Smoking habits and risk of fatal stroke: 18 years follow up of the Oslo Study.

STUDY OBJECTIVE: To examine the risk of fatal stroke in relation to smoking habits in men screened for the Oslo study. DESIGN: The Oslo study is a prospective, cohort study of the epidemiology and preventive aspects of cardiovascular diseases in middle aged men. Screening started in May 1972 and results after 18 years of follow up are reported. PARTICIPANTS: There were 16209 men aged 40-49 years, of whom 16173 had no stroke history. Eighty five men died from stroke, of whom 48 were daily cigarettes smokers, 7 were pipe and cigar smokers, 15 smoked cigarettes and pipe or cigars daily, 11 were previous cigarette smokers, and 4 had never smoked cigarettes. MAIN RESULTS: Results of proportional hazards regression analysis adjusted for age, diastolic blood pressure, and glucose concentration showed the following rate ratios (RR) (95% confidence interval) of smoking groups compared with those who had never smoked or had previously smoked: combined cigarette and cigar or pipe smokers, RR = 6.1 (3.0, 12.5); cigarettes only, RR = 4.1 (2.3,7.4); and pipe and/or cigars only RR = 2.2 (0.9,5.5). The overall, age adjusted risk of smoking cigarettes daily was 3.5 and was found to increase with increasing cigarette consumption. Regardless of their smoking group, stroke cases had increased diastolic (DBP) and systolic blood pressure (SBP) when compared with men who had not had a stroke. The absolute differences in DBP and SBP between stroke cases and others for never and previous cigarette smokers versus daily smokers were twice as large: DBP, 12.1 mmHg versus 6.5 mmHg respectively and SBP, 16.0 mmHg versus 7.1 mmHg respectively. A high BMI increased the risk of fatal stroke of never and previous cigarette smokers. Men being treated for hypertension at the time of screening had three times the crude risk of fatal stroke of men who were not taking hypertensive treatment. CONCLUSIONS: Daily cigarette smoking increased the risk of fatal stroke three and a half times. Combined cigarette and pipe or cigar smoking had a higher risk than smoking cigarettes only. An increased risk was found in relation to increased daily cigarette consumption.     

Lung cancer among cigar and pipe smokers

The effect of pipe and cigar smoking on lung cancer risk is reviewed using data from an ongoing hospital-based, case-control study of smoking-related cancers. Data from 2,085 patients with histologically defined lung cancer and 3,948 matched controls interviewed between 1977 and 1984 were analyzed. Cigar and pipe smokers experienced much lower lung cancer risks than cigarette smokers. Risk, expressed as the odds ratio in current smokers of cigarettes only, was 16.0 times that of never smokers (95% confidence intervals, 12.2 to 20.9), 3.1 times that of cigars only (1.8 to 5.6), 1.9 times that of pipes only (0.8 to 4.3), and 2.5 times that of cigars and pipes (1.0 to 6.1). Risks were high in mixed smokers of cigars, pipes, or cigars and pipes, who also smoked cigarettes, odds ratio 10.5 (7.7 to 14.4). Among pipe and/or cigar smokers only, patients with lung cancer were more likely than controls to have been long-time smokers of 5 or more cigars or 5 or more pipefuls per day and to have inhaled. The odds ratio for those smoking 5 to 9 cigars or pipes per day was 3.2 and for those smoking 10 or more units 6.7. The odds ratio of those cigar or pipe smokers who inhaled was 12.3. The proportion of Kreyberg I cancers was higher in cigar and pipe smokers than in cigarette smokers.     

Tobacco use and prostate cancer: 26-year follow-up of US veterans

A 26-year follow-up of nearly 250,000 US veterans who responded to a questionnaire revealed 4,607 deaths from prostate cancer, providing the largest number of cases to date for evaluating relation to tobacco habits. Cigarette smokers had a significant increase in relative risk (RR = 1.18; 95% confidence interval 1.09-1.28) and a dose response reaching 1.51 among smokers of 40 or more cigarettes per day. Risks were elevated, but not significantly, among users of smokeless tobacco and pipe/cigar smokers. Despite limited data in the literature to support this finding, our study suggests that cigarette smoking may be related to prostate cancer, perhaps through its effect on sex hormone metabolism.     

