ets exposure, lung cancer - Legacy Tobacco Documents Library

"$ f3arifnkel, Auerbach, and Joub .ri
a1SCUSS(ON
In a previous paper (4) the problem of classifying
involuntar . smoking on the basis of the hus,band's
smoking habit was discussed It was pointed out that
questions directed at ascertaining a quantitative estimate
of the number of hours a day that subjects were exposed
might be a better measure than the total number of
cigarettes that the husband smoked, inasmuch as not all
of the husband's smoking was done at home . In the
present study we classified the exposure both ways : by the
number of hours per day the subjects were exposed to
smoke of others and by the husband's smoking habits .
We also recorded the respondent's estimate of how many
cigarettes a day the husband smoked at homeIn this
`ioup of women, husbands who smoked cigarettes
smoked an average of 27 cigarettes a day, of which 11 .5
cigarettes on average (M) were smoked at home . Of
course, all cigarettes smoked at home were not necessarily
smoked in a room where the sub)ect could have been
exposed, In this study, the husband's smoking at home
was related to the women's lung cancer, whereas number
of hours of exposure a day to all sources of tobacco smoke
was not related .
A potential source of error was the hospital's report of
whether the subject smoked or not, In this stud), 40% of
the women with lung cancer, classified as nonsmokers (or
smoking not stated) on the hospital record, were smokers
at some time (table 1) . Another 13% did not have primary
lung cancer It is apparent, therefore, that in any study of
involuntary inhalatton and lung cancer, the smoking
histories of the subjects have to be confirmed as well as
the extent of their involuntary exposures Smoking
histories of husbands were obtained for the 113 women
who were smokers The distribution by smoking habit is
shown in table 9 . As we might have expected, smokers are
more likely to be married to smokers than are non•
smokers The table shows that 43 of 134 women, or 32 1%,
of the cases included as never smoked in this study had
husbands who never smoked ; but only 21 of 113, or 18 6% .
of women who smoked and were mistakenly classified as
nonsmokers in the hospital record had husbands who did
not smoke . Among the controls only 8 .5% of women who
were called nonsmokers (or smoking was not stated) were
smokers
The table shows the effect on the OR, when one
assumes that 8 .5% of the additiorul controls needed for
the 1 :3 match had husbands with the same smoking
distribution as the husbands of cases who were smokers,
and that the balance had the same distribution as that of
the 402 controls included in the study . The OR (or the
husband's smoking increase to 1 .61 overall and are as
high as 1 .63 for the 20-59 cigarette a day smokers and 2 .32
for the women whose husbands smoked 40 or more
cigarettes a day . For exposure to the husband's smoke at
home, the OR are 1 .66 overall, 1 .53 for women whose
husbands smoke 10-19 cigarettes a day, and 2 .85 for those
whose husbands smoke 20 or more a dny at home Thus
the inclusion of women whose smoking habits have not
been reviewed greatly increases the OR .
TABLE 9 .-Nypot)ttical OR resvltinp from rombininp wrom .tn in etudy u•itA women oripinally ctassiJud
oy Kotttmoktrs but u•ho actaally smoked
Husband's toul smoking hsbiu
Variable Ci`arettes; day Cigar All Touls
None
endr or
types of
< 20 20 39 Z40
pipe
smoking
No of cues
Nonsmokers (in study) 43 11 82 30 18 91 134
Smokers (originally called nonsmokers) 21 9 43 24 16 92 113
Total (untcreened) 64 20 75 64 84 163 247
No . of controls
Nonsmokers (in study) 148 45 102 52 55 254 402
Additional controls' 119 88 90 45 47 220 339
Total (unureened) 167 63 192 97 102 474 741
OR 1 .00 1 .01 1 .63 2 .32 1 .39 1 .61
None
Htuband's smoking habits at home
Civarettu/day Cir .r All Totals