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Lung cancer and passive smoking
1Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, St Bartholomew's, London, UK.
Statistical Methods in Medical Research
|July 9, 1998
Summary
Exposure to environmental tobacco smoke causes lung cancer in nonsmokers. Studies confirm a causal link, with risks increasing based on spouse
Area of Science:
- Environmental Health
- Oncology
- Toxicology
Background:
- Environmental tobacco smoke (ETS) contains carcinogens and metabolites like nicotine and cotinine, which are inhaled by non-smokers.
- Epidemiological and toxicological data confirm a causal association between ETS exposure and lung cancer risk.
Purpose of the Study:
- To evaluate the causal association between environmental tobacco smoke exposure and lung cancer risk in lifelong non-smoking women.
- To quantify the excess risk of lung cancer attributable to passive smoking from a spouse.
Main Methods:
- Analysis of epidemiological data from lifelong non-smoking women exposed to spousal smoking.
- Assessment of biochemical markers (nicotine, cotinine) indicating ETS inhalation.
- Statistical adjustment for potential biases like misclassification and dietary confounding.
Main Results:
- A statistically significant excess lung cancer risk of 24% (95% CI 13-36%) was observed in non-smoking women exposed to spousal ETS.
- Risk increased with the number of cigarettes smoked by the spouse and duration of marriage.
- Adjusted analysis, accounting for misclassification and confounding, confirmed a significant ETS-attributable lung cancer risk.
Conclusions:
- Environmental tobacco smoke exposure is a significant and avoidable cause of lung cancer in non-smokers.
- Public health policies should focus on reducing smoking in public and private spaces to mitigate passive smoking risks.
- Approximately one in six non-smokers in Britain are exposed to ETS in the home.