Assessing the impact of environmental tobacco smoke on five-year cancer mortality

Environmental tobacco smoke (ETS), also known as passive smoke, is a major public health concern due to its adverse health effects, which are comparable to those of active smoking. Although the risks of ETS for cardiovascular and respiratory outcomes are well documented, less is known about its impact on cancer prognosis. This study evaluated the association between ETS exposure and five-year all-cause mortality among patients diagnosed with breast, colorectal, lung, melanoma, or stomach cancer.

Clinical data were obtained from the UC San Diego Health system and the UC Health Data Warehouse. The study cohort included 17,729 adult patients with a confirmed cancer diagnosis and no recorded history of active smoking. ETS exposure and five-year mortality were identified using structured electronic health record data. Multivariable exact logistic regression and Cox proportional hazards models were used to estimate the association between ETS exposure and five-year mortality, adjusting for age, sex, cancer type, race, ethnicity, hypertension, hyperlipidemia, and type 2 diabetes.

Among patients with documented ETS exposure, the five-year mortality rate was 86.95 %, compared to 61.69 % among those without ETS exposure. ETS exposure was independently associated with significantly increased odds of five-year mortality (OR = 7.83, 95 % CI: 3.64-5.85, p < 0.001). Lung and stomach cancers were associated with higher mortality risk relative to breast cancer, whereas female sex, colon cancer, melanoma, White race, hypertension, hyperlipidemia, and type 2 diabetes were associated with reduced mortality.

ETS exposure is a significant predictor of five-year mortality among cancer patients with no history of smoking. These findings underscore the need for increased clinical attention and public health efforts to reduce involuntary exposure to tobacco smoke in vulnerable populations.