Exposure to Spouse's Smoking and Relative Risk of Cancer

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TABLE 7.1

EXPOSURE TO SPOUSE'S SMOKING AND RELATIVE RISK (RR)
OF ALL CANCERS IN ADULTS

Cohort Studies # Cases Exposure to RR (95% CI) for
Passive Smoking Spouse's Smoking

Hirayama, 1984 Husband's smoking
All cancers^a 634 Nonsmoking 1.00
1341 Ex-/1-19/day 1.12 (1.03 - 1.21)^b
730 20+/day 1.23 (1.12 - 1.35)

Sandler et al., 1989 Males Household smoking
All cancers^a 84 No 1.0
31 Yes 1.01 (0.66 - 1.53)
Females
211 No 1.00
290 Yes 1.00 (0.82 - 1.21)
All cancers classified as:

Smoking-related cancers Males
24 No 1.0
8 Yes 0.96 (0.43 - 2.62)
Females
27 No 1.0
49 Yes 1.45 (0.88 - 2.40)

Other cancers Males
60 No 1.0
23 Yes 1.03 (0.40 - 2.62)
Females
184 No 1.0
241 Yes 0.93 (0.76 - 1.54)

Reynold et al., 1987 Husband's smoking
All cancers^a 71^c No 1.00
Yes 1.68 (1.12 - 1.5)^b
Smoking-related cancers 4^c No 1.00
Yes 7.01 (1.05 - 47.0)

a There were 200 lung cancers in Hirayama (1984); 2 lung cancers in Sandler et al., 1989;
and an unspecified number in Reynold et al., 1987.

b 90% CI confidence intervals.

c The distribution of the 71 cancers by husband's smoking was not presented; the specific
cancer sites were not presented.

TABLE 7.2A

HAIR CONCENTRATIONS OF NICOTINE AND COTININE IN
WOMEN AND THEIR NEWBORN INFANTS

Mean (SEM)^* Mean (SEM)
Concentration of Concentration of
Nicotine (ng/ml) Cotinine (ng/ml)

Active smoking women (n=36) 19.2 (4.9) 6.3 (4.0)

Newborn of active smoking women 2.4 (0.9) 2.8 (0.8)

Passive smoking women^a (n=23) 3.2 (0.8) 0.9 (0.3)

Newborn of passive smoking women 0.28 (0.05) 0.6 (0.15)^b

Nonsmoking women (n=35) 1.2 (0.4) 0.3 (0.06)

Newborn of nonsmoking women 0.4 (0.09) 0.26 (0.04)

Reference: Eliopoulos et al. (1994)

a Defined as regular and steady gestational exposure to other person’s cigarette smoke, either at home or in the workplace.

b p< 0.01 when compared to newborns of active smoking women and newborns of nonsmokers.

* (SEM) = Standard error of the mean.

TABLE 7.2B

4-AMINOBIPHENYL HEMOGLOBIN ADDUCT CONCENTRATIONS IN PREGNANT WOMEN AND FETUSES BY EXPOSURE TO TOBACCO SMOKE

Mean Standard

Concentration Deviation

(pg/g of hemoglobin)

Nonsmoking pregnant women^a (n=40) 22 8
Smoking pregnant women (n=15) 183 108

Nonsmoking women by levels of
exposure to passive smoking based
on nicotine concentrations^b,c

µg/m³
<0.5 (n = 7) 17.6 2.4
0.5 - 1.9 (n = 20) 20.8 2.0
>2.0 (n = 9) 27.8 1.4

Fetuses of nonsmoking mothers^b (n = 40) 17 13
Fetuses of smoking mothers (n=16) 92 54

a Reference: Coghlin et al. (1991)

b Reference: Hammond et al. (1993)

c This represented weekly average nicotine concentrations measured during the third trimester when each subject wore a lightweight monitor. Nonsmoking women in this study were the same nonsmoking pregnant women reported in Coghlin et al. 1991.

TABLE 7.2C

COTININE AND PAH-ALBUMIN LEVELS IN MOTHERS

AND THEIR PRESCHOOL CHILDREN

Mean (SE)^* Mean (SE) PAH-

Cotinine (ng/ml) albumin (fmol/m g)

Level Level

Active smoking women (n=31) 170 (21.2) 0.80 (0.15)

Preschool children of 4.14 (0.54) 0.35 (0.07)

active smoking women

Passive smoking women^a (n=32) 1.64 (0.97) 0.49 (0.08)

Preschool children of 0.87 (0.20)^b 0.18 (0.04)^c

passive smoking women

Nonsmoking women (n=24) 0.96 (0.79) 0.31 (0.08)

Preschool children of 0.25 (0.12) 0.15 (0.02)

non-smoking women

Reference: Crawford et al. (1994)

Abbreviations: PAH = polyaromatic hydrocarbon; SE = standard error

a Exposure to ETS at home from other household members and visitors.