Prospective study on the relation of cigarette smoking with cancer of the liver and stomach in an endemic region

BACKGROUND: Smoking has not been confirmed as a risk factor for cancers of the liver and stomach. The authors examined prospectively the relationship between smoking and these cancers in an endemic region. METHODS: The data used were a cohort study on the relationship between lifestyle and health in the region having the highest liver cancer mortality in Japan. Of the cohort members, 4050 males aged > or =40 years were included in the present analysis with a 9-year mean follow-up. Cox proportional hazards regression was used to estimate relative risks (RR) for cancer of the liver, stomach, smoking-related sites and others, while adjusting for age, residence, and alcohol intake. RESULTS: By the end of the study period, 59 cases of liver cancer and 53 cases of stomach cancer were identified. Current smokers, compared to subjects who had never smoked, had a threefold risk of liver cancer (RR = 3.3; 95% CI: 1.2-9.5) and a twofold risk of stomach cancer (RR = 2.2; 95% CI: 0.8-5.7). Sub-cohort analysis showed that adjustment for history of chronic liver disease did not attenuate the risk of liver cancer. Light/medium smokers had almost the same risk of these cancers as heavy smokers, while they showed a relatively low risk of smoke-related cancers. CONCLUSIONS: The present results indicate that smoking is a risk factor of liver and stomach cancer in a population with a high background risk for these cancers. However, causal inferences should be made cautiously due to a lack of information on known risk factors.     

A prospective study of job strain and coronary heart disease in US women

BACKGROUND: Previous studies of job strain and coronary heart disease (CHD) in men have established job strain as a predictor of CHD risk. Despite the wealth of convincing evidence in men for an association between job strain and CHD, data in women remain sparse. METHODS: We prospectively evaluated the relation between job strain and CHD risk in the Nurses' Health Study. In this analysis, we followed a sample of 35 038 US female nurses aged 46-71 years, who completed questions about job strain in 1992 and who were free of diagnosed CHD, stroke, and cancer at baseline. The main outcome measure was the incidence of CHD occurring between baseline (1 June 1992) and 31 May 1996. RESULTS: During 4 years of follow-up, we documented 146 incident cases of CHD (108 non-fatal cases of myocardial infarction and 38 CHD deaths). No evidence was found for a relationship between job strain and risk of CHD. In multivariate analyses controlling for age, smoking, alcohol intake, body mass index, history of hypertension, diabetes mellitus, and other covariates, women in high strain jobs did not have an increased risk of CHD (relative risk [RR] = 0.71, 95% CI: 0.42-1.19) compared with women in low strain jobs. Neither women in passive jobs (RR = 1.08, 95% CI: 0.69-1.68) nor those in active jobs (RR = 0.91, 95% CI: 0.54-1.53) had an increased risk of CHD. CONCLUSIONS: Job strain was not related to an increase in the incidence of CHD in the present cohort of nurses.     

Mortality in relation to cigarette and pipe smoking: 16 years'' observation of 25,000 Swedish men.

In a random sample of 25,129 Swedish men who responded to a questionnaire on smoking habits in 1963 the cause specific mortality was followed through 1979. In the cohort, 32% smoked cigarettes, 27% a pipe, and 5% cigars. There were clear covariations (p less than 0.001) between the amount of tobacco smoked and the risk of death due to cancer of the oral cavity and larynx, oesophagus, liver, pancreas, lung, and bladder as well as due to bronchitis and emphysema, ischaemic heart disease, aortic aneurysm, and peptic ulcer. Pipe smokers showed similar risk levels to cigarette smokers. There was a close to linear increase in lung cancer risk in relation to the amount of tobacco smoked for cigarette, pipe, and cigar smokers, respectively. An increasing risk of ischaemic heart disease with amount smoked was seen among both cigarette and pipe smokers. A similar fraction of inhalers in Swedish cigarette and pipe smokers may explain the similarity in risks.     

