Table 2.
Hazard Ratios and 95% Confidence Intervals for Invasive Breast Cancer Incidence Associated With Smoking Status Among 76,628 Postmenopausal Women by Obesity Status, the Women's Health Initiative Observational Study, United States, 1993–2009a
Exposure | Nonobese |
Obese |
Pinteraction | ||||
No. of Cases | Multi-adjusted HRb | 95% CI | No. of Cases | Multi-adjusted HRb | 95% CI | ||
Smoking history | |||||||
Never smokers | 1,210 | 1.00 | Referent | 458 | 1.00 | Referent | |
Ever smokers | 1,296 | 1.16 | 1.07, 1.26 | 414 | 0.96 | 0.84, 1.10 | 0.01 |
Smoking status | 0.047 | ||||||
Former smokers | 1,133 | 1.15 | 1.05, 1.25 | 374 | 0.96 | 0.83, 1.11 | |
Current smokers | 163 | 1.25 | 1.05, 1.47 | 40 | 0.96 | 0.69, 1.34 | |
Age at smoking initiation, years | 0.10 | ||||||
<20 | 747 | 1.19 | 1.08, 1.31 | 245 | 1.00 | 0.85, 1.18 | |
20–24 | 422 | 1.15 | 1.03, 1.29 | 119 | 0.92 | 0.75, 1.14 | |
≥25 | 127 | 1.03 | 0.86, 1.24 | 50 | 0.88 | 0.66, 1.18 | |
Ptrend | 0.0002 | 0.73 | |||||
Average no. of cigarettes/day | 0.03 | ||||||
<15 | 708 | 1.13 | 1.03, 1.25 | 212 | 0.97 | 0.82, 1.15 | |
≥15 | 588 | 1.20 | 1.08, 1.33 | 202 | 0.95 | 0.80, 1.13 | |
Ptrend | 0.0003 | 0.54 | |||||
Total no. of smoking years | 0.03 | ||||||
<10 | 288 | 1.02 | 0.90, 1.16 | 96 | 0.96 | 0.77, 1.20 | |
10–29 | 588 | 1.16 | 1.05, 1.28 | 174 | 0.91 | 0.76, 1.09 | |
30–49 | 370 | 1.25 | 1.11, 1.41 | 138 | 1.07 | 0.88, 1.30 | |
≥50 | 50 | 1.62 | 1.22, 2.17 | 6 | 0.62 | 0.28, 1.40 | |
Ptrend | <0.0001 | 0.76 | |||||
No. of smoking pack-years | 0.005 | ||||||
<10 | 517 | 1.05 | 0.95, 1.17 | 170 | 1.01 | 0.84, 1.21 | |
10–<30 | 463 | 1.31 | 1.17, 1.46 | 112 | 0.86 | 0.69, 1.06 | |
30–<50 | 174 | 1.14 | 0.97, 1.34 | 60 | 0.87 | 0.66, 1.15 | |
≥50 | 142 | 1.20 | 1.00, 1.43 | 72 | 1.15 | 0.89, 1.48 | |
Ptrend | 0.0001 | 0.84 | |||||
Years since quit smoking (former smokers) | 0.6 | ||||||
<10 | 201 | 1.25 | 1.08, 1.46 | 77 | 0.94 | 0.73, 1.20 | |
10–<20 | 284 | 1.18 | 1.03, 1.35 | 108 | 1.02 | 0.82, 1.26 | |
20–<30 | 278 | 1.11 | 0.97, 1.27 | 83 | 0.94 | 0.74, 1.19 | |
≥30 | 303 | 1.14 | 1.00, 1.29 | 86 | 0.95 | 0.75, 1.20 | |
Ptrend | 0.0005 | 0.69 |
Abbreviations: CI, confidence interval; HR, hazard ratio.
“Obese” here was defined as body mass index ≥30.
The adjusted variables in all multi-adjusted models included age (<55, 55–59, 60–64, 65–69, 70–74, ≥75 years), race (American Indian or Alaska Native, Asian or Pacific Islander, black or African American, Hispanic/Latino, non-Hispanic white, and other), education (high school or less, some college/technical training, college or some postcollege, and master's degree or higher), family history of cancer (yes/no), age at menarche (<12, 12–13, 14–15, ≥16 years), age at first livebirth (never had term pregnancy, <20, 20–29, ≥30 years), hormone use (no, estrogen alone, estrogen and progestin, mixed), parity (never pregnant, never had term pregnancy, 1, 2, 3, 4, ≥5), alcohol intake (nondrinker, past drinker, <1 drink/month, 1 drink/month–<1 drink/week, 1–<7 drinks/week, ≥7 drinks/week), body mass index (<18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, 35.0–39.9, ≥40), physical activity (metabolic equivalent tasks/week: <5, 5–<10, 10–<20, 20–<30, ≥30), and mammography during the last 2 years (yes/no). The Ptrend test included the reference group.