^{b Levels in preschool children in households with ETS exposure
were significantly higher

(p <0.01) than those in children in nonsmoking households.

c Levels in
preschool children in households with ETS exposure were not significantly higher than
those in children in nonsmoking households.

^{* (SE) = Standard
error}}
TABLE 7.3

MATERNAL SMOKING DURING INDEX PREGNANCY AND RISK OF
ALL CHILDHOOD CANCERS COMBINED

Cohort Studies # Cases Smoking Odds Ratio (95% CI)

(Age of Subjects) Habits for Maternal Smoking
(cig/day)

Neutel and Buck, 1970 34 No 1.0
(Age <10) 30 Yes 1.3 (0.8 - 2.2)

Pershagen et al., 1992 230 No 1.0
(Age <5) 61 <10 1.04 (0.8 - 1.4)
36 >10 0.92 (0.6 - 1.3)

Case-Control # Cases/ Smoking Odds Ratio (95% CI)

Studies # Controls Habits for Maternal Smoking
(Age of Subjects) (cig/day)

Stjernfeldt et al., 1986 177/220 0 1.0
(Age <16) 30/35 1-9 1.07 (0.6 - 1.8)
73/58 10+ 1.56 (1.1 - 2.3)

McKinney et al., 1986 555/1100a 0 1.0
(Age <15) 1-10 1.12 (0.9 - 1.5)
11+ 0.84 (0.7 - 1.1)

Buckley et al., 1986 1814/720a 0 1.0
(Age <15) 1-9 1.31 (0.9 - 1.9)
10+ 0.97 (0.8 - 1.2)

Golding et al., 1990b 13/61 <5 1.0
(Age <10) 20/38 >5 2.47 (1.2 - 5.1)

John et al., 1991 223/196a 0 1.0
(Age <14) 1-10 1.4 (0.7 - 2.7)
11+ 1.5 (0.8 - 2.7)

a Numbers represent total cases/controls. Case/control distribution of maternal smoking by case/control status was not presented.

b Case-cohort study.

TABLE 7.4
STUDY CHARACTERISTICS OF THE FOUR U.S. CASE-CONTROL STUDIES
OF LUNG CANCER AND ETS PUBLISHED SINCE 1991

	Stockwell et al. (1992)	Brownson et al. (1992)	Fontham et al. (1994)	Kabat et al. (1995)
Area	Central Florida	Missouri	5 U.S. metropolitan areas	4 U.S. cities
Accrual Period	1987-1991	1986-1991	1985-1991	1983-1990
Sample size¹ cases controls	210 (F) 301 (F)	432 (F) 1166 (F)	653 (F) 1253 (F)	69 (F), 41 (M) 187 (F), 117 (M)
Ages	NA (% by birth year groupings provided)	30-84	20-79	not specified
Source of cases	Florida Cancer Registry	Missouri Cancer Registry	All hospital/registries in specific geographic areas	6 hospitals in the 4 cities
Source of controls	RDD	DMV, HCFA	RDD, HCFA	other hospital patients
Matching variables of lifetime nonsmoking controls	NA	age	age, area, & ethnicity	age, race, hospital, date of interview
Percent of self-respondents cases controls	33 100	34* 100	63 100	100 100
Mode of data collection	in-person, telephone, mailed questionnaires	telephone	in-person	in-person
% Histologic confirmation	100%	76%**	100%**	100%
% adenocarcinoma	61%	66%	76%	NA
Definition of lifetime nonsmoker	smoked for a total of < 6 months or <100 cigarettes in their lifetime	not described	<100 cigarettes, no use of other tobacco for> 6 mos	<365 cigarettes over lifetime
Verification of nonsmoking status	multistep- medical record, physician, at initial contact & interview	at interview	multistep- medical record, physician, at initial contact & interview	at interview
Biological markers	none	none	urinary cotinine	none

^{1 Sample size of lifetime nonsmokers in study

* presented for nonsmokers and ex-smokers combined

** confirmed by independent histologic review

Abbreviations: F-females, M-males, NA-not available, RDD-random digit dialing,

DMV-Department of Motor Vehicle, HCFA-Health Care Financing Administration}
TABLE 7.5