Prospective study of cataract extraction and risk of coronary heart disease in women

Oxidative damage to proteins in the human lens is believed to be important in the etiology of age-related cataract. Because free radical-mediated oxidative damage to lipoproteins may accelerate atherosclerosis, the authors hypothesized that the development of cataract might be a marker for such damage and therefore might be associated with future risk of coronary heart disease (CHD). The authors followed 60,657 women aged 45--63 years and without known coronary disease, stroke, or cancer in 1984. During 10 years of follow-up (674,283 person-years), the authors documented 887 incident cases of CHD and 2,322 deaths. After adjustment for age, smoking, and other coronary risk factors, cataract extraction was significantly associated with higher risk of CHD (relative risk (RR) = 1.88, 95% confidence interval (CI): 1.41, 2.50) for total CHD, 2.44 (95% CI: 1.54, 3.89) for fatal CHD, and 1.63 (95% CI: 1.14, 2.34) for nonfatal myocardial infarction). The positive association between cataract extraction and total CHD was stronger among women with a history of diabetes (RR = 2.80, 95% CI: 1.77, 4.42) than among those without reported diabetes (RR = 1.51, 95 percent CI: 1.04, 2.18). In multivariate analyses, cataract extraction was associated with significantly increased overall mortality (RR = 1.37, 95 percent CI: 1.13, 1.66), which was entirely explained by the increased mortality from cardiovascular disease (RR = 1.84, 95% CI: 1.29, 2.64). These findings are compatible with current hypotheses relating oxidative damage and tissue aging to the development of cataract and CHD.     

Patterns of cigar use in California in 1999.

BACKGROUND: Adult cigar use in California increased substantially between 1990 and 1996. METHODS: Cigar smoking prevalence is from the 1990, 1996, and 1999 California Tobacco Surveys (CTS), large cross-sectional random-digit-dialed surveys designed to identify trends in tobacco use in the California population. Questions added to the 1999 CTS allowed a more detailed assessment of cigar smoking patterns. RESULTS: Adult cigar use prevalence increased from 2.5% (95% confidence interval [CI], 2.2-2.8) in 1990 to 4.9% (95% CI=4.5-5.3) in 1996, and declined to 4.4% (95% CI=4.1-4.7) in 1999. Nearly the entire decrease was accounted for by less use in adults who had never been cigarette smokers. Among current cigar smokers in 1999, 43.3% (95% CI=37.8-48.8) had not smoked a cigar in the last month, just 16.2% (95% CI=7.9-24.5) of never cigarette smokers smoked three or more cigars in the past month, but 10.4% (95% CI=5.0-15.8) of former cigarette smokers-the group with the highest level of cigar consumption-reported daily use. CONCLUSIONS: Cigar use may have peaked in California around 1996; in 1999, the intensity of use was generally at modest levels. California's bans on smoking in bars and restaurants may limit cigar smoking while drinking, so that the observed patterns may or may not reflect those in the rest of the United States.     

中老年男性吸烟状况与心血管疾病发生风险的关联性

  目的  探讨中老年男性吸烟状况与心血管疾病(cardiovascular disease,CVD)及其亚型发生风险的关联性。  方法  本研究选取东风-同济(Dongfeng-Tongji,DFTJ)队列中基线未患冠心病(coronary heart disease,CHD)、中风、癌症、严重心电图异常的13 940名男性为研究对象。研究对象均完成了基线调查,包括问卷调查、体格检查、生化指标检查和血液样本采集。采用Cox比例风险回归模型进行关联性分析,计算风险比(hazard ratio,HR)和95%置信区间(confidence intervals,CI)。  结果  多因素调整后,与从不吸烟者相比,现在吸烟者发生CVD、CHD和中风的风险增加,吸烟指数≥ 40包年者发生CVD、CHD和中风的风险HR值分别为1.49(95%CI:1.32~1.68,P_trend=0.001)、1.40(95%CI:1.22~1.62,P_trend=0.026)和1.59(95%CI:1.26~2.00,P_trend=0.029),开始吸烟年龄 < 20岁者发生CVD和CHD的风险HR值分别为1.29(95%CI:1.06~1.58,P_trend=0.007)和1.30(95%CI:1.03~1.64,P_trend=0.010);与现在吸烟者相比,戒烟时长≥ 10年者发生CVD和中风的风险显著降低,HR值分别为0.80(95%CI:0.71~0.91,P_trend=0.017)和0.65(95%CI:0.50~0.84,P_trend=0.207)。  结论  吸烟能增加CVD、CHD和中风的发生风险,且吸烟指数越大或开始吸烟年龄越小,CVD发生风险越高。戒烟可降低CVD和中风的发生风险。     

