Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1992 Oct;66(4):700–705. doi: 10.1038/bjc.1992.341

Lung cancer and passive smoking: reconciling the biochemical and epidemiological approaches.

R L Tweedie 1, K L Mengersen 1
PMCID: PMC1977429  PMID: 1419610

Abstract

The accurate determination of exposure to environmental tobacco smoke is notoriously difficult. There have been to date two approaches to determining this exposure in the study of association of passive smoking and lung cancer: the biochemical approach, using cotinine in the main as a marker, and the epidemiological approach. Typically results of the former have yielded much lower relative risk than the latter, and have tended to be ignored in favour of the latter, although there has been considerable debate as to the logical basis for this. We settle this question by showing that, using the epidemiologically based meta-analysis technique of Wald et al. (1986), and misclassification models in the EPA Draft Review (1990), one arrives using all current studies at a result which is virtually identical with the biochemically-based conclusions of Darby and Pike (1988) or Repace and Lowry (1990). The conduct of this meta-analysis itself raises a number of important methodological questions, including the validity of inclusion of studies, the use of estimates adjusted for covariates, and the statistical significance of estimates based on meta-analysis of the epidemiological data. The best estimate of relative risk from spousal smoking is shown to be approximately 1.05-1.10, based on either of these approaches; but it is suggested that considerable extra work is needed to establish whether this is significantly raised.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akiba S., Kato H., Blot W. J. Passive smoking and lung cancer among Japanese women. Cancer Res. 1986 Sep;46(9):4804–4807. [PubMed] [Google Scholar]
  2. Brownson R. C., Reif J. S., Keefe T. J., Ferguson S. W., Pritzl J. A. Risk factors for adenocarcinoma of the lung. Am J Epidemiol. 1987 Jan;125(1):25–34. doi: 10.1093/oxfordjournals.aje.a114509. [DOI] [PubMed] [Google Scholar]
  3. Correa P., Pickle L. W., Fontham E., Lin Y., Haenszel W. Passive smoking and lung cancer. Lancet. 1983 Sep 10;2(8350):595–597. doi: 10.1016/s0140-6736(83)90680-3. [DOI] [PubMed] [Google Scholar]
  4. Darby S. C., Pike M. C. Lung cancer and passive smoking: predicted effects from a mathematical model for cigarette smoking and lung cancer. Br J Cancer. 1988 Dec;58(6):825–831. doi: 10.1038/bjc.1988.319. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fontham E. T., Correa P., WuWilliams A., Reynolds P., Greenberg R. S., Buffler P. A., Chen V. W., Boyd P., Alterman T., Austin D. F. Lung cancer in nonsmoking women: a multicenter case-control study. Cancer Epidemiol Biomarkers Prev. 1991 Nov-Dec;1(1):35–43. [PubMed] [Google Scholar]
  6. Gao Y. T., Blot W. J., Zheng W., Ershow A. G., Hsu C. W., Levin L. I., Zhang R., Fraumeni J. F., Jr Lung cancer among Chinese women. Int J Cancer. 1987 Nov 15;40(5):604–609. doi: 10.1002/ijc.2910400505. [DOI] [PubMed] [Google Scholar]
  7. Garfinkel L., Auerbach O., Joubert L. Involuntary smoking and lung cancer: a case-control study. J Natl Cancer Inst. 1985 Sep;75(3):463–469. [PubMed] [Google Scholar]
  8. Garfinkel L. Time trends in lung cancer mortality among nonsmokers and a note on passive smoking. J Natl Cancer Inst. 1981 Jun;66(6):1061–1066. doi: 10.1093/jnci/66.6.1061. [DOI] [PubMed] [Google Scholar]
  9. Gillis C. R., Hole D. J., Hawthorne V. M., Boyle P. The effect of environmental tobacco smoke in two urban communities in the west of Scotland. Eur J Respir Dis Suppl. 1984;133:121–126. [PubMed] [Google Scholar]
  10. Hirayama T. Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan. Br Med J (Clin Res Ed) 1981 Jan 17;282(6259):183–185. doi: 10.1136/bmj.282.6259.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Humble C. G., Samet J. M., Pathak D. R. Marriage to a smoker and lung cancer risk. Am J Public Health. 1987 May;77(5):598–602. doi: 10.2105/ajph.77.5.598. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Jarvis M., Tunstall-Pedoe H., Feyerabend C., Vesey C., Salloojee Y. Biochemical markers of smoke absorption and self reported exposure to passive smoking. J Epidemiol Community Health. 1984 Dec;38(4):335–339. doi: 10.1136/jech.38.4.335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kabat G. C., Wynder E. L. Lung cancer in nonsmokers. Cancer. 1984 Mar 1;53(5):1214–1221. doi: 10.1002/1097-0142(19840301)53:5<1214::aid-cncr2820530532>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  14. Kalandidi A., Katsouyanni K., Voropoulou N., Bastas G., Saracci R., Trichopoulos D. Passive smoking and diet in the etiology of lung cancer among non-smokers. Cancer Causes Control. 1990 Jul;1(1):15–21. doi: 10.1007/BF00053179. [DOI] [PubMed] [Google Scholar]