ASSOCIATION BETWEEN RISK OF LUNG CANCER IN LIFETIME NONSMOKING FEMALES
AND EXPOSURE TO SPOUSAL SMOKING

Study	Exposure Status	Adjusted Odds ratio (95% CI) for exposed	Years exposed / Amount smoked by spouse	Odds ratio (95% CI) for yrs exp/amt smoked by spouse
Stockwell et al. (1992)	Spouse smoked ^a no yes	AOR^a 1.0 1.6 (0.8-3.0)	Smoke-years in adult household (spouse and others)^a < 22 23-39 40+	AOR^a 1.6 (0.8-3.2) 1.4 (0.7-2.9) 2.4 (1.1-5.3)
Brownson et al. (1992)	Spouse smoked Cases* Controls* never 213 568 ever 218 598	AOR^b 1.0 1.0 (0.8-1.2)	Cigarette pack-years cases controls 0 213 568 0-15 32 128 15-40 54 200 40+ 110 216	AOR^b 1.0 0.7 (0.5-1.1) 0.7 (0.5-1.0) 1.3 (1.0-1.7)
Fontham et al. (1994)	Spouse cases exposed/ controls exp smoked total cases /total controls any type tobacco 433/651 766/1253 cigarettes 366/648 691/1253 cigars 85/641 138/1253 pipes 86/640 158/1253	AOR^c 1.29 (1.04-1.60) 1.18 (0.96-1.46) 1.25 (0.92-1.71) 1.19 (0.88-1.60)	By pack-years of exposure to spouses cases* controls* 0 267 562 < 15.0 146 300 15.1- 39.9 92 190 40.0-79.9 80 126 80.0+ 24 27	AOR^c 1.00 1.08 (0.86-1.39) 1.04 (0.76-1.42) 1.36 (0.97-1.91) 1.79 (0.99-3.25)
Kabat et al. (1995)	Males Spouse smoked: cases/controls* no 28 / 79 yes 11 / 19 Females Spouse smoked: cases/controls* no 26 / 71 yes 41 / 102	AOR^d 1.0 1.60 (0.67-3.82) 1.0 1.08 (0.60-1.94)	Males Spouse smoked: cases/controls* 1-10 cigs/day 5 / 17 11+ cigs/day 5 / 2 Females Spouse smoked: cases/controls* 1-10 cigs/day 17 / 50 11+ cigs/day 12 / 28	AOR^d 0.74 (0.24-2.23) 7.48 (1.35-41.36) 0.82 (0.42-1.61) 1.06 (0.49-2.30)

^{a Distribution of cases and controls was not presented; ORs adjusted for age,
race, and eduction; ORs are from Table 2 of Stockwell et al. (1992).
^{b Adjusted for age, previous lung disease; ORs are from Table 2 of Brownson et
al. (1992).
^{c Adjusted for age, race, study area, education, fruits & vegetables &
supplemental vitamin index, dietary cholesterol, family history of lung cancer,

and employment in high-risk occupations; ORs are from Table 3 of Fontham et al. (1994).
^{d Adjusted for age, years of education, and type of hospital; ORs are from Table
4 of Kabat et al. (1995).

* The number of cases and controls by intensity of exposure may not add up to the total
numbers of subjects due to missing values.}}}}
TABLE 7.6
ASSOCIATION BETWEEN RISK OF LUNG CANCER AND
ETS EXPOSURES FROM PARENTS AND OTHER HOUSEHOLD MEMBERS

Study/study area	Sex	ETS exposure	Cases/ Controls	Odds Ratio (95% CI) for exposed
STUDIES CONDUCTED IN THE U.S.
Janerich et al. (1990) /New York	M, F	Smoker-years in childhood/adolescence 0 1-24 25+	37 68 82 94 52 29	1.0 1.09 (0.68-1.73) 2.07 (1.16-3.68)
Stockwell et al. (1992) /Central Florida	F	(Distributions by exposure not presented) mother father siblings During childhood/adolescence from parents and siblings (in yrs) < 18 18-21 22+	210 301	1.6 (0.6-4.3) 1.2 (0.6-2.3) 1.7 (0.8-3.9) 1.6 (0.7-3.6) 1.1 (0.5-2.6) 2.4 (1.1-5.4)
Brownson et al. (1992) /Missouri	F	During childhood from parents never ever During childhood from any household members never ever	357 877 74 289 323 802 108 364	1.0 0.7 (0.5-0.9) 1.0 0.8 (0.6-1.1)
Fontham et al. (1994) /Five U.S. areas	F	During childhood father no yes mother no yes Childhood household exposure (in yrs.) 0 1-17 18+	304 699 299 556 76 161 548 1079 148 444 95 291 146 485	1.00 0.83 (0.67-1.02) 1.00 0.86 (0.62-1.18) 1.00 0.99 (0.73-1.35) 0.89 (0.67-1.16)

