ABSTRACT: BACKGROUND:Prospective evidence on the association between secondhand smoke (SHS) and ischemic stroke and chronic obstructive pulmonary disease (COPD) is scarce. METHODS:We prospectively examined the relationship between SHS and major tobacco related deaths, particular COPD and stroke, in 910 (439 men and 471 women) Chinese who never smoked from a 17 year follow up study in Xi'an, China. SHS exposure was defined as exposure to another person's tobacco smoke at home or in the workplace. RESULTS:At baseline among 910 subjects (439 men), 44.2% were exposed to SHS at home, 52.9% in workplaces, and 67.1% at home or work. From 1 March 1994 to 1 July 2011, 249 (150 men and 99 women) died within 14,016 person-years.Those who were exposed to SHS had increased mortality due to coronary heart disease (CHD) (adjusted relative risk, RR=2.15, 95% confidence intervals, CI=1.00-7.66), ischemic stroke (2.88, 1.10-7.55), lung cancer (2.00, 0.62-6.40), and COPD (2.30, 1.06-5.00) and all-causes (1.72, 1.29-2.20), with significant dose-response relationships between cumulative SHS exposure at home and work and the increased risk of cause-specific and total mortality (P for linear trend ranged from 0.045 to <0.001). CONCLUSIONS:This study has shown dose response relationships between SHS and major tobacco related mortality, and provided new evidence to support causation for COPD and ischemic stroke.
Chest 05/2012; · 5.25 Impact Factor