Patterns of cigar use in Clifornia in 1999

Background: Adult cigar use in California increased substantially between 1990 and 1996.Methods: Cigar smoking prevalence is from the 1990, 1996, and 1999 California Tobacco Surveys (CTS), large cross-sectional random-digit-dialed surveys designed to identify trends in tobacco use in the California population. Questions added to the 1999 CTS allowed a more detailed assessment of cigar smoking patterns.Results: Adult cigar use prevalence increased from 2.5% (95% confidence interval [CI], 2.2–2.8) in 1990 to 4.9% (95% CI=4.5–5.3) in 1996, and declined to 4.4% (95% CI=4.1–4.7) in 1999. Nearly the entire decrease was accounted for by less use in adults who had never been cigarette smokers. Among current cigar smokers in 1999, 43.3% (95% CI=37.8–48.8) had not smoked a cigar in the last month, just 16.2% (95% CI=7.9–24.5) of never cigarette smokers smoked three or more cigars in the past month, but 10.4% (95% CI=5.0–15.8) of former cigarette smokers—the group with the highest level of cigar consumption—reported daily use.Conclusions: Cigar use may have peaked in California around 1996; in 1999, the intensity of use was generally at modest levels. California’s bans on smoking in bars and restaurants may limit cigar smoking while drinking, so that the observed patterns may or may not reflect those in the rest of the United States.     

Tobacco associated mortality in Mumbai (Bombay) India. Results of the Bombay Cohort Study

BACKGROUND: Little is known about the excess mortality from forms of tobacco use other than cigarette smoking that are widely prevalent in India, such as bidi smoking and the various forms of smokeless tobacco use. We report on absolute and relative risks of mortality among various kinds of ever tobacco users vs never-users in the city of Mumbai, India. METHODS: Using the Mumbai voters' list as the selection frame, 99 570 individuals aged > or = 35 years were interviewed at their homes during 1992-94. At active follow-up (during 1997-99) after 5.5 years, 97 244 (97.7%) were traced. Among these, 7531 deaths (4119 men, 3412 women) were recorded, of which 89% died within study area. It was possible to abstract cause of death information from the records of the municipal corporation for 5470 deaths. These were coded using ICD 10. RESULTS: The adjusted relative risk was 1.37 (95% CI 1.23-1.53) for (men) cigarette smokers and 1.64 (95% CI 1.47-1.81) for bidi smokers, with a significant dose-response relationship for number of bidis or cigarettes smoked. Women were essentially smokeless tobacco users; the adjusted relative risk was 1.25 (95% CI 1.15-1.35). The risk of deaths from respiratory diseases (RR 2.12, 95% CI 1.57-2.87), tuberculosis (RR 2.30, 95% CI 1.68-3.15), and neoplasms (RR 2.60, 95% CI 1.78-3.80) were significantly high in male smokers than never tobacco users. CONCLUSIONS: Bidi is no less hazardous than cigarette smoking, and smokeless tobacco use may also result in significantly increased mortality.     

Effect of smoking cessation and tobacco type on the risk of cancers of the upper aero-digestive tract in Brazil.