TABLE 7.6 (continued)
ASSOCIATION BETWEEN RISK OF LUNG CANCER AND
ETS EXPOSURES FROM PARENTS AND OTHER HOUSEHOLD MEMBERS

Study/study area	Sex	ETS exposure	Cases/ Controls	Odds Ratio (95% CI) for exposed
Kabat et al. (1995) /Four U.S. cities	M F M F	Childhood exposure no yes #smokers: 1 #smokers: 2+ no yes #smokers: 1 #smokers: 2+ Adulthood household exposure no yes #smokers: 1 #smokers: 2+ no yes #smokers: 1 #smokers: 2+	15 41 25 76 18 53 7 22 22 81 47 106 39 82 8 23 28 83 13 34 6 28 7 5 26 68 43 119 34 93 9 25	1.00 0.90 (0.43-1.89) 1.12 (0.46-2.70) 1.13 (0.34-3.75) 1.00 1.55 (0.95-2.79) 1.75 (0.91-3.35) 1.27 (0.43-3.78) 1.00 1.13 (0.53-2.45) 0.64 (0.19-2.13) 4.15 (1.34-12.87) 1.00 0.95 (0.53-1.67) 0.96 (0.50-1.84) 0.94 (0.34-2.63)
Wu et al. (1985) /Los Angeles	F	Parents smoked no yes	18 29 11 33	1.0 0.6 (0.2-1.7)
Kabat and Wynder (1984) /U.S.A.	M F	Current ETS exposure at home no yes no yes	19 20 6 5 37 36 16 17	1.00 1.26 (0.33-4.83) 1.00 0.92 (0.40-2.08)
Kabat et al. (1990)	M F	Family member smoked no yes no yes	15 36 21 69 17 61 36 77	1.00 0.73 (0.34-1.59) 1.00 1.68 (0.86-3.27)
STUDIES CONDUCTED IN ASIA
Sobue (1990) /Japan	F	During childhood father no yes mother no yes Other household member no yes	35 143 109 588 127 668 17 63 113 587 31 114	1.00 0.79 (0.52-1.21) 1.00 1.33 (0.74-2.37) 1.00 1.18 (0.76-1.84)

TABLE 7.6 (continued)
ASSOCIATION BETWEEN RISK OF LUNG CANCER AND
ETS EXPOSURES FROM PARENTS AND OTHER HOUSEHOLD MEMBERS

Study /study area	Sex	ETS exposure	Cases/ Controls	Odds Ratio (95% CI) for exposed
Shimizu et al. (1988) /Japan	F	During childhood and/or adult life (distribution of exposure presented for controls) father mother father-in-law mother-in-law brother(s) or sister(s) son(s) or daughter(s)		1.1 ^a 4.0 (p<0.05) 3.2 (p<0.05) 0.8 0.8 0.8
Gao et al. (1987) /Shanghai	F	Lived with a smoker during childhood		1.1 (0.7-1.7)
Koo et al. (1987) /Hong Kong	F	# cohabitants who smoked (included spouse, parents, in-laws, children, or other cohabitants) 0 1 2+	27 49 48 68 13 20	1.0 1.73 (0.6-6.4) 1.35 (0.6-5.0)
Wu-Williams et al. (1990) /North China	F	father smoked no yes mother smoked no yes	335 352 182 250 298 410 119 192	1.0 1.1 (0.8-1.4) 1.0 0.9 (0.6-1.1)
STUDIES CONDUCTED IN EUROPE
Pershagen et al. (1986) /Sweden	F	parents smoked no yes	9 18 38 76	1.0 1.0 (0.4-2.3)
Svensson et al. (1989) /Sweden	F	father smoked no yes mother smoked no yes	19 98 12 71 19 98 3 5	1.0 0.9 (0.4-2.3) 1.0 3.3 (0.5-18.8)

^{a Shimizu et al. reported p values for findings, but did not report
confidence intervals, and confidence intervals could not be calculated from the reported
information.}

