title: Passive cigarette smoking is a risk factor in cervical neoplasia.
abstract: OBJECTIVE
  To determine the role of spouse's cigarette smoking in the detection of high-grade squamous intraepithelial lesions of the cervix.
  
  
  METHODS
  Prospective cohort study with multivariate analysis.
  
  
  METHODS
  Colposcopy clinic in a tertiary hospital.
  
  
  METHODS
  Women referred to a colposcopy clinic for evaluation of abnormal Papanicolaou smears showing either repeated inflammatory changes, low-grade squamous intraepithelial lesion (LSIL), or high-grade squamous intraepithelial lesion (HSIL). Data collection. The women were interviewed with a structured questionnaire for sexual history, use of oral contraceptive pills, personal and spouse cigarette-smoking history, and obstetric history.
  
  
  RESULTS
  There were 623 women in the cohort. They were grouped into normal, LSIL, and HSIL categories based on colposcopy and histologic assessment. There were very few women who had had more than one sexual partner or a history of sexually transmitted diseases (STDs). The prevalence of oral contraceptive pill usage was 2.9% among the women in the normal group, 4.3% in women with LSIL, and 5.1% in women with HSIL. The incidence of cigarette smoking by the women was 2.5%, 3.2%, and 6.8% for the three groups of women, respectively. The incidence of spouse cigarette smoking was 25%, 35%, and 43% respectively. Compared to women in the normal group, women with HSIL were younger at first sexual intercourse, more likely to smoke cigarettes, and have spouses who smoked cigarettes. After controlling for age, age at first sexual intercourse, usage of combined contraceptive pills, and the woman's own cigarette-smoking habit, the odds ratio for HSIL was 1.046 for every stick of cigarette smoked by the spouse. In other words, the risk of detection of HSIL increased by 4.6% for every stick of cigarette her spouse smoked.
  
  
  CONCLUSIONS
  Among women attending a colposcopy clinic, the risk of detection of HSIL increases with the spouse's cigarette-smoking habit. Further studies are warranted in quantifying the risk in a general population.
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore 169608, Singapore. gogtsk@sgh.com.sg
authors.forename: Sun-Kuie
authors.initials: SK
authors.lastname: Tay
authors.forename: Kae-Jack
authors.initials: KJ
authors.lastname: Tay
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003127:Colposcopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008593:Menopause; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D002583:Uterine Cervical Neoplasms / Q000209:etiology* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000209:etiology* / Q000473:pathology
chemical_list: D014028:Tobacco Smoke Pollution