Tobacco smoking has long been identified as the most important risk factor for upper aero-digestive tract cancers. To investigate the effect of different tobacco types and the benefit of smoking cessation, we analyzed data from a case-control study of 784 cases of mouth, pharynx, and larynx cancers and 1,578 non-cancer controls in three metropolitan hospital areas in Brazil. Subjects were interviewed as to their smoking and drinking habits, demographics, environmental exposures, occupational history, health characteristics, and diet. Controlling for total tobacco and alcohol consumption, risks for ex-smokers compared with current smokers decreased substantially with time since cessation of the habit. Compared with never smokers, ex-smokers of >20 years had a relative risk (RR) of 1.98 [95% confidence interval (CI) = 1.0-3.8] for all upper aerodigestive tract cancers. RRs for long-term (>20 years) ex-smokers tended to be lower for mouth (RR = 1.61) and pharynx (RR = 1.52) than for larynx (RR = 3.63) cancers. The benefit of quitting was strongest for commercial cigarettes (RR = 1.45, 95% CI = 0.7-3.0) for ex-smokers of >10 years, as compared with smoking of black tobacco (RR = 2.57, 95% CI = 1.4-4.6), cigars (RR = 2.59, 95% CI = 0.6-11.6), and pipe tobacco (RR = 3.40, 95% CI = 1.3-8.8).     

Smoking cessation and risk of cataract extraction among US women and men.

Although the observational evidence linking cigarette smoking with risk of senile cataract is well-established, it is unclear whether any benefit is obtained from quitting smoking. Therefore, in this study, the authors examined the association between time since quitting smoking and incidence of cataract extraction in women and men enrolled in the Nurses' Health Study and the Health Professionals Follow-up Study, respectively. There were 4,281 incident physician-confirmed cases of cataract and 1,038,493 accumulated person-years of follow-up. Compared with current smokers, former smokers who had quit smoking 25 or more years previously had a 20% lower risk of cataract extraction after adjustment for age, average number of cigarettes smoked per day, and other potential risk factors (relative risk (RR) = 0.80, 95% confidence interval (CI): 0.71, 0.91). However, risk among past smokers did not decrease to the level seen among never smokers (for never smokers, RR = 0.64, 95% CI: 0.52, 0.79). The observed relation was similar when data were examined by cataract subtype (>25 years since quitting vs. current smoking: primarily nuclear cataract, RR = 0.82, 95% CI: 0.68, 0.97; primarily posterior subcapsular cataract, RR = 0.90, 95% CI: 0.71, 1.13). These findings suggest that any healing from damage due to cigarette smoking occurs at a very modest pace, and they emphasize the importance of never starting to smoke or quitting early in life.     

Cigarette smoking and erectile dysfunction among Chinese men without clinical vascular disease

The authors examined the association between cigarette smoking and risk of erectile dysfunction among 7,684 Chinese men aged 35-74 years without clinical vascular disease. Cigarette smoking and erectile dysfunction were assessed by questionnaire. Vascular risk factors were measured according to standard methods. After adjustment for age, education, alcohol consumption, physical inactivity, diabetes, hypertension, overweight, and hypercholesterolemia, the odds ratio of erectile dysfunction was 1.41 (95% confidence interval (CI): 1.09, 1.81) for cigarette smokers compared with never smokers. There was a statistically significant dose-response relation between cigarette smoking and risk of erectile dysfunction (p(trend) = 0.005). Multivariate-adjusted odds ratios of erectile dysfunction were 1.27 (95% CI: 0.91, 1.77), 1.45 (95% CI: 1.08, 1.95), and 1.65 (95% CI: 1.08, 2.50) for those who smoked 1-10, 11-20, and more than 20 cigarettes per day, respectively, compared with never smokers. The association was stronger in participants with diabetes (odds ratio = 3.29, 95% CI: 1.49, 7.27) than in participants without diabetes (odds ratio = 1.33, 95% CI: 1.03, 1.73). If the association is causal, an estimated 22.7% of erectile dysfunction cases (11.8 million cases) among Chinese men are attributable to cigarette smoking. This 2000-2001 study of Chinese men documented an independent and dose-response relation between cigarette smoking and risk of erectile dysfunction.     

