A study done by the Environment and Genetics in Lung Cancer Etiology (EAGLE) and the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer screening trial in the United States reviewed data from current and former smokers in Italy and found that the amount of time it takes to smoke the first cigarette in the morning may have an effect on risk for lung cancer.
"An individual smoker's risk for developing lung or head and neck cancer may be related to how dependent they are on nicotine," Dr Michael B. Steinberg, editorial board member of HemOnc Today, said in an interview. "Asking a question like 'How soon do you smoke in the morning?' may be a way of getting at that information and giving an individual their own risk for developing cancer." "Time to First Cigarette (TTFC)" was measured by how soon after one wakes up does one smoke their first cigarette.
Out of the 3,249 smokers from the EAGLE study, 1,812 of them were lung cancer patients, and 1,437 were control subjects. It was found that those with shorter TTFC had a higher risk for lung cancer. Also, in a very interesting note, the risk of lung cancer in the case of TTFC was lower in heavy smokers when compared to light smokers. The authors said, "Assessing TTFC may improve lung cancer risk prediction and could be useful in lung cancer screening and smoking cessation programs."
The researchers of a study completed by Joshua Muscat from the Department of Public Health Services at Penn State College of Medicine, wrote, "There is clearly inter-individual variability in the way smokers regulate their nicotine intake per cigarette, with increasing frequency in a natural setting and in attempting to quit. It is not feasible to measure how smokers regulate their nicotine uptake in studies of disease risk, but the TTFC is a behavior that is strongly associated with the level of cotinine per cigarette smoked. TTFC is a distinct nicotine dependence phenotype and was also shown to be an independent risk factor for lung cancer in the current study." They also found a connection between TTFC and head and neck cancer.