Smoking and hematolymphopoietic malignancies.
OBJECTIVE
Tobacco use is the most prominent cause of respiratory cancers. Little is known, however, about the influence of smoking on hematolymphopoietic malignancies. To evaluate this relation, a population-based case-control study was carried out in 12 areas of Italy.


METHODS
Detailed interviews on tobacco smoking habits were administered to 1450 non-Hodgkin's lymphoma (NHL), 365 Hodgkin's disease (HD), 270 multiple myeloma (MM), and 649 leukemia (LEU) patients occurring from 1990 to 1993, and 1779 population controls.


RESULTS
We found a slightly increased risk for NHL in smokers (odds ratio 1.2, 95% confidence interval 1.0-1.4 for ever smokers), but a consistent positive association was shown only for follicular NHL. In this subtype, a significant excess risk was observed for ever versus never smokers, after adjustment for gender, age, geographic residence, education, and respondent (OR = 1.8, 95%, CI 1.3-2.7), with a positive exposure-response gradient for smoking duration (p < 0.01). The risk for follicular NHL was significantly elevated only among women, with ever smokers showing OR = 2.3 (CI 1.4-3.8), while for men we found OR = 1.3 (CI 0.69-2.3). No major differences were shown according to age. Female subjects also showed significant positive exposure-response trends for duration.


CONCLUSIONS
Cigarette smoking could be a risk factor for follicular NHL among women. For HD, MM, or LEU, no clear association was observed.
Stagnaro
E
E
Epidemiology Unit of National Cancer Research Institute, Genoa, Italy. stagnaro@hp380.ist.unige.it
Ramazzotti
V
V
Crosignani
P
P
Fontana
A
A
Masala
G
G
Miligi
L
L
Nanni
O
O
Neri
M
M
Rodella
S
S
Costantini
A S
AS
Tumino
R
R
Viganò
C
C
Vindigni
C
C
Vineis
P
P
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006689:Hodgkin Disease / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007938:Leukemia / Q000453:epidemiology / Q000209:etiology*; D016015:Logistic Models; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires