title: Does smoking or alcohol modify the risk of Epstein-Barr virus-positive or -negative Hodgkin lymphoma?
abstract: BACKGROUND
  The aim was to investigate whether 2 subgroups of Hodgkin lymphoma (Epstein-Barr virus-positive and Epstein-Barr virus-negative) are associated with smoking or alcohol.
  
  
  METHODS
  Patients with lymphoma diagnosed between age 16 and 69 years in geographically defined areas of England were recruited between 1998 and 2003. One control, matched to each lymphoma case on sex, date of birth, and area of residence, was randomly selected from population registers. Self-reported histories of tobacco and alcohol use were collected during face-to-face interviews with cases and controls.
  
  
  RESULTS
  Compared with lifelong nonsmokers, ever-smokers were at increased risk of Hodgkin lymphoma (odds ratio =1.4; 95% confidence interval = 1.1-1.9). This excess was among current smokers, defined as smoking 2 years before diagnosis (1.7; 1.2-2.3). An increasing trend was observed with rising numbers of years smoked. Risks fell as the number of years stopped smoking increased, becoming equivalent to that of a nonsmoker 10 or more years after quitting. Associations were suggested for Epstein-Barr virus-positive Hodgkin lymphoma, but less so for Epstein-Barr negative Hodgkin lymphoma. No associations between Hodgkin lymphoma and alcohol consumption were observed.
  
  
  CONCLUSIONS
  The association between smoking and Hodgkin lymphoma in general, and Epstein-Barr-positive Hodgkin lymphoma in particular, is consistent with previous studies. Further exploration of the relationship between Hodgkin lymphoma and smoking and of the potential mechanisms by which smoking could interact with Epstein-Barr virus status to increase Hodgkin lymphoma risk are required.
authors.affiliation: Epidemiology and Genetics Unit, Department of Health Sciences, University of York, York, UK.
authors.forename: Eleanor V
authors.initials: EV
authors.lastname: Willett
authors.forename: Sheila
authors.initials: S
authors.lastname: O'Connor
authors.forename: Alexandra G
authors.initials: AG
authors.lastname: Smith
authors.forename: Eve
authors.initials: E
authors.lastname: Roman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D016022:Case-Control Studies; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000145:classification / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology