European study reports passive smoking dangers

By Karen Birchard
Copyright 1998 The Lancet
October 16, 1998

The results of a long-awaited European study on passive smoking by the International Agency for Research on Cancer (IARC), Lyon, France, show weak but measurable evidence of a dose-response association between lung-cancer risk and exposure to smoke from a spouse or in the workplace, thus adding weight to previous studies.

But the study failed to find an association between childhood exposure to passive smoking in the home and lung cancer. In addition, there was no detectable increase in risk in non-smokers who had not been exposed to smoke for 15 years or more, compared with non-smokers who had never been exposed (J Natl Cancer Inst 1998; 90: 1440-50).

509 women and 141 men who had never smoked but had lung cancer and a control group of 1542 non-smokers without lung cancer were surveyed at 12 centres across Europe. They were asked about their exposure to environmental tobacco smoke (ETS) during childhood, adulthood, at home, in the workplace, in vehicles, and in public places.

Paolo Boffetta and colleagues report that an increased risk of developing lung cancer is associated with any exposure to ETS in the workplace (odds ratio 1·17) or to a spouse's smoke (OR 1·16). Risk tended to increase with duration of exposure to ETS.

Previous studies linking passive smoking with lung cancer have been criticised for their small size or flawed methodology. But, in an editorial, William Blot and Joseph McLaughlin (International Epidemiology Institute, Rockville, MD, USA) say that: "The results [of the IARC study] have been eagerly awaited because of the size of the study, the special attempts to minimize misclassification of cigarette smoking status and the ability to control for various potential confounding factors."

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