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Table 3.55. Associations between adult exposure to environmental tobacco smoke (ETS) from spouses or household members or in the workplace and relative risks for mortality or morbidity from coronary heart disease (CHD), among persons who never smoked, cohort studies

StudyPopulationYears study began/average length of follow-upNumber of CHD eventsRelative risk (95% confidence
interval)
Adjustment factors
Hirayama 1984b 91,540 married women
Japan
1966
16 years
494 deaths1.3 (1.1-1.6) * Age, spouse's occupation
Garland et al. 1985 695 married women San Diego, California1972
10 years
10 deaths2.7 ** Age, systolic blood pressure, plasma cholesterol level, obesity, years of marriage
Svendsen et al. 1987 1,245 married men
18 U.S. cities
1973
7 years
13 deaths 69 fatal and nonfatal events2.2 (0.7-6.9)§
1.6 (1.0-2.7)
Age, blood pressure, cholesterol level, weight, alcohol use, education
Butler 1998 9,785 women (from spuse pairs)
Loma Linda, California
3,488 women,1,489 men
Adventist Health Smog Study
Loma Linda, California
1976
6 years

1976
6 years
87 deaths


Women: 70 deaths
Men: 76 deaths
1.4 (05-3.8) >§<§


1.5 (0.0-2.5)
0.6 (0.3-1.2)
Age
Helsing et al.1988 12,348 women, 3,454 men
Western Maryland
1963Women: 988 deaths
Men:370 deaths
1.2 (1.1-1.4)¶¶
1.3 (1.1-1.6)¶¶
Education, marital status, age housing quality
Hole et al. 1989 2,455 women and men
Scotland
1972
11.5 years
84 deaths2.0 (1.2-3.4) *** Age, gender, social class, diastolic blood pressure, serum cholesterol level, body mass index
Humble et al. 1990 513 married women Evans County, Georgia1960
20 years
76 deaths1.6 (1.0-2.6)§ Age, blood pressure, cholesterol level, body mass index
LeVois and Layard 1995 247,412 women, 88,458 men
CPS-I¶¶

226,067 women, 108,772 men
CPS-II ***
1960
13 years



1983
6 years
Women and men:
14,901 deaths
Women:7,133
deaths
Men:7,768 deaths
Women:1,099
deaths
Men:1,966 deaths
1.00 (0.97-1.04)

1.03 (0.98-1.1)§

0.97 (0.9-1.1)§

1.0 (0.98-1.1)§
0.97 (0.9-1.1)§
Age, race
Steenland et al. 1996 208,372 women,
101,227 men
CPS-II
1982
7 years
Women: 1,325
deaths
Men:2,494 deaths
1.1 (0.96-1.3) >§<§
1.2 (1.1-1.4) >§<§
Age; history of heart disease, hypertension, arthritis; body mass index; alcohol use; use of aspirin and diuretics; employment status; exercise; estrogen use in women
Kawachi et al. 1997a 32,046 women Nurses' Health Study1982
10 years
152 total events
127 nonfatal myocardial infarctions
25 deaths
1.7 (1.03-2.8)§§
1.7 (0.99-3.0)§§

1.9 (0.6-8.2)§§
Alcohol use; body mass index; history of hypertension, diabetes, hypercholesterolemia, infarctions; menopausal status; use of hormones; physical activity; intake of vitamin E and fat; aspirin use; family history
*

Spouse smoked > 20 cigarettes/day vs. spouse never smoked.

**

Spouse was current or former smoker vs.spouse did not smoke; the confidence interval was not provided, but the p value was reported to be <0.10.

§

Spouse smoked vs.spouse did not smoke.

>§<§

Spouse was current smoker vs.spouse never smoked.

Spouse was current smoker vs.spouse never smoked.

¶¶

Score for household ETS>1 vs. 0.

***

Any passive smoking vs.none.

¶¶

CPS-I = Cancer Prevention Study I; American Cancer Society cohort.

***

CPS-II = Cancer Prevention Study II; American Cancer Society cohort.

§§

Any ETS exposure at home or at work vs.none.

From: Chapter 3. Health Consequences of Tobacco Use Among Women

Cover of Women and Smoking
Women and Smoking: A Report of the Surgeon General.
Office on Smoking and Health (US).

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