Even when they don’t smoke themselves, cancer patients who regularly
breathe indoor air contaminated by tobacco smoke can have higher
death rates and an increased risk of heart attack and strokes, the
authors write in Cancer Epidemiology, Biomarkers and Prevention.
For the study, researchers analyzed data on secondhand smoke
exposure for 686 cancer survivors in nationally representative
surveys done in two-year cycles from 1999 to 2012. Overall, only
about 16 percent of participants were exposed to secondhand smoke by
the end of the study period, down from roughly 40 percent at the
While the decline is encouraging, the trouble with the results is
that these cancer survivors are being exposed to secondhand smoke at
rates similar to the general population, said lead study author Dr.
Oladimeji Akinboro, of Montefiore New Rochelle Hospital and Albert
Einstein College of Medicine in New York.
“It may reflect a lack of appreciation, on the part of patients with
certain types of cancer along with their close household and social
contacts, of the dangers that ongoing exposure of cancer patients
and survivors to tobacco smoke, such as higher death rates,”
Akinboro said by email.
“Furthermore, ongoing exposure to secondhand tobacco smoke in the
home makes it less likely that smokers who have, or have had cancer,
will quit smoking,” Akinboro added.
To examine trends in secondhand exposure, researchers looked at
interview data from survey participants and also examined results
from blood tests for levels of cotinine, a breakdown product of
nicotine that marks exposure to tobacco smoke.
Overall, about 28 percent of adult cancer survivors in the study had
been exposed to secondhand smoke and about 5 percent reported living
in a household where someone smoked. But certain segments of the
population had much higher rates of exposure.
For example, 26 percent of white people in the study were exposed to
secondhand smoke, compared with 56 percent of black participants.
About 22 percent of people with some education beyond high school
breathed secondhand smoke, compared to 42 percent of people who
didn’t finish high school.
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And, 53 percent of the poorest people in the study had secondhand
smoke exposure - more than double the odds for the most affluent
The risk was also higher for people with lung tumors and other
smoking-related cancers: 36 percent had been exposed to secondhand
smoke compared with 26 percent of people who had malignancies not
linked to smoking.
“It’s difficult to explain the disparities,” said Dr. Maher
Karam-Hage, associate medical director of the tobacco treatment
program at the University of Texas MD Anderson Cancer Center in
With less education, people might not fully understand the risks,
Karam-Hage, who wasn’t involved in the study, said by email. And
with less income, people might not be able to afford to move to
avoid secondhand smoke exposure at home.
“In addition, those who are survivors of smoking-related cancers may
have been smokers themselves and/or had smokers as household members
and therefore continue to be exposed to their household members
smoking,” Karam-Hage said. “Patients can use these solid and
irrefutable data and findings as evidence to help them advocate with
others the need to establish safe and healthy living areas.”
SOURCE: http://bit.ly/2t1BYZG Cancer Epidemiology, Biomarkers and
Prevention, online June 22, 2017.
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