title: Active and passive cigarette smoking and mortality among Hispanic and non-Hispanic white women diagnosed with invasive breast cancer.
abstract: OBJECTIVE
  Women who smoke at breast cancer diagnosis have higher risk of breast cancer-specific and all-cause mortality than nonsmokers; however, differences by ethnicity or prognostic factors and risk for noncancer mortality have not been evaluated.
  
  
  METHODS
  We examined associations of active and passive smoke exposure with mortality among Hispanic (n = 1020) and non-Hispanic white (n = 1198) women with invasive breast cancer in the Breast Cancer Health Disparities Study (median follow-up of 10.6 years).
  
  
  RESULTS
  Risk of breast cancer-specific (HR = 1.55, 95% CI = 1.11-2.16) and all-cause (HR = 1.68, 95% CI = 1.30-2.17) mortality was increased for current smokers, with similar results stratified by ethnicity. Ever smokers had an increased risk of noncancer mortality (HR = 1.68, 95% CI = 1.12-2.51). Associations were strongest for current smokers who smoked for 20 years or more were postmenopausal, overweight and/or obese, or reported moderate and/or high alcohol consumption; however, interactions were not significant. Breast cancer-specific mortality was increased two fold for moderate and/or high recent passive smoke exposure among never smokers (HR = 2.12, 95% CI = 1.24-3.63).
  
  
  CONCLUSIONS
  Findings support associations of active-smoking and passive-smoking diagnosis with risk of breast cancer-specific and all-cause mortality and ever smoking with noncancer mortality, regardless of ethnicity, and other factors. Smoking is a modifiable lifestyle factor and effective smoking cessation, and maintenance programs should be routinely recommended for women with breast cancer.
authors.affiliation: Department of Epidemiology & Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY. Electronic address: stephanie.boone@louisville.edu.
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Boone
authors.affiliation: Department of Epidemiology & Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY.
authors.forename: Kathy B
authors.initials: KB
authors.lastname: Baumgartner
authors.affiliation: Department of Epidemiology & Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Baumgartner
authors.affiliation: Department of Epidemiology & Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY.
authors.forename: Avonne E
authors.initials: AE
authors.lastname: Connor
authors.affiliation: Cancer Prevention Institute of California, Fremont; Division of Epidemiology, Department of Health Research and Policy, and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA.
authors.forename: Esther M
authors.initials: EM
authors.lastname: John
authors.affiliation: H. Lee Moffit Cancer Center & Research Institute, Tampa, FL.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
authors.affiliation: Department of Biology, University of Colorado, Colorado Springs, Colorado Springs.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Hines
authors.affiliation: Department of Bioinformatics and Biostatistics, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY.
authors.forename: Shesh N
authors.initials: SN
authors.lastname: Rai
authors.affiliation: Department of Medicine-Oncology and Hematology, School of Medicine, James Graham Brown Cancer Center, University of Louisville, Louisville, KY.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Riley
authors.affiliation: Department of Bioinformatics and Biostatistics, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Pinkston
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City.
authors.forename: Roger K
authors.initials: RK
authors.lastname: Wolff
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Slattery
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000208:ethnology / Q000209:etiology* / Q000401:mortality*; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D011795:Surveys and Questionnaires; D013534:Survival; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Breast cancer; Ethnicity; Hispanic; Mortality; Native American ancestry; Smoking; Survival