TABLE 7.7
STUDIES ON ETS EXPOSURE AT THE WORKPLACE AND LUNG CANCER
AMONG LIFETIME NONSMOKING SUBJECTS

Study/ Year of study	Questions on ETS exposure	#unexposed/ #exposed cases	#unexposed/ #exposed controls	OR (95% CI) for exposed
STUDIES IN U.S.
Kabat & Wynder et al. (1984) 1961-80	current or last job males females	7/18 27/26	14/11 22/31	3.3 (1.0-10.4) 0.7 (0.3-1.5)
Garfinkel et al. (1985) 1971-81	#hrs/day exposed to smoke of others at work: past 5 years. Past 25 years.	80/14 42/34	262/52 135/118	0.88 (0.7-1.2) 0.93 (0.7-1.2)
Wu et al. (1985) 1981-82	# years exposed at each job	13/16	31/31	1.3 (0.5-3.3)
Janerich et al. (1990) 1982-84	# smokers at work (lifetime), amount of time working with smokers	NA	NA	no association
Brownson et al. (1992) 1986-91	current/most recent job, exposed to other’s smoke	NA	NA	no association overall 1.2 (0.9-1.7)^a
Stockwell et al. (1992) 1987-91	not described	NA	NA	no association
Fontham et al. (1994) 1985-91	# years exposed at each job (lifetime years of exposure at work) By years of exposure 0 1-15 16-30 31+	224/385 cases 224 213 118 54	491/756 controls 491 450 223 83	1.39 (1.1-1.7)^b 1.00 ^c 1.30 (1.01-1.67) 1.40 (1.04-1.88) 1.86 (1.24-2.78)^b
Kabat et al. (1995) 1983-1990	four (4) jobs that lasted 1 year or more males females	18/23 23/35	52/65 64/85	1.02 (0.50-2.09) 1.15 (0.62-2.13)
STUDIES IN UK AND GREECE
Lee et al. (1986) 1977-82	timing of job not specified, exposure as no, little, a lot males females	3/7 12/3	40/57 113/47	1.61 (0.4-6.6) 0.63 (0.2-2.3)
Kalandidi et al. (1990) 1987-89	current/last job #smokers at work	24/65	40/78	1.39 (0.8-2.5)
STUDIES IN ASIA
Koo et al. (1987) 1981-83	any ETS exposure at work (all jobs)	NA	NA	0.91
Shimizu et al. (1988) 1982-85	most recent/current job, any smokers at work	NA	NA	1.2
Wu-Williams et al. (1990) 1985-87	exposure at each job	187/230	301/301	1.2 (0.9-1.6)

^{a For highest quartile of exposure
^{b p<0.01
^{c Trend, p = 0.001}}}
TABLE 7.8

ASSOCIATION BETWEEN PASSIVE SMOKE EXPOSURE AND RISK OF NASAL SINUS CANCER IN NONSMOKERS

Studies Exposure to Relative Risk (95% CI)

Passive Smoking

Cohort Studies

Hirayama (1984) Spouse's smoking
in cig/day

No (5)^a 1.0

Exsmoker or Smokers
1-14 (9) 1.7 (0.7 - 4.2)
15 - 19 (4) 2.0 (0.6 - 6.3)
20+ (10) 2.6 (1.0 - 6.3)

Case-Control Studies

Fukuda and Shibata (1990) # Smokers in household

0 (11/35)^b 1.0
1 (15/34) 1.4 (0.6 - 3.5)
2+ (9/5) 5.7^c (1.7 - 19.4)
1+ (24/39) 2.0 (0.8 - 4.5)

Zheng et al. (1993) Ever exposed^d
No 1.0
Yes 3.0 (1.0 - 8.9)

a Number of nasal sinus cancer deaths.

b Number of cases/controls

c p for trend = 0.02.

d Number of cases/controls by exposure category was not presented.

