Search tips
Search criteria 


Logo of bmjcredLink to Publisher's site
Br Med J (Clin Res Ed). 1986 November 8; 293(6556): 1217–1222.
PMCID: PMC1341990

Does breathing other people's tobacco smoke cause lung cancer?


The available epidemiological studies of lung cancer and exposure to other people's tobacco smoke, in which exposure was assessed by whether or not a person classified as a non-smoker lived with a smoker, were identified and the results combined. There were 10 case-control studies and three prospective studies. Overall, there was a highly significant 35% increase in the risk of lung cancer among non-smokers living with smokers compared with non-smokers living with non-smokers (relative risk 1.35, 95% confidence interval 1.19 to 1.54). Part of this increase was almost certainly caused by the misclassification of some smokers as non-smokers. As smokers, who are more likely to get lung cancer than non-smokers, tend to live with smokers this misclassification probably exaggerated the estimated increase in risk. Adjustment for this error reduced the estimate to 30% (relative risk 1.30), but as people who live with non-smokers may still be exposed to other people's smoke this estimate was revised again to allow for the fact that a truly unexposed reference group was not used. The increase in risk among non-smokers living with smokers compared with a completely unexposed group was thus estimated as 53% (relative risk of 1.53). This analysis, and the fact that non-smokers breathe environmental tobacco smoke, which contains carcinogens, into their lungs and that the generally accepted view is that there is no safe threshold for the effect of carcinogens, leads to the conclusion that breathing other people's tobacco smoke is a cause of lung cancer. About a third of the cases of lung cancer in non-smokers who live with smokers, and about a quarter of the cases in non-smokers in general, may be attributed to such exposure.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Wald N, Ritchie C. Validation of studies on lung cancer in non-smokers married to smokers. Lancet. 1984 May 12;1(8385):1067–1067. [PubMed]
  • Correa P, Pickle LW, Fontham E, Lin Y, Haenszel W. Passive smoking and lung cancer. Lancet. 1983 Sep 10;2(8350):595–597. [PubMed]
  • Kabat GC, Wynder EL. Lung cancer in nonsmokers. Cancer. 1984 Mar 1;53(5):1214–1221. [PubMed]
  • Garfinkel L, Auerbach O, Joubert L. Involuntary smoking and lung cancer: a case-control study. J Natl Cancer Inst. 1985 Sep;75(3):463–469. [PubMed]
  • Akiba S, Kato H, Blot WJ. Passive smoking and lung cancer among Japanese women. Cancer Res. 1986 Sep;46(9):4804–4807. [PubMed]
  • Lee PN, Chamberlain J, Alderson MR. Relationship of passive smoking to risk of lung cancer and other smoking-associated diseases. Br J Cancer. 1986 Jul;54(1):97–105. [PubMed]
  • Garfinkel L. Time trends in lung cancer mortality among nonsmokers and a note on passive smoking. J Natl Cancer Inst. 1981 Jun;66(6):1061–1066. [PubMed]
  • Gillis CR, Hole DJ, Hawthorne VM, Boyle P. The effect of environmental tobacco smoke in two urban communities in the west of Scotland. Eur J Respir Dis Suppl. 1984;133:121–126. [PubMed]
  • Hirayama T. Cancer mortality in nonsmoking women with smoking husbands based on a large-scale cohort study in Japan. Prev Med. 1984 Nov;13(6):680–690. [PubMed]
  • Sandler DP, Everson RB, Wilcox AJ. Passive smoking in adulthood and cancer risk. Am J Epidemiol. 1985 Jan;121(1):37–48. [PubMed]
  • Wu AH, Henderson BE, Pike MC, Yu MC. Smoking and other risk factors for lung cancer in women. J Natl Cancer Inst. 1985 Apr;74(4):747–751. [PubMed]
  • Koo LC, Ho JH, Lee N. An analysis of some risk factors for lung cancer in Hong Kong. Int J Cancer. 1985 Feb 15;35(2):149–155. [PubMed]
  • Yusuf S, Peto R, Lewis J, Collins R, Sleight P. Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis. 1985 Mar-Apr;27(5):335–371. [PubMed]
  • WOOLF B. On estimating the relation between blood group and disease. Ann Hum Genet. 1955 Jun;19(4):251–253. [PubMed]
  • Hammond EC. Smoking in relation to the death rates of one million men and women. Natl Cancer Inst Monogr. 1966 Jan;19:127–204. [PubMed]
  • Doll R, Gray R, Hafner B, Peto R. Mortality in relation to smoking: 22 years' observations on female British doctors. Br Med J. 1980 Apr 5;280(6219):967–971. [PMC free article] [PubMed]
  • Doll R, Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. [PMC free article] [PubMed]
  • Smith RG, Rowe MJ, Smith AN, Eastwood MA, Drummond E, Brydon WG. A study of bulking agents in elderly patients. Age Ageing. 1980 Nov;9(4):267–271. [PubMed]
  • Vernick DM, Kelly JH. Sudden hearing loss associated with piroxicam. Am J Otol. 1986 Mar;7(2):97–98. [PubMed]

Articles from British Medical Journal (Clinical Research Ed.) are provided here courtesy of BMJ Publishing Group