title: Stroke mortality associated with environmental tobacco smoke among never-smoking Japanese women: a prospective cohort study.
abstract: OBJECTIVE
  This study examined the association of exposure to environmental tobacco smoke (ETS) during adulthood with stroke and its subtypes using data from a large-scale prospective cohort study in Japan.
  
  
  METHODS
  The study population included 36,021 never-smoking Japanese women who were enrolled between 1983 and 1985 and were followed-up for 15 years. We used Cox proportional hazard regression models to estimate hazard ratios (HRs) for stroke death associated with ETS exposure at home during adulthood.
  
  
  RESULTS
  A total of 906 cases of stroke death were observed during 437,715 person-years of follow-up. Compared with never-smoking women without smoking family members, HRs for stroke mortality among never-smoking women living with smoking family members in all subjects, in those aged 40-79 years, and in those aged ≥ 80 years were 1.14 (95% confidence interval: 0.99-1.31), 1.24 (95% CI: 1.05-1.46), and 0.89 (95% CI: 0.66-1.19), respectively, after adjustment for possible confounders. The risk was most evident for subarachnoid hemorrhage [HR: 1.66 (95% CI: 1.02-2.70) in all subjects].
  
  
  CONCLUSIONS
  This study suggests that exposure to ETS at home during adulthood is associated with an increased risk of stroke among never-smoking Japanese women.
authors.affiliation: Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi 981-1293, Japan. Electronic address: nishino-yo202@umin.net.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nishino
authors.affiliation: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.
authors.forename: Tomio
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: School of Nursing, Miyagi University, 1 Gakuen, Taiwa, Kurokawa-gun, Miyagi 981-3298, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Nakatsuka
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Ito
authors.affiliation: Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.
authors.forename: Takaichiro
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Katanoda
authors.affiliation: Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Sobue
authors.affiliation: Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan.
authors.forename: Suketami
authors.initials: S
authors.lastname: Tominaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000401:mortality*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Cohort studies; Japan; Mortality; Stroke; Tobacco smoke pollution