A prospective cohort study of bladder cancer risk in relation to active cigarette smoking and household exposure to secondhand cigarette smoke

Active cigarette smoking is a major risk factor for bladder cancer. Secondhand exposure to cigarette smoke may also contribute to bladder carcinogenesis. The authors conducted a prospective cohort study to examine the influence of both active smoking and household exposure to secondhand smoke (SHS) on subsequent bladder cancer risk. The study population included persons from two cohorts established from private censuses conducted in Washington County, Maryland, in 1963 (n = 45,749; 93 cases) and 1975 (n = 48,172; 172 cases). Poisson regression models were fitted to estimate the relative risk of bladder cancer associated with active and passive smoke exposure in the two cohorts (referent category: never smokers who did not live with any smokers). Current smokers had an elevated risk of bladder cancer in both the 1963 cohort (relative risk (RR) = 2.7, 95% confidence limits (CL): 1.6, 4.7) and the 1975 cohort (RR = 2.6, 95% CL: 1.7, 3.9) after adjustment for age, education, and marital status. Among nonsmoking women, current household SHS exposure was associated with bladder cancer risk in the 1963 cohort (RR = 2.3, 95% CL: 1.0, 5.4) but not in the 1975 cohort (RR = 0.9, 95% CL: 0.4, 2.3). This study further solidifies the evidence that active smoking is causally associated with bladder cancer. Additional studies are needed to determine whether passive smoking is a risk factor for bladder cancer.     

The relationship of smoking cessation to coronary heart disease and lung cancer in the Multiple Risk Factor Intervention Trial (MRFIT).

The impact of smoking cessation on coronary heart disease (CHD) and lung cancer was assessed after 10.5 years of follow-up in the 12,866 men in the Multiple Risk Factor Intervention Trial (MRFIT). Those men who died of lung cancer (n = 119) were either cigarette smokers at entry or ex-smokers; no lung cancer deaths occurred among the 1,859 men who reported never smoking cigarettes. The risk of lung cancer for smokers, adjusted for selected baseline variables using a Cox proportional hazards model, increased as the number of cigarettes smoked increased (B = 0.0203, SE = 0.0076). There was not the same graded response for CHD among smokers at entry. The risk of CHD death was greater among smokers than nonsmokers (RR = 1.57) (B = -0.0034, S.E. = 0.0048). After one year of cessation, the relative risk of dying of CHD for the quitters as compared to non-quitters (RR = 0.63) was significantly lower even after adjusting for baseline differences and changes in other risk factors. The relative risk for smokers who quit for at least the first three years of the trial was even lower compared to non-quitters (RR = 0.38). However, the relative risk for lung cancer for quitters versus non-quitters was close to 1 both for quitters at 12 months and at three years. These data support the benefits of cessation in relation to CHD and are consistent with other epidemiologic studies which suggest that the lag time for a beneficial effect of smoking cessation on lung cancer may be as long as 20 years.     

Smoking, prevalence of disease and health service utilization among the Swiss population

The data of the 1981-83 Swiss National Health Survey "SOMIPOPS", based on a randomly selected sample of 4,235 individuals aged 20 or over representative of the whole Swiss population, were used to investigate the relation between smoking, prevalence of disease and frequency of health care utilization. The risks of several conditions, including hypertension, myocardial infarction and other heart diseases, asthma, tuberculosis and kidney disease were elevated among ex-smokers. The diseases showing elevated risks among current smokers and significantly positive dose-risk trends included acute bronchitis (relative risk, RR = 3.2 for heavy cigarette smokers vs never smokers), chronic bronchitis or lung emphysema (RR = 2.0), gastro-duodenal ulcer (RR = 1.8) and bone fractures (RR = 1.6). For respiratory conditions, the risk of pipe or cigar smokers was comparable to that of moderate cigarette smokers, whereas for ulcer (RR = 4.1) or fractures (RR = 2.0) the point estimates were even higher than for heavy cigarette smokers. Smokers tended to consult more frequently general practitioners, used more other outpatients services, and were more frequently admitted to hospital during the year preceding the interview. These effects were consistent across strata of age, socio-economic indicators, and persisted after allowance for major identified potential distorting factors. Thus, the results of this survey confirm that smoking is an important cause of morbidity and a major contributory factor to the use of health services.     