Table 7.9
Relationship Between Active and Passive Smoke Exposure and Risk of Cervical Cancer

# Cases/# Controls Passive Smoking
Study Cervical Cytology Active Smoking (Among Never Smokers)

(among cases)

CA/CO Adj. ORa Hrs/dayb CA/CO Adj. ORa
Slattery 266 cases/408 Never 81/305 1.0 None NA 1.0
et al., 1989 controls (cases: Exsmoker 37/48 1.4 (0.8 - 2.5) 0.1 - 0.9 NA 1.1 (0.5 - 2.9)
78% carcinoma Current smoker 148/55 3.4 (2.1 - 5.6) 1.0 - 2.9 NA 1.6 (0.5 - 4.7)
in-situ, 22% >3.0 NA 3.4 (1.2 - 9.5)
invasive cancer)

At Home
CA/CO Adj. ORc Yrs Exposure CA/CO Adj. ORc
Coker 103 cases/268 Never 37/170 1.0 Not exposed 9/49 1.0
et al., 1992 controls (All Ever smoked 66/96 1.7 (0.9 - 3.3) <17 yrs 18/52 1.5 (0.5 - 4.0)
biopsy-confirmed Current smoker 66/49 3.4 (1.7 - 7.0) >18 yrs 9/69 0.4 (0.1 - 1.3)
cervical
intraepithelial
neoplasia,
class II or III)
At work
Yrs Exposure
Not exposed 28/132 1.0
1-4 yrs 6/21 1.7 (0.5 - 5.1)
>5 yrs 2/16 0.4 (0.1 - 2.5)

a Adjusted for age, church attendance, education, and number of sexual partners of the women.

b Number of hours of exposure per day inside and outside of the home; NA = not available

c Adjusted for age, years of education, race, number of pap smears, number of partners, and genital warts.

Table 7.10
nicotine and cotinine measured in the Cervical Mucus of smokers,

passive smokers, and nonsmokers

Levels (ng/ml) of

Nicotine Cotinine

Sasson et al., 1985a

Smokers (n = 10) 740 316
Nonsmokers (n = 8) 16 3

Hellberg et al., 1988a
Smokers (n = 17) 1056 1061
Nonsmokers with ETS exposure
Yesb (n = 4) 20 51
No (n = 14) 43 78

Levels of Nicotine (ng/ml)

Mean Median Range

Jones et al., 1991c

Smokers (n=31) 34.3 11.8 2.8 - 383.4
Nonsmokers with
ETS exposured
at home (n=32) 0.1 0.8 <0.2 - 8.2
outside of home (n = 42) NA^f 0.4 <0.2 - 5.2
none (n = 70) NA 0.2 <0.2 - 3.8

McCann et al., 1992c
Smokers (n=25) 107.2 56 4 - 358
Nonsmokers with
ETS exposured
Yese (n = 12) 3.6 3.5 <0.2 - 12
No (n = 12) 3.9 3.5^g <0.2 - 14

a Cervical mucus collected using aspiration methods.

b Exposed at home or work, time of passive smoke exposure relative to specimen collection not specified.

c Cervical mucus collected using cervical flush techniques.

d Passive smoke exposure in the last 24 hours.

e Nonsmokers with ETS exposure at home or at work.

f NA = not available.

g Excluded one outlier who was usually exposed to passive smoking several hours/day, but had no exposure within the last 24 hours.

Table 7.11

Passive Smoking and Bladder Cancer Among Nonsmokers

Males Females
# Exposed # Exposed
Cases/Controls OR (95% CI) Cases/Controls OR (95% CI)

Kabat et al. (1986)a
Exposed to passive smoking
At home 6/10 1.5 (0.5, 4.5) 6/13 0.6 (0.5, 1.2)
At work or in transportation 11/25 0.7 (0.2, 1.8) 6/5 2.5 (0.6, 10.1)

Burch et al. (1989)b
Exposed to passive smoking
At home 37/72 0.9 (0.5 - 2.0) 66/90 0.8 (0.3 - 1.7)
At work 25/45 1.0 (0.5 - 1.9) 26/38 0.9 (0.5 - 1.8)

a Total number of nonsmokers were: males - 23 cases, 44 controls; females - 17 cases, 28 controls.

b Total number of nonsmokers were: males - 61 cases, 112 controls; females - 81 cases, 105 controls.

Table 7.12
Mean Levels of Hemoglobin Adducts of 4- and 3- Aminobiphenyls
in Nonsmokers

4-ABP 3-ABP
(pg/g Hb) (pg/g Hb)

Exsmokers (at baseline) 130.4 16.0

Exsmokers (after stopping smoking 33.3 1.7
for two months)

Nonsmokers
ETS exposure (-)^a and 45.9 1.2
Cotinine level (-)

ETS exposure (+)^b and 49.2 1.9
Cotinine level (+)

Reference: MaClure et al. (1989)

a Based on 44 subjects - 15 subjects had low levels of self-reported ETS exposure and no detectable cotinine levels; 29 subjects had no reported ETS exposure and no detectable cotinine levels.

b Based on 13 subjects - 7 subjects had low levels of self-reported ETS exposure and detectable cotinine levels, 6 subjects had high levels of self-reported ETS exposure and detectable cotinine levels. The 6 subjects who reported high exposure to ETS showed the highest mean levels of 4-ABP (54 pg/g) and 3-ABP (2.4 pg/g) and median levels of 4-ABP (48 pg/g) and 3-ABP (2.6 pg/g).

