Table 8.2

Case-control studies of exposure to secondhand smoke and the risk of coronary heart disease (CHD) among nonsmokers

Population
StudyYear and location of studyCasesControlsExposureRelative risk (95% confidence interval)Variables controlled for
Lee et al. 1986 1979–1982
England
41 male and 77 female patients with ischemic heart disease
Lifetime nonsmokers and married
133 male and 318 female hospital patients with diseases probably or definitely not related to smoking
Lifetime nonsmokers and married
Spouse smoked1.03 (0.65–1.62)Age, gender, hospital region
He 1989 (not included in the meta-analysis conducted for this 2006 Surgeon General’s report)Years were not reported
China
34 female hospital patients
Nonsmokers
34 female hospital patients
34 females, population based
All nonsmokers
Husband smoked1.5 (1.3–1.8)Alcohol consumption, exercise, personal and family history of CHD, hypertension, hyperlipidemia
Jackson 1989 (data included in McElduff et al. 1998 study in the 2006 meta-analysis conducted for this 2006 Surgeon General’s report)1987–1988
New Zealand
44 male and 22 female hospital patients
All nonsmokers
Myocardial infarction (MI) or death from CHD
84 male and 174 female hospital patients
All nonsmokers
MI or death from CHD
Home and work exposures combinedMI
 Men: 1.0 (0.3–3.0)
 Women: 2.7 (0.6–12.3)

Death from CHD
 Men: 1.1 (0.2–5.3)
 Women: 5.8 (1.0–35.2)
Age, social status, history of CHD
Dobson et al. 1991 (data included in McElduff et al. 1998 study in the meta-analysis conducted for this 2006 Surgeon General’s report)1988–1989
Australia (New South Wales)
183 male and 160 female hospital patients
MI or death from CHD
Nonsmokers
293 male and 174 female hospital patients
Nonsmokers
Participants in a risk factor prevalence survey
Home and work exposuresMen: 1.0 (0.5–1.8)
Women: 2.5 (1.5–4.1)
Age, history of MI
La Vecchia et al. 1993 1988–1989
Italy
69 men and 44 women with acute incident MI
Lifetime nonsmokers and married
Enrolled in the Gruppo
Italiano per lo Studio della Sopravvivenza nell’Infarto-2
Median age: 63 years
217 married hospital controls (161 men, 56 women)
Lifetime nonsmokers
Admitted for acute diseases not related to any potential cardiovascular disease risk factors in the same network of hospitals
Median age: 57 years
Spouse smoked1.21 (0.57–2.52)Age, gender, level of education, coffee consumption, body mass index (BMI), serum cholesterol level, hypertension, diabetes mellitus, family history of acute MI
He et al. 1994 1989–1992
China
59 female patients with nonfatal incident CHD in 3 hospitals
Nonsmokers
Average age: 58 years
126 patients in the same hospitals or from the community
Lifetime nonsmokers
Average age: 55 years
Husband smoked and workplace exposure for ≥5 years2.36 (1.01–5.55)Age, hypertension, personality type, total serum and high-density lipoprotein cholesterol level
Layard 1995 (not included in the meta-analysis conducted for this 2006 Surgeon General’s report)1986 National Followback Survey
United States
475 men and 914 women who died from heart disease998 men and 1,930 women who died from other causesSpouse smokedMen: 1.0 (0.7–1.3)
Women: 1.0 (0.8–1.2)
Age, race
Muscat and Wynder 1995 1980–1990
United States
68 men and 46 women hospitalized with incident MI in 4 cities
Lifetime nonsmokers
Average age: 59 years
108 men and 50 women in the same hospitals
Lifetime nonsmokers
Frequency matched for age, race, year of diagnosis
Average age: 58 years
Home, current workplace, and childhood exposures2.4 (1.1–4.8)Age, housing, tenure, cholesterol level, diastolic blood pressure
Tunstall-Pedoe et al. 1995 (not included in the meta-analysis conducted for this 2006 Surgeon General’s report)1984–1986
Scotland
70 men and women aged 40–59 years from general practitioner list
Self-reported CHD diagnosis
Nonsmokers
2,278 men and women aged 40–59 years from general practitioner list
Self-reported CHD diagnosis
Any exposure from someone else in the 3 days before the survey1.5 (0.9–2.6)Age, gender, race, level of education, hypertension, year of diagnosis
Ciruzzi et al. 1998 1991–1994
Argentina
336 male and female patients with acute incident MI in 35 coronary care units
Median age: 66 years
446 patients in the same hospitals
Matched for age, gender, medical center
Median age: 65 years
Spouse and children smoked1.68 (1.2–2.37)Age, gender, race, level of education, BMI, hyperlipidemia, history of diabetes or hypertension, family history of CHD, exercise
McElduff et al. 1998 (not included in 2001 review)1986–1994
Australia and New Zealand
686 male and 267 female patients with fatal or nonfatal MI or unclassifiable coronary death from population register of coronary events
Lifetime nonsmokers or former smokers for >10 years
3,189 residents of the same communities participating in independent community-based surveyHome and workplace exposures combined1.41 (0.73–2.71)Age, education, history of CHD, BMI
Rosenlund et al. 2001 (not included in 2001 review)1992–1994
Sweden
All nonfatal MIs among nonsmoking Swedish citizens aged 45–70 years, residing in study area during 1992–1993 (n = 334; 199 men)
Average age: 62 years
401 males and 276 females
Lifetime nonsmokers
Matched for gender, age, and hospital catchment area
Spouse smoked1.37 (0.9–2.09)Age, gender, hospital catchment area, BMI, socioeconomic status, job strain, hypertension, diet, diabetes mellitus

Note: All studies appear in both the original review and the meta-analysis conducted for this 2006 Surgeon General’s report unless otherwise indicated.

From: 8, Cardiovascular Diseases from Exposure to Secondhand Smoke

Cover of The Health Consequences of Involuntary Exposure to Tobacco Smoke
The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.
Office on Smoking and Health (US).

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