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. 2015 Nov;25(11):824-31.
doi: 10.1016/j.annepidem.2015.08.007. Epub 2015 Aug 28.

Active and passive cigarette smoking and mortality among Hispanic and non-Hispanic white women diagnosed with invasive breast cancer

Stephanie D Boone  1 , Kathy B Baumgartner  2 , Richard N Baumgartner  2 , Avonne E Connor  2 , Esther M John  3 , Anna R Giuliano  4 , Lisa M Hines  5 , Shesh N Rai  6 , Elizabeth C Riley  7 , Christina M Pinkston  6 , Roger K Wolff  8 , Martha L Slattery  8
Affiliations

Active and passive cigarette smoking and mortality among Hispanic and non-Hispanic white women diagnosed with invasive breast cancer

Stephanie D Boone et al. Ann Epidemiol. 2015 Nov.

Abstract

Purpose: Women who smoke at breast cancer diagnosis have higher risk of breast cancer-specific and all-cause mortality than nonsmokers; however, differences by ethnicity or prognostic factors and risk for noncancer mortality have not been evaluated.

Methods: We examined associations of active and passive smoke exposure with mortality among Hispanic (n = 1020) and non-Hispanic white (n = 1198) women with invasive breast cancer in the Breast Cancer Health Disparities Study (median follow-up of 10.6 years).

Results: Risk of breast cancer-specific (HR = 1.55, 95% CI = 1.11-2.16) and all-cause (HR = 1.68, 95% CI = 1.30-2.17) mortality was increased for current smokers, with similar results stratified by ethnicity. Ever smokers had an increased risk of noncancer mortality (HR = 1.68, 95% CI = 1.12-2.51). Associations were strongest for current smokers who smoked for 20 years or more were postmenopausal, overweight and/or obese, or reported moderate and/or high alcohol consumption; however, interactions were not significant. Breast cancer-specific mortality was increased two fold for moderate and/or high recent passive smoke exposure among never smokers (HR = 2.12, 95% CI = 1.24-3.63).

Conclusions: Findings support associations of active-smoking and passive-smoking diagnosis with risk of breast cancer-specific and all-cause mortality and ever smoking with noncancer mortality, regardless of ethnicity, and other factors. Smoking is a modifiable lifestyle factor and effective smoking cessation, and maintenance programs should be routinely recommended for women with breast cancer.

Keywords: Breast cancer; Ethnicity; Hispanic; Mortality; Native American ancestry; Smoking; Survival.

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Figures

Figure 1
Figure 1. Adjusted breast cancer survival by ethnicity and cigarette smoking status
Log-rank p-value=0.01; Wald p=0.01; Adjusted for age, study, body mass index, stage, alcohol consumption, and education Sidak multiple comparisons adjusted Log-rank pair-wise p-values: Within Hispanic women: current vs. former, p= 0.22; current vs. never, p=0.99; former vs. never, p= 0.99. Within non-Hispanic women: current vs. former, p= 0.10; current vs. never, p=0.96; former vs. never, p= 0.99
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