Table 7.13

Mean Levels of 4-ABP Hemoglobin Adducts (pg/g of Hemoglobin)
Among Smokers and Nonsmokers by Acetylator Phenotype

Acetylator Phenotype

Slow Fast

Black-tobacco smokers (n=16) 175.0 117.5
Blond-tobacco smokers (n=31) 111.8 86.4
Nonsmokers (n=50) 31.7 19.4
Exposed to ETS

No (n=35) 30.4 12.3
Yes (n=15) 34.8 33.6

Reference: Bartsch et al. (1990)

Table 7.14
Brain TumorS in Children and Exposure to parent's Smoking

Study # Cases/ OR for Smoking Habits of
(Age of Subjects) Controls Mother Father

continued smoking during
pregnancy^a
Gold et al., 1979 84/73 5.0 No data
(Age <20) (population)

84/78 ¥
(hospital)
During pregnancy During pregnancy
Preston-Martin 209/209 1.1 1.5a
et al., 1982

(Age <25)
# cig/day during pregnancy
Stjernfeldt et al., 1986 43/340 0 1-9 10+ cig/day
(Age <16) 1.0 1.0 0.9 No data

# cig/day during pregnancy
0 1-9 10+ cig/day
McKinney and 78/156 1.0 1.1 1.0 No data
Stiller, 1986

(Age <15)
During pregnancy During pregnancy
Howe et al., 1989 74/132 1.4 1.1
(Age <20)
During first trimester 12 months prior to birth
John et al., 1991 48/196 1.0 1.4
(Age <14)
Mother’s smoking alone Father’s smoking alone
* 1.9 (0.9 - 4.2)

at 2-3 mos of pregnancy
0 <10 10+ cig/day
Pershagen et al., 1992 81^b 1.0 0.9 1.1 No data
(Age <5)

a p<0.05

b cohort study

c OR if data obtained from mother

d OR if data obtained from father

e Cases restricted to astrocytoma

* 0 exposed cases, 8 exposed controls

Table 7.14 (Continued)
Brain TumorS in Children and Exposure to parent's Smoking

Study # Cases/ OR for Smoking Habits of
(Age of Subjects) Controls Mother Father

Gold et al., 1993 361/1083 Ever smoked Ever smoked
(Age <18) 0.9 1.1

During yr of birth During yr of birth
0 <1 pack/day pack/day 0 <1 pack/day pack/day
1.0 0.8 1.0 1.0 0.7 1.1

2 yrs before birth 2 yrs before birth
0 <1 pack/day pack/day 0 <1 pack/day pack/day
1.0 0.8 1.0 1.0 0.9 1.2

Mother’s smoking alone Father’s smoking alone
1.1 0.9

McCredie et al., 1994 82/104 During pregnancy During pregnancy
(Age < 14) 1.3 2.2^a
4.2^c
1.1^d

Kuijten et al., 1990 163^e/163 During pregnancy During pregnancy
(Age < 14) 1.0 0.8

a p<0.05

b cohort study

c OR if data obtained from mother

d OR if data obtained from father

e Cases restricted to astrocytoma

* 0 exposed cases, 8 exposed controls

Table 7.15
Maternal or Parental Smoking During Pregnancy and

Childhood Leukemia

Cohort Studies # Cases Smoking OR (95% CI) for OR (95% CI) for
(Age of Subjects) (Type of Habits (cig/day) Maternal Smoking Paternal Smoking
Leukemia)

Pershagen et al., 1992 All Leukemia 2-3 mos of pregnancy
(Age <5) 72 No 1.0 Not available
18 1-9 0.9 (0.6-1.6)
9 10+ 0.7 (0.4-1.5)

21 (lymphatic) Yes 0.8 (0.5-1.3)
6 (myeloid) Yes 1.6 (0.6-4.8)

Case-Control # Cases/ Smoking OR (95% CI) OR (95% CI)
Studies (Age of Subjects) # Controls Habits (cig/day) Maternal Smoking Paternal Smoking