  15. Koo L. C., Ho J. H., Saw D., Ho C. Y. Measurements of passive smoking and estimates of lung cancer risk among non-smoking Chinese females. Int J Cancer. 1987 Feb 15;39(2):162–169. doi: 10.1002/ijc.2910390207. [DOI] [PubMed] [Google Scholar]
  16. Lam T. H., Kung I. T., Wong C. M., Lam W. K., Kleevens J. W., Saw D., Hsu C., Seneviratne S., Lam S. Y., Lo K. K. Smoking, passive smoking and histological types in lung cancer in Hong Kong Chinese women. Br J Cancer. 1987 Nov;56(5):673–678. doi: 10.1038/bjc.1987.264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lee P. N., Chamberlain J., Alderson M. R. Relationship of passive smoking to risk of lung cancer and other smoking-associated diseases. Br J Cancer. 1986 Jul;54(1):97–105. doi: 10.1038/bjc.1986.157. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lee P. Lung cancer and passive smoking (continued) Br J Cancer. 1991 Jul;64(1):200–201. doi: 10.1038/bjc.1991.271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Lee P. Lung cancer and passive smoking. Br J Cancer. 1991 Jan;63(1):161–163. doi: 10.1038/bjc.1991.37. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Liu Z. Y., He X. Z., Chapman R. S. Smoking and other risk factors for lung cancer in Xuanwei, China. Int J Epidemiol. 1991 Mar;20(1):26–31. doi: 10.1093/ije/20.1.26. [DOI] [PubMed] [Google Scholar]
  21. Pershagen G., Hrubec Z., Svensson C. Passive smoking and lung cancer in Swedish women. Am J Epidemiol. 1987 Jan;125(1):17–24. doi: 10.1093/oxfordjournals.aje.a114504. [DOI] [PubMed] [Google Scholar]
  22. Repace J. L., Lowrey A. H. Risk assessment methodologies for passive smoking-induced lung cancer. Risk Anal. 1990 Mar;10(1):27–37. doi: 10.1111/j.1539-6924.1990.tb01017.x. [DOI] [PubMed] [Google Scholar]
  23. Svensson C., Pershagen G., Klominek J. Smoking and passive smoking in relation to lung cancer in women. Acta Oncol. 1989;28(5):623–629. doi: 10.3109/02841868909092282. [DOI] [PubMed] [Google Scholar]
  24. Trichopoulos D., Kalandidi A., Sparros L. Lung cancer and passive smoking: conclusion of Greek study. Lancet. 1983 Sep 17;2(8351):677–678. doi: 10.1016/s0140-6736(83)92549-7. [DOI] [PubMed] [Google Scholar]
  25. Trichopoulos D., Kalandidi A., Sparros L., MacMahon B. Lung cancer and passive smoking. Int J Cancer. 1981 Jan 15;27(1):1–4. doi: 10.1002/ijc.2910270102. [DOI] [PubMed] [Google Scholar]
  26. Uberla K. Lung cancer from passive smoking: hypothesis or convincing evidence? Int Arch Occup Environ Health. 1987;59(5):421–437. doi: 10.1007/BF00377837. [DOI] [PubMed] [Google Scholar]
  27. Vutuc C. Quantitative aspects of passive smoking and lung cancer. Prev Med. 1984 Nov;13(6):698–704. doi: 10.1016/s0091-7435(84)80019-5. [DOI] [PubMed] [Google Scholar]
  28. Wald N. J., Nanchahal K., Thompson S. G., Cuckle H. S. Does breathing other people's tobacco smoke cause lung cancer? Br Med J (Clin Res Ed) 1986 Nov 8;293(6556):1217–1222. doi: 10.1136/bmj.293.6556.1217. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Wald N., Nanchahal K., Cuckle H., Thompson S. Lung cancer and passive smoking. Br J Cancer. 1990 Feb;61(2):337–338. doi: 10.1038/bjc.1990.67. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wald N., Ritchie C. Validation of studies on lung cancer in non-smokers married to smokers. Lancet. 1984 May 12;1(8385):1067–1067. doi: 10.1016/s0140-6736(84)91467-3. [DOI] [PubMed] [Google Scholar]
  31. Wu-Williams A. H., Dai X. D., Blot W., Xu Z. Y., Sun X. W., Xiao H. P., Stone B. J., Yu S. F., Feng Y. P., Ershow A. G. Lung cancer among women in north-east China. Br J Cancer. 1990 Dec;62(6):982–987. doi: 10.1038/bjc.1990.421. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Wu-Williams A. H., Samet J. M. Environmental tobacco smoke: exposure-response relationships in epidemiologic studies. Risk Anal. 1990 Mar;10(1):39–48. doi: 10.1111/j.1539-6924.1990.tb01018.x. [DOI] [PubMed] [Google Scholar]
  33. Wu A. H., Henderson B. E., Pike M. C., Yu M. C. Smoking and other risk factors for lung cancer in women. J Natl Cancer Inst. 1985 Apr;74(4):747–751. [PubMed] [Google Scholar]
  34. Yusuf S., Peto R., Lewis J., Collins R., Sleight P. Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis. 1985 Mar-Apr;27(5):335–371. doi: 10.1016/s0033-0620(85)80003-7. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES