Summary
Self-reported smoking histories were collected during face-to-face interviews with 807 patients with acute leukaemia and 1593 age- and sex-matched controls. Individuals who had smoked regularly at some time during their lives were more likely to develop acute leukaemia than those who had never smoked (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.0–1.4). The association was strongest for current smokers, defined here as smoking 2 years before diagnosis (OR = 1.4, 95% CI 1.1–1.7). With respect to the numbers of years smoked, risk estimates were raised in all groups except those who had smoked for fewer than 10 years. Similarly, the odds ratio decreased as the number of years ‘stopped smoking’ increased, falling to one amongst those who had given up smoking for more than 10 years. No significant linear trends were found, however, with either the numbers of years smoked or the numbers of years stopped smoking, and no significant differences were found between AML and ALL.
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References
Adami, J, Nyrén, O, Bergström, R, Ekbom, A, Engholm, G, Englund, E & Glimelius, B (1998). Smoking and the risk of leukemia, lymphoma, and multiple myeloma (Sweden). Cancer Causes Control 9: 49–56.
Aksoy, M (1985). Benzene as a leukemogenic and carcinogenic agent. Am J Ind Med 8: 9–20.
Austin, H & Cole, P (1986). Cigarette smoking and leukemia. J Chron Dis 39: 417–421.
Bennett, N, Jarvis, L, Rowlands, O, Singleton, N & Haselden, L (1996). Smoking. InLiving in Britain: Results from the General Household Survey. Office of Population Censuses and Surveys, Social Survey Division 1994, HMSO: London
Blackwelder, WC, Yano, K, Rhoads, GG, Kagan, A, Gordon, T & Palesch, Y (1980). Alcohol and mortality: the Honolulu Heart Study. Am J Med 68: 164–169.
Breslow, NE & Day, NE (1980). Classical methods of analysis of matched data. InThe Analysis of Case–Control Studies, 6th edn.International Agency for Research in Cancer: Lyon
Brown, LM, Gibson, R, Blair, A, Burmeister, LF, Schuman, LM, Cantor, KP & Fraumeni, JFJ (1992a). Smoking and risk of leukemia. Am J Epidemiol 135: 763–767.
Brown, LM, Gibson, R, Burmeister, LF, Schuman, LM, Everett, GD & Blair, A (1992b). Alcohol consumption and risk of leukemia, non-Hodgkin’s lymphoma, and multiple myeloma. Leukemia Res 16: 979–984.
Brownson, RC (1989). Cigarette smoking and risk of leukemia. J Clin Epidemiol 42: 1025–1026.
Brownson, RC, Chang, JC & Davis, JR (1991). Cigarette smoking and risk of acute leukemia. Am J Epidemiol 134: 938–941.
Brownson, RC, Novotny, TE & Perry, MC (1993). Cigarette smoking and adult leukemia. Arch Intern Med 153: 469–475.
Carstensen, JM, Bygren, LO & Hatschek, T (1990). Cancer incidence among Swedish brewery workers. Int J Cancer 45: 393–396.
Cartwright, RA, Darwin, C, McKinney, PA, Roberts, B, Richards, IDG & Bird, CC (1988). Acute myeloid leukemia in adults: a case–control study in Yorkshire. Leukemia 2: 687–690.
Cartwright, RA, McNally, RJQ, Rowland, DJ & Thomas, J (1997). The descriptive epidemiology of leukaemia and related conditions in parts of the United Kingdom 1984–1993. Leukaemia Research Fund: London
Crane, MM, Godwin, JE, Annegers, JF & Keating, MJ (1992). Is histological subtype a marker for environmental exposures in acute myelogenous leukemia?. Cancer Epidemiol Biomarkers Prev 1: 183–188.
Curtis, RE, Hankey, BF, Myers, MH & Young, JL (1984). Risk of leukemia associated with the first course of cancer treatment: an analysis of the surveillance, epidemiology, and end results program experience. J Natl Cancer Inst 72: 531–544.
Engeland, A, Andersen, A, Haldorsen, T & Tretli, S (1996). Smoking habits and risk of cancers other than lung cancer: 28 years’ follow-up of 26 000 Norwegian men and women. Cancer Causes Control 7: 497–506.
Frenzilli, G, Betti, C, Davini, C, Desideri, M, Fornai, E, Giannessi, L, Maggiorelli, F, Paoletti, P & Barale, R (1997). Evaluation of DNA damage in leukocytes of ex-smokers by single cell gel electrophoresis. Mutat Res 375: 117–123.
Friedman, GD (1993). Cigarette smoking, leukemia, and multiple myeloma. Ann Epidemiol 3: 425–428.
Garfinkel, L & Boffetta, P (1990). Association between smoking and leukemia in two American Cancer Society prospective studies. Cancer 65: 2356–2360.
Ghosh, R & Ghosh, PK (1987). The effect of tobacco smoking on the frequency of sister chromatid exchanges in human lymphocyte chromosomes. Cancer Genet Cytogenet 27: 15–19.
Hardy, RJ & Thompson, SG (1998). Detecting and describing heterogeneity in meta-analysis. Stat Med 17: 841–856.
Hay, DR & Foster, FH (1984). Intercensal trends in cigarette smoking in New Zealand 2: Social and occupational factors. NZ Med J 97: 395–398.
Heath, CW (1982). The leukemias. In Cancer Epidemiology and Prevention, WB Saunders: Philadelphia
Hersey, P, Prendergast, D & Edwards, A (1983). Effects of cigarette smoking on the immune system. Follow-up studies in normal subjects after cessation of smoking. Med J Aust 2: 425–429.
Hinds, MW, Kolonel, LN, Lee, J & Hirohata, T (1980). Associations between cancer incidence and alcohol/cigarette consumption among five ethnic groups in Hawaii. Br J Cancer 41: 929–940.
Hursting, SD, Margolin, BH & Switzer, BR (1990). Diet and human leukemia: an analysis of international data. Prev Med 19: 242–253.
Jensen, OM (1979). Cancer morbidity and causes of death among Danish brewery workers. Int J Cancer 23: 454–463.
Kabat, GC, Augustine, A & Herbert, JR (1988). Smoking and adult leukemia: a case–control study. J Clin Epidemiol 41: 907–914.
Kinlen, LJ & Rogot, E (1988). Leukaemia and smoking habits among United States veterans. Br Med J 297: 657–659.
Kwiatkowski, A (1993). Dietary and other environmental risk factors in acute leukaemias: a case-control study of 119 patients. Eur J Cancer Prev 2: 139–146.
Linet, MS, McLaughlin, JK, Hsing, AW, Wacholder, S, Co-Chien, HT, Schuman, LM, Bjelke, E & Blot, WJ (1991). Cigarette smoking and leukemia: results from the Lutheran Brotherhood Cohort Study. Cancer Causes Control 2: 413–417.
McLaughlin, JK (1989). Cigarette smoking and leukemia. J Natl Cancer Inst 81: 262–263.
McLaughlin, JK, Hrubec, Z, Blot, WJ & Fraumeni, JFJ (1995). Smoking and cancer mortality among US veterans: a 26-year follow-up. Int J Cancer 60: 190–193.
McNally, RJQ, Rowland, D, Roman, E & Cartwright, RA (1997). Age and sex distributions of hematological malignancies in the UK. Hematol Oncol 15: 173–189.
Mele, A, Szklo, M, Visani, G, Stazi, MA, Castelli, G, Pasquini, P & Mandelli, F the Italian Leukemia Study Group (1994). Hair dye use and other risk factors for leukemia and pre-leukemia: a case–control study. Am J Epidemiol 139: 609–619.
Mills, PK, Newell, GR, Beeson, WL, Fraser, GE & Phillips, RL (1990). History of cigarette smoking and risk of leukemia and myeloma: results from the Adventist Health Study. J Natl Cancer Inst 82: 1832–1836.
Pasqualetti, P, Festuccia, V, Acitelli, P, Collacciani, A, Giusti, A & Casale, R (1997). Tobacco smoking and risk of haematological malignancies in adults: a case–control study. Br J Haematol 97: 659–662.
Perera, FP, Santella, RM, Brenner, D, Poirier, MC, Munshi, AA, Fischman, HK & Van Ryzin, J (1987). DNA adducts, protein adducts, and sister chromatid exchange in cigarette smokers and nonsmokers. J Natl Cancer Inst 79: 449–456.
Petitti, DB & Kipp, H (1986). The leukocyte count: associations with intensity of smoking and persistence of effect after quitting. Am J Epidemiol 123: 89–95.
Rinsky, RA, Smith, AB, Hornung, R, Filloon, TG, Young, RJ, Okun, AH & Landrigan, PJ (1987). Benzene and leukemia. An epidemiologic risk assessment. N Engl J Med 316: 1044–1050.
Sandler, DP, Shore, DL, Anderson, JR, Davey, FR, Arthur, D, Mayer, RJ, Silver, RT, Weiss, RB, Moore, JO, Schiffer, CA, Wurster-Hill, DH, McIntyre, OR & Bloomfield, CD (1993). Cigarette smoking and risk of acute leukemia: associations with morphology and cytogenetic abnormalities in bone marrow. J Natl Cancer Inst 85: 1994–2003.
Schmidt, W & Popham, RE (1981). The role of drinking and smoking in mortality from cancer and other causes in male alcoholics. Cancer 47: 1031–1041.
Severson, RK (1987). Cigarette smoking and leukemia. Cancer 60: 141–144.
Severson, RK, Davis, S, Heuser, L, Daling, JR & Thomas, DB (1990). Cigarette smoking and acute nonlymphocytic leukemia. Am J Epidemiol 132: 418–421.
Shisa, H, Matsudaira, Y, Hiai, H & Nishizuka, Y (1975). Origin of leukemic cells in mouse leukemia induced by N-butylnitrosourea. Gann 66: 37–42.
Siegel, M (1993). Smoking and leukemia: evaluation of a causal hypothesis. Am J Epidemiol 138: 1–9.
Smith, PG & Doll, R (1982). Mortality among patients with ankylosing spondilitis after a single course with X-rays. Br Med J 284: 449–460.
Spitz, MR, Fueger, JJ, Newell, GR & Keating, MJ (1990). Leukemia and cigarette smoking. Cancer Causes Control 1: 195–196.
Stata Corporation (1997). Intercooled Stata 5.0 for Windows 95. Stata Corporation: Texas
Townsend, P, Phillimore, P & Beattie, A (1988). Health and deprivation: inequality and the North. Croom Helm: London
Vesselinovitch, SD & Mihailovich, N (1966). Significance of newborn age and dose of urethan in leukemogenesis. Cancer Res 26: 1633–1637.
Williams, RR & Horm, JW (1977). Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. J Natl Cancer Inst 58: 525–547.
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Kane, E., Roman, E., Cartwright, R. et al. Tobacco and the risk of acute leukaemia in adults. Br J Cancer 81, 1228–1233 (1999). https://doi.org/10.1038/sj.bjc.6690833
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DOI: https://doi.org/10.1038/sj.bjc.6690833
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