Van Steensel-Moll 519/507 Yes, yr before
et al.,1985

(Age <15) (ALL)a Pregnancy 1.0 (0.8-1.3) Not available

Yes, during
pregnancy 1.0 (0.7-1.3)

During pregnancy
Stjernfeldt et al., 1986 132/340 1-9 1.3 (0.7-2.6) Not available
(Age <16) (ALL) 10+ 2.1 (1.3-3.3)

During pregnancy
McKinney et al., 1986 171/342 1-10 1.0 (0.6-1.7) No association
(Age <15) (78 ALL, 11+ 0.6 (0.4-1.0)
93 non-ALL)
During pregnancy
Buckley et al., 1986 742/740 1-9 1.0 (0.6-1.5) No association
(Age <15) (ALL) 10+ 0.9 (0.7-1.1)

Magnani et al., 1990 142/307 Smoking up to child's birth
(Not specified) (ALL) Yes 0.7 (0.5-1.1) 0.9 (0.6-1.5)
1-15 cig/day 0.6 (0.4-1.0) 0.9 (0.5-1.6)
16+ cig/day 1.0 (0.4-2.7) 0.9 (0.6-1.5)
22/307
(non-ALL) Yes 2.0 (0.8-4.8) 0.9 (0.3-2.1)

a ALL = Acute lymphocytic leukemias, non-ALL = non acute lymphocytic leukemias.

Table 7.15 (continued)
Maternal or Parental Smoking During Pregnancy and

Childhood Leukemia

Case-Control Studies # Cases/ Smoking OR (95% CI) for OR (95% CI) for
(Age of Subjects) # Controls Habits (cig/day) Maternal Smoking Paternal Smoking
(Type of

Leukemia)

During 3 trimesters During pregnancy
John et al., 1991 73/196 1-10 2.0 (0.7-5.9) 2.6 (0.9-7.9)
(Age <14) (ALL)^a 11-20 2.9 (1.2-6.8) 1.6 (0.7-3.7)
21+ 1.6 (0.7-4.0)

Parent smoking in absence of other parent
2.9 (0.8 - 10.3) 1.7 (0.7 - 3.8)

(non-ALL) During 3 trimesters During pregnancy
Yes 0.6 (0.1-3.0) 0.8 (0.2-2.3)

Severson et al., 1993 187/187 During pregnancy

(Age < 18) (acute Yes 1.2 (0.8 - 1.9) No association

myeloid
leukemia)

a ALL = Acute lymphocytic leukemias, non-ALL = non acute lymphocytic leukemias.

Table 7.16
Association Between Exposure to Passive Smoking and Risk of Non-Hodgkins Lymphoma and Lymphoma in Children

Studies Exposure to Passive Smoking Relative Risk 95% CI

Stjernfeldt et al., 1986 Non-Hodgkins Lymphoma (n = 16)
Mother's smoking during pregnancy
0 (cig/day) 1.0
1-9 1.9 (0.3 - 6.7)
10+ 2.1 (0.7 - 6.4)

Hodgkins Lymphoma (n = 15)
0 (cig/day) 1.0
1-9 1.1 (0.2 - 4.9)
10+ 0.3 (0.1 - 2.2)

Buckley et al., 1986 Non-Hodgkins Lymphoma (n = 169)
Mother's smoking during pregnancy
0 (cig/day) 1.0
1-9 0.8 (0.3 - 1.8)
10+ 1.0 (0.7 - 1.4)

Magnani et al., 1990 Non-Hodgkins Lymphoma (n = 19)
Mother's smoking up to child’s birth 1.7 (0.7 - 4.5)
Father's smoking up to child’s birth 6.7 (1.0 - 43.4)

McKinney and Lymphomas (n = 74)
Stiller, 1986 Mother's smoking during pregnancy
0 (cig/day) 1.0
1-10 1.9 (0.9 - 4.0)
11+ 1.0 (0.5 - 2.1)

John et al., 1991 Lymphoma (n = 26)
Mother's smoking
- Three months prior to conception 1.9 (0.7 - 5.2)
- First trimester of pregnancy 2.5 (0.9 - 7.0)
- All three trimesters of pregnancy 2.7 (1.0 - 7.6)
Father's smoking during pregnancy 1.9 (0.7 - 4.8)

Pershagen et al., 1992 Hematopoietic and Lymphatic
excluding leukemia (n = 30)
Mother's smoking at 2-3 months of pregnancy
0 (cig/day) 1.0
1-9 2.4 (1.0 - 5.5)
10+ 1.1 (0.3 - 3.6)