This summary table contains detailed information about research studies. While viewing summary tables offers an informative glimpse at the science behind many breast cancer guidelines and recommendations, they should be viewed with some caution. There are a number of concepts you must understand to be able to successfully read and interpret research tables. To get some background information about understanding research tables, please see How to Read a Research Table.
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Introduction: Secondhand smoke exposure (also called passive smoking) is one of many proposed environmental risk factors for breast cancer. Large, prospective cohort studies have found no link between secondhand smoke exposure and breast cancer risk. However, there is evidence from smaller case-control studies of a potential increase in breast cancer risk, especially among premenopausal women. Because there is no established link between smoking and breast cancer risk, it is unlikely that secondhand smoke exposure is related to an increase in risk [1]. However, more research is needed to draw solid conclusions.
For more on smoking and risk of breast cancer, see Table 21.
Find more information on the strengths and weaknesses of different types of studies.
See how this risk factor compares with other risk factors for breast cancer.
Study selection criteria: Available prospective cohort studies and case-control studies with at least 300 cases and meta-analyses.
Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.
Study
|
Study population
(number of participants)
|
Follow-up
(years)
|
Secondhand smoke exposure
|
Relative risk of breast cancer
RR (95% CI)
|
Prospective cohort studies
|
| Million Women Study [2] |
224,917
(2,518 cases) |
3.5 |
Exposure in home |
1.02 (0.86-1.16) |
| California Teachers Study [3] |
116,544
(2,005 cases) |
5 |
Exposure in home |
0.94 (0.82-1.07)*
|
| Nurses' Health Study [4] |
78,206
(3,140 cases)
|
14 |
Exposure in home or at work |
0.90 (0.67-1.22) |
Miyagi cohort [5]
|
9,675
(426 cases)
|
9
|
Exposure in home
|
0.58 (0.34-0.99)
|
Case-control studies
|
| |
Cases
|
Controls
|
|
|
|
| Young et al. [6] |
6,235 |
6,533 |
|
Exposure in home or at work |
0.97 (0.88-1.08) |
Lissowska et al. [7]
|
2,386 |
2,502 |
|
Exposure in home or at work |
1.11 (0.85-1.46) |
Johnson et al. [8]
|
2,317
|
2,438
|
|
Exposure in home or at work
|
Premenopausal women
2.6 (1.1-6.0)
Postmenopausal women
1.1 (0.6-1.8)
|
| Slattery et al. [9] |
1,527 |
1,601 |
|
Exposure in home, at work or outside of home
|
Premenopausal women
1.2 (0.6-2.7)†
Postmenopausal women
1.0 (0.6-1.7)†
|
Shrubsole et al. [10]
|
1,013 |
1,117 |
|
Exposure in home or at work |
1.1 (0.8-1.4)*
|
| Roddam et al. [11] |
639 |
640 |
|
Exposure in home |
Premenopausal women
0.89 (0.64-1.25)
|
| Kropp et al. [12] |
468 |
1,093 |
|
Exposure in home or at work |
Premenopausal women
1.61 (1.08-2.39) |
Bonner et al. [13]
|
376
|
684
|
|
Exposure in home
|
Postmenopausal women
1.25 (0.79-1.96)
|
| |
|
|
|
Exposure at work
|
Postmenopausal women
1.09 (0.76-1.57)
|
| Lash et al. [14] |
305 |
249 |
|
Exposure in home |
0.85 (0.63-1.10) |
Meta-analyses
|
| Pirie et al. [2] |
8 studies with prospective data |
|
Exposure in home or at work
|
0.99 (0.93-1.05) |
| |
17 studies with retrospective data |
|
Exposure in home or at work |
1.21 (1.11-1.32) |
Johnson [15]
|
19 studies
|
|
Exposure in home or at work
|
1.27 (1.11-1.45)‡
|
Miller et al. [16]
|
19
|
|
Exposure in home or at work
|
1.25 (1.08-1.44)‡
|
* Results were similar when pre- and postmenopausal women were examined separately.
† Results for non-Hispanic white women in this study. Among 798 cases and 924 control women who were Hispanic or American Indian, there was an increase in risk of breast cancer among pre- and peri-menopausal women with RR=2.3 (1.2-4.5), but not among postmenopausal women with RR=1.0 (0.6-1.8).
‡ Increase in risk of breast cancer only found among case-control studies. When cohort study results were combined, no increase in risk was found.
References
1. U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.
2. Pirie K, Beral V, Peto R, Roddam A, Reeves G, Green J for the Million Women Study Collaborators. Passive smoking and breast cancer in never smokers: prospective study and meta-analysis. Int J Epidemiol. 37(5):1069-79, 2008.
3. Reynolds P, Hurley S, Goldberg DE, et al. Active smoking, household passive smoking, and breast cancer: evidence from the California Teachers Study. J Natl Cancer Inst. 96(1):29-37, 2004.
4. Egan KM, Stampfer MJ, Hunter D, et al. Active and passive smoking in breast cancer: prospective results from the Nurses' Health Study. Epidemiology. 13(2):138-45, 2002.
5. Nishino Y, Tsubono Y, Tsuji I, et al. Passive smoking at home and cancer risk: a population-based prospective study in Japanese nonsmoking women. Cancer Causes Control. 12(9):797-802, 2001.
6. Young E, Leatherdale ST, Sloan M, Kreiger N, Barisic A. Age of smoking initiation and risk of breast cancer in a sample of Ontario women. Tob Induc Dis. 5(1):4, 2009.
7. Lissowski J, Brinton LA, Zatonski W, et al. Tobacco smoking, NAT2 acetylation genotype and breast cancer risk. Int J Cancer. 119(8):1961-9, 2006.
8. Johnson KC, Hu J, Mao Y and The Canadian Cancer Registries Epidemiology Research Group. Passive and active smoking and breast cancer risk in Canada, 1994-97. Cancer Causes Control. 11(3):211-21, 2000.
9. Slattery ML, Curtin K, Giuliano AR, et al. Active and passive smoking, IL6, ESR1, and breast cancer risk. Breast Cancer Res Treat. 109(1):101-11, 2008.
10. Shrubsole MJ, Gao YT, Dai Q, et al. Passive smoking and breast cancer risk among non-smoking Chinese women. Int J Cancer. 110(4):605-9, 2004.
11. Roddam AW, Pirie K, Pike MC, et al. Active and passive smoking and the risk of breast cancer in women aged 36-45 years: a population based case-control study in the UK. Br J Cancer. 97(3):434-9, 2007.
12. Kropp S, Chang-Claude J. Active and passive smoking and risk of breast cancer by age 50 years among German women. Am J Epidemiol. 156(7):616-26, 2002.
13. Bonner MR, Nie J, Han D, et al. Secondhand smoke exposure in early life and the risk of breast cancer among never smokers (United States). Cancer Causes Control. 16(6):683-9, 2005.
14. Lash TL, Aschengrau A. A null association between active or passive cigarette smoking and breast cancer risk. Breast Cancer Res Treat. 75(2):181-4, 2002.
15. Johnson KC. Accumulating evidence on passive and active smoking and breast cancer risk. Int J Cancer. 117(4):619-28, 2005.
16. Miller MD, Marty MA, Broadwin R, et al. for the California Environmental Protection Agency. The association between exposure to environmental tobacco smoke and breast cancer: a review by the California Environmental Protection Agency. Prev Med. 44(2):93-106, 2007.
Updated 10/22/09
