title: Cigarette smoking, passive smoking, and non-Hodgkin lymphoma risk: evidence from the California Teachers Study.
abstract: Epidemiologic studies conducted to date have shown evidence of a causal relation between smoking and non-Hodgkin lymphoma (NHL) risk. However, previous studies did not account for passive smoking exposure in the never-smoking reference group. The California Teachers Study collected information about lifetime smoking and household passive smoking exposure in 1995 and about lifetime exposure to passive smoking in 3 settings (household, workplace, and social settings) in 1997-1998. Multivariable-adjusted relative risks and 95% confidence intervals were estimated by fitting Cox proportional hazards models with follow-up through 2007. Compared with never smokers, ever smokers had a 1.11-fold (95% confidence interval (CI): 0.94, 1.30) higher NHL risk that increased to a 1.22-fold (95% CI: 0.95, 1.57) higher risk when women with household passive smoking were excluded from the reference category. Statistically significant dose responses were observed for lifetime cumulative smoking exposure (intensity and pack-years; both P 's for trend = 0.02) when women with household passive smoking were excluded from the reference category. Among never smokers, NHL risk increased with increasing lifetime exposure to passive smoking (relative risk = 1.51 (95% CI: 1.03, 2.22) for >40 years vs. ≤5 years of passive smoking; P for trend = 0.03), particularly for follicular lymphoma (relative risk = 2.89 (95% CI: 1.23, 6.80); P for trend = 0.01). The present study provides evidence that smoking and passive smoking may influence NHL etiology, particularly for follicular lymphoma.
authors.affiliation: Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 East Duarte Road, Duarte, CA 91010, USA. yalu@coh.org
authors.forename: Yani
authors.initials: Y
authors.lastname: Lu
authors.forename: Sophia S
authors.initials: SS
authors.lastname: Wang
authors.forename: Peggy
authors.initials: P
authors.lastname: Reynolds
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Chang
authors.forename: Huiyan
authors.initials: H
authors.lastname: Ma
authors.forename: Jane
authors.initials: J
authors.lastname: Sullivan-Halley
authors.forename: Christina A
authors.initials: CA
authors.lastname: Clarke
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology*; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution