The relationship between the use of cigarettes and other tobacco products and the risk of multiple myeloma was examined in a cohort of nearly 250,000 American veterans followed prospectively for 26 years. Compared with men who had never used tobacco, the risk of death from myeloma was not increased among current (relative risk [RR]=0.9, 95 percent confidence interval [CI]=0.8−1.2) or former (RR=1.0, CI=0.8−1.3) cigarette smokers, nor among users of chewing tobacco or snuff (RR=1.0, CI=0.4−2.3). Risk was only slightly and nonsignificantly increased among pipe or cigar smokers (RR=1.2, CI=0.9−1.5). There was no indication of increasing risk with amount of tobacco used or earlier age at first use. With over 90 percent power to detect a 30 percent increased risk of this tumor occuring among current cigarette smokers, this study provides the strongest evidence to date against an association of cigarette smoking with multiple myeloma.
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References
Gloeckler Ries LA, Hankey BF, Edwards BK, eds. Cancer Statistics Review 1973–1987. Washington, DC: US Department of Health and Human Services, Public Health Service, National Institutes of Health, 1990; DHHS Pub. No. (NIH) 90–2789.
Riedel DA, Pottern LM, Blattner WA. The epidemiology of multiple myeloma. In: Wiernik PH, Canellos GP, Kyle RA, Schiffer CA, eds. Neoplastic Disease of the Blood, 2nd edn. New York: Churchill Livingstone, Inc., 1991; 347–72.
Mills PK, Newell GR, Beeson WL, Fraser GE, Phillips RL, History of cigarette smoking and risk of leukemia and myeloma: results from the Adventist Health Study. JNCI 1990; 82: 1832–6.
Heath CWJr. Cigarette smoking and hematopoietic cancer. JNCI 1990; 82: 1800–1.
Brownson RC. Cigarette smoking and risk of myeloma. JNCI 1991; 83: 1036–7.
Boffetta P, Stellman SD, Garfinkel L. A case-control study of multiple myeloma nested in the American Cancer Society prospective study. Int J Cancer 1989; 43: 443–9.
Flodin U, Fredriksson M, Persson B. Multiple myeloma and engine exhausts, fresh wood, and creosote: a casereferent study. Am J Indust Med 1987; 12: 519–29.
Linet MS, Harlow SD, McLaughlin JK. A case-control study of multiple myeloma in whites: chronic antigenic stimulation, occupation, and drug use. Cancer Res 1987; 47: 2978–81.
Gallagher RP, Spinelli JJ, Elwood JM, Skippen DH. Allergies and agricultural exposure as risk factors for multiple myeloma. Br J Cancer 1983; 48: 853–7.
Garfinkel L. Cancer mortality in nonsmokers: prospective study by the American Cancer Society. JNCI 1980; 65: 1169–73.
Hammond EC, Horn D. Smoking and death rates—report on forty-four months of follow-up of 187,783 men. J Am Med Assoc 1958; 166: 1294–1308.
Kahn HA. The Dorn study of smoking and mortality among US veterans: report of eight and one-half years of observation. NCI Monogr 1966; 19: 1–126.
Rogot E, Murray JL. Smoking and causes of death among US veterans: 16 years of observation. Public Health Rep 1980; 95: 213–22.
World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death, 7th rev. Geneva: United Nations, 1957.
Dorn HF. Tobacco consumption and mortality from cancer and other diseases. Public Health Rep 1959; 74: 581–93.
Breslow NE, Day NE. Statistical Methods in Cancer Research. Vol. II. The Design and Analysis of Cohort Studies. Lyon, France: International Agency for Research on Cancer, 1987; IARC Sci. Pub. No. 8282: 113–14, 120–59.
Boice JDJr, Lubin JH, Preston DL. EPITOME: Epidemiologic Analysis with a Personal Computer, Bethesda, MD: US Department of Health and Human Services, Public Health Service, National Institutes of Health, 1991; NIH Pub. No. 91–3180.
Williams RR, Horm JW. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. JNCI 1977; 58: 525–47.
A Report of the Surgeon General. Reducing the Health Consequences of Smoking: 25 Years of Progress. Rockville, MD: Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion, 1989; DHHS Pub. No. (CDC) 89-8411.
Percy C, Stanek EIII, Gloeckler L. Accuracy of cancer death certificates and its effect on cancer mortality statistics. Am J Public Health 1981; 71(3): 242–50.
McLaughlin JK, Hrubec Z, Linet MS, Heineman EF, Blot WJ, Fraumeni JFJr. Cigarette smoking and leukemia. JNCI 1989; 81: 1262–3.
McLaughlin JK, Hrubec Z, Heineman EF, Blot WJ, Fraumeni JFJr. Renal cancer and cigarette smoking in a 26-year followup of US veterans. Public Health Rep 1990; 105: 535–7.
Hsing AW, McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni JFJr. Cigarette smoking and liver cancer among US veterans. Cancer Causes Control 1990; 1: 217–21.
Hollander VP, Takakura K, Yamada H. Endocrine factors in the pathogenesis of plasma cell tumors. Recent Prog Horm Res 1968; 24: 81–137.
Sandler RS, Sandler DP, Comstock GW, Helsing KJ, Shore DL. Cigarette smoking and the risk of colorectal cancer in women. JNCI 1988; 80: 1329–33.
Khaw KT, Tazuke S, Barrett-Connor E. Cigarette smoking and levels of adrenal androgens in postmenopausal women. N Engl J Med 1988; 318: 1705–9.
Davis DL, Hoel D, Fox J, Lopez A. International trends in cancer mortality in France, West Germany, Italy, Japan, England and Wales, and the USA. Lancet 1990; 336: 474–81.
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Epidemiology and Biometry Program, Division of Cancer Etiology, National Cancer Institute. Westat, Inc. Rockville, MD. National Cancer Institute, 6130 Executive Blvd, Room 418, Rockville, MD 20892, USA.
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Heineman, E.F., Zahm, S.H., McLaughlin, J.K. et al. A prospective study of tobacco use and multiple myeloma: evidence against an association. Cancer Causes Control 3, 31–36 (1992). https://doi.org/10.1007/BF00051909
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DOI: https://doi.org/10.1007/BF00051909