":"2020","journal-title":"Cancer"},{"issue":"18","key":"pone.0306517.ref004","doi-asserted-by":"crossref","first-page":"5626","DOI":"10.1158\/1078-0432.CCR-09-0376","article-title":"Lung cancer in never smokers: clinical epidemiology and environmental risk factors","volume":"15","author":"JM Samet","year":"2009","journal-title":"Clinical Cancer Research"},{"key":"pone.0306517.ref005","author":"Organization WH","year":"2010","journal-title":"Global estimate of the burden of disease from second-hand smoke"},{"issue":"3","key":"pone.0306517.ref006","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1023\/A:1018401120233","article-title":"Risk of lung cancer from environmental exposures to tobacco smoke.","volume":"8","author":"DW Dockery","year":"1997","journal-title":"Cancer Causes & Control"},{"issue":"7114","key":"pone.0306517.ref007","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1136\/bmj.315.7114.980","article-title":"The accumulated evidence on lung cancer and environmental tobacco smoke","volume":"315","author":"AK Hackshaw","year":"1997","journal-title":"Bmj"},{"issue":"19","key":"pone.0306517.ref008","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1093\/jnci\/90.19.1440","article-title":"Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe.","volume":"90","author":"P Boffetta","year":"1998","journal-title":"JNCI: Journal of the National Cancer Institute"},{"issue":"1","key":"pone.0306517.ref009","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0169-5002(99)00093-8","article-title":"Exposure to environmental tobacco smoke and the risk of lung cancer: a meta-analysis","volume":"27","author":"L Zhong","year":"2000","journal-title":"Lung cancer"},{"key":"pone.0306517.ref010","unstructured":"General USPHSOotS. 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