NDLI: Second-hand smoke, cotinine levels, and risk of circulatory mortality in a large cohort study of never-smokers.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Gallo, Valentina Neasham, David Airoldi, Luisa Ferrari, Pietro Jenab, Mazda Boffetta, Paolo Overvad, Kim Tjønneland, Anne Clavel-Chapelon, Francoise Boeing, Heiner Pala, Valeria Palli, Domenico Panico, Salvatore Tumino, Rosario Arriola, Larraitz Lund, Eiliv Bueno-De-Mesquita, Bas Peeters, Petra H. Melander, Olle Hallmans, Goran Riboli, Elio Saracci, Rodolfo Vineis, Paolo
Spatial Coverage	Europe
Description	Country affiliation: United kingdom Author Affiliation: Gallo V ( Division of Epidemiology, Public Health and Primary Care, Imperial College, London W2 1PG, United Kingdom. v.gallo@imperial.ac.uk)
Abstract	BACKGROUND: Exposure to second-hand smoke has been shown to be associated with increased cardiovascular mortality in several, but not all, epidemiologic studies. Our aim was to investigate the risk of circulatory death associated with exposure to second-hand smoke in never-smokers in a very large prospective study, the European Prospective Investigation into Cancer and Nutrition. A secondary aim was to use cotinine levels for cross-validating self-reported second-hand smoke exposure. METHODS: Cox proportional hazard models were used to investigate the risk of death due to circulatory causes associated with second-hand smoke exposure in 135,233 never-smokers. Exposure to second-hand smoke was assessed through a questionnaire at enrollment and then validated against plasma cotinine measurements in a subsample. RESULTS: Study participants who reported second-hand smoke exposure at home had higher cotinine levels (median plasma cotinine concentration in exposed = 0.82 microg/L; in those unexposed 0.02 microg/L). Second-hand smoke exposure at home was associated with an increased risk of dying from cardiovascular diseases (hazard ratio [HR] = 1.38 [95% confidence interval = 1.01-1.90]), all circulatory diseases (1.28 [0.98-1.69]), and coronary heart disease (1.31 [0.83-2.08]) after adjustment for age, sex, education, physical activity, and body mass index. Dose-response relationships were observed between exposure to second-hand smoke at home and risk of circulatory death (HR per each additional hour/d = 1.25 [1.04-1.50]). Having a partner who smokes more than 30 cigarettes per day considerably increased the risk of a circulatory death (2.94 [1.11-7.78]). Second-hand smoke exposure at home was not associated with total mortality (1.03 [0.93-1.13]). DISCUSSION: Exposure to second-hand smoke at home (as confirmed by plasma cotinine levels) increases the risk of cardiovascular mortality.
File Format	HTM / HTML
ISSN	10443983
Issue Number	2
Volume Number	21
e-ISSN	15315487
Journal	Epidemiology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Public Health Discipline Epidemiology Cardiovascular Diseases Mortality Cotinine Blood Tobacco Smoke Pollution Adverse Effects Age Factors Etiology Cohort Studies Confidence Intervals Coronary Disease Dose-response Relationship, Drug Europe Epidemiology Family Characteristics Female Humans Male Middle Aged Proportional Hazards Models Risk Factors Sex Factors Statistics & Numerical Data Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Epidemiology

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