Smoking habits of 118 male patients with cancer of the lung from a rural area of Switzerland were compared with those obtained in a survey of all male inhabitants of a rural town in the same region. Adjusted relative risks of pulmonary cancer were computed for cigar and pipe smokers in relation to cigarette smokers. Adjustment was made for amounts smoked among cigarette smokers and an estimate of relative risk was obtained in relation to nonsmokers. Risk of pulmonary cancer for all smokers of products other than cigarettes was 5.6 times (95% confidence limits: 3.6 to 8.6) that for nonsmokers. For heavy cigar a n d pipe smokers the risk was 1.7 times that of cigarette smokers and 14.7 times that of nonsmokers (95% confidence limits: 8.9 to 24.4). T h e results of this study differ from those obtained i n the United States but are compatible with findings in countries with a larger proportion of cigar and pipe smokers.
LTHOUGH CIGARETTE SMOKING IS GENERAI.LY A recognized as a major cause of cancer of the lung, there is still doubt concerning the carcinogenic properties of other types of tobacco products. Studies from the United States, Canada and Great Britain show a much lower risk of pulmonary cancer for pipe and cigar smokers than for cigarette smokers, although a higher risk than for nonsmokers. These findings have led to the idea that it may be advisable for smokers to turn from cigarettes to cigars and pipes.
However, these studies were done in countries where cigar and pipe smokers are a very small, and perhaps highly selected, part of the population. Reports from countries with a larger proportion o E cigar and pipe smokers indicate that a considerable number of deaths from cancer of the lung occurred in smokers of products other than cigarettes;', 4 , 7 9 1 5 therefore we reexamined the risks of pulmonary cancer for pipe and cigar smokers in one of these countries.
This study is based on information from a rural area of Switzerland, where a large pro-Froin the