Cigarette smoking and mortality. MRFIT Research Group.

METHODS. The relationship of cigarette smoking and smoking cessation to mortality was investigated among men screened for and also among those randomized to the Multiple Risk Factor Intervention Trial (MRFIT). RESULTS. Among the 361,662 men screened for the MRFIT, cigarette smoking was an important risk factor for all-cause, coronary heart disease (CHD), stroke, and cancer mortality. These risks, on the log relative scale, were strongest for cancers of the lung, mouth, and larynx. The excess risk associated with cigarette smoking was greatest for death from CHD. Overall, approximately one-half of all deaths were associated with cigarette smoking. Among the 12,866 randomized participants, weak positive associations with duration of cigarette smoking habit and tar and nicotine levels were found with all-cause mortality. For both SI and UC men, substantial differences in subsequent CHD (34-49%) and all-cause (35-47%) mortality were evident for men who reported cigarette smoking cessation by the end of the trial compared with those continuing to smoke. There was no evidence that lung cancer death rates were lower among cigarette smokers who quite compared with those who continued to smoke in this 10-year follow-up period. CONCLUSION. The data are consistent with results of previous epidemiologic studies indicating that the benefits of smoking cessation on CHD are rapid, while for lung cancer, the benefit is not evident in a 10-year follow-up period.     

Alcohol, smoking, and body size in relation to incident Hodgkin's and non-Hodgkin's lymphoma risk

Studies associate alcohol consumption, cigarette smoking, and body size with the risk of overall or subtype lymphoma. Current data come mostly from case-control studies or prospective studies with few cases. In the prospective National Institutes of Health-former American Association of Retired Persons (NIH-AARP) Diet and Health Study, the authors assessed the above lifestyle factors via baseline questionnaire among 285,079 men and 188,905 women aged 50-71 years and ascertained histologically confirmed Hodgkin's lymphoma (n = 58) and non-Hodgkin's lymphoma (n = 1,381) cases through linkage with cancer registries from 1995 to 2000. Compared with nondrinkers, alcohol consumers had a lower risk for non-Hodgkin's lymphoma overall (for >28 drinks/week: adjusted relative risk (RR) = 0.77, 95% confidence interval (CI): 0.59, 1.00; p(trend) among drinkers = 0.02) and for its main subtypes. Compared with never smokers, current smokers and recent quitters (or=35: RR = 1.29, 95% CI: 1.02, 1.64) and taller height (RR = 1.19, 95% CI: 1.03, 1.38) were associated moderately with non-Hodgkin's lymphoma. These findings add to the evidence that lifestyle factors and relevant anthropometric characteristics play a role in lymphoma etiology.     

Active and passive smoking and risk of colds in women

PURPOSE: To evaluate the association between active and passive smoking and frequency of colds in women. METHODS: Data on cigarette smoking and frequency and duration of colds were analyzed in the Women's Health Study (WHS), a randomized, double-blind, placebo-controlled trial of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer among 39,876 female health professionals. RESULTS: After adjustment for age, body-mass index, prevalence of asthma and chronic lung diseases, alcohol intake, physical activity, and multivitamin use, current heavy smokers had no appreciable increase in the frequency of colds (relative risk (RR) for >or= 3 versus no colds in the past year, 1.05; 95% confidence interval (CI), 0.80-1.39), but a significantly increased risk of prolonged colds (RR for colds of > 7 vs. 1-3 days, 2.53; 95% CI, 1.95-3.29). There was no difference in the number of days confined to home. Nonsmoking women passively exposed to cigarette smoke had a slightly increased risk of both more frequent colds (RR, 1.33; 95% CI, 1.18-1.51) and more prolonged colds during the previous year (RR, 1.12; 95% CI, 0.99-1.27). CONCLUSIONS: Women who are currently heavy smokers are at increased risk of having colds with longer duration compared with nonsmokers. Nonsmoking women passively exposed to cigarette smoking are at slightly increased risk of having more frequent and longer colds than nonsmoking women not exposed to passive smoke.