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Effects of exposure to secondhand smoke

Institution: Kaiser Foundation Research Institute
Investigator(s): Carlos Iribarren, M.D., Ph.D., M.P.H.
Award Cycle: 1999 (Cycle 8) Grant #: 8KT-0028 Award: $194,404
Subject Area: Epidemiology
Award Type: New Investigator Awards
Abstracts

Initial Award Abstract
We are proposing a new study of the long-term health consequences of being exposed to the environmental tobacco smoke (ETS) of others, also called "secondhand smoke". Exposure to ETS has been associated with increased risk of heart disease, cancers of the lung and other organs, emphysema, asthma, and other breathing disorders in previous epidemiological studies. However, the strength of the associations, the relative importance of the source of exposures (home, workplace), and whether certain subgroups of the population are particularly impacted by ETS, remain unresolved questions.

Specifically, we are interested in finding out whether non-smokers who said they were exposed to ETS at home, in small spaces (e.g., offices, cars, airplanes), and/or in large spaces (e.g., restaurants, hotel lobbies or lecture halls) are at increased risk of developing tobacco-related cancers, heart disease, and lung disease. To conduct this study, we will utilize information collected over the years from a large, well-defined population of over 114,000 members of the northern California Kaiser Permanente Medical Care Program (KPMCP), in conjunction with comprehensive follow-up data for this group regarding cancer incidence, hospitalizations, and mortality from 1979 through the end of 1998. Because the members of the KPMCP of northern California have diverse ethnic and cultural backgrounds, we will be able to discern whether the risks linked to ETS are particularly important for certain populations.

This study offers a unique opportunity to gather a considerable body of data on ETS and long-term health outcomes in a cost-effective manner. The findings will add to our understanding of the damaging effects of secondhand smoke and will help inform efforts of public health authorities and policy makers.

Final Report
Introduction and Topic Addressed The overall objective of this study was to examine the heath risks associated with being exposed to smoke because of smoking by other persons among non-smokers. The specific aims were to quantify the magnitude of these health risks with particular attention paid to cardiovascular diseases, cancer, and asthma. We were also interested in common heath problems such as colds, headaches and hearing loss.

Progress toward Specific Aims In our work using a large population of men and women who were members of a health plan in the Bay Area, being exposed to smoking by others was indeed related to greater risk of hay fever and asthma, severe headache, accelerated hearing loss with age, and cold/flu symptoms. It was also related with subsequent increased risk of heart disease and stroke, and we found that being exposed to cigarette smoke at home was worse than being exposed outside the home.

Future Directions and Impact We are now studying whether exposure to second hand smoke might increase risk of certain forms of cancer, including lung, upper respiratory tract, stomach, pancreas, bladder, cervical and breast. Our findings may be useful to inform the public and the public health authorities about the dangers of exposure to secondhand smoke.
Publications

Exposure to environmental tobacco smoke: association with personal characteristics and self-reported health conditions
Periodical: Journal of Epidemiol Community Health Index Medicus:
Authors: Iribarren C, Friedman GD, Klatsky AL, Eisner MD J ART
Yr: 2001 Vol: 55 Nbr: Abs: Pg: 721 - 728

Environmental tobacco smoke exposure and risk of coronary heart disease in the Northern California Kaiser Permanente multiphasic cohort.
Periodical: American Journal of Public Health Index Medicus:
Authors: Iribarren C, Klatsky AL, and Friedman GD ART
Yr: 0 Vol: Nbr: Abs: Pg:

Cohort study of exposure to environmental tobacco smoke and risk of stroke.
Periodical: Lancet Index Medicus:
Authors: Iribarren C, Darbinian J, Klatsky AL, and Friedman GD ART
Yr: 0 Vol: Nbr: Abs: Pg: