Smoking and hematolymphopoietic malignancies

Objective: Tobacco use is the most prominent cause of respiratory cancers. Little is known, however, about the influence of smoking on hematolymphopoi etic malignancies. To evaluate this relation, a population-based case-contr ol study was carried out in 12 areas of Italy. Methods: Detailed interviews on tobacco smoking habits were administered to 1450 non-Hodgkin's lymphoma (NHL), 365 Hodgkin's disease (HD), 270 multipl e myeloma (MM), and 649 leukemia (LEU) patients occurring from 1990 to 1993 , and 1779 population controls. Results: We found a slightly increased risk for NHL in smokers (odds ratio 1.2, 95% confidence interval 1.0-1.4 for ever smokers), but a consistent po sitive association was shown only for follicular NHL. In this subtype, a si gnificant excess risk was observed for ever versus never smokers, after adj ustment for gender, age, geographic residence, education, and respondent (O R = 1.8, 95%, CI 1.3-2.7), with a positive exposure-response gradient for s moking duration (p < 0.01). The risk for follicular NHL was significantly e levated only among women, with ever smokers showing OR = 2.3 (CI 1.4-3.8), while for men we found OR = 1.3 (CI 0.69-2.3). No major differences were sh own according to age. Female subjects also showed significant positive expo sure-response trends for duration. Conclusion: Cigarette smoking could be a risk factor for follicular NHL amo ng women. For HD, MM, or LEU, no clear association was observed.