Smoking as a risk factor for lung cancer and cardiac infarct as mediated by psychosocial variables. A prospective investigation

In 1965-66, a prospective psychosomatic investigation was started with 1,353 relatively old inhabitants of the village of Crvenka, Yugoslavia. The present article reports on the relevance of smoking for the incidence of lung cancer and cardiac infarct. The main results are: (1) The relevance of smoking is reduced, but not eliminated, by introducing psychosocial control variables, suggesting that the latter have direct influences both on smoking and on the diseases. (2) The relevance of smoking interacts very strongly with psychosocial background conditions: it is nearly reduced to zero when the latter are favorable, and is correspondingly high when they are unfavorable. The results are also interpreted in biochemical terms.