Intended for healthcare professionals


Is breast cancer associated with tobacco smoking?

BMJ 2011; 342 doi: (Published 01 March 2011) Cite this as: BMJ 2011;342:d1093
  1. Paolo Boffetta, professor1,
  2. Philippe Autier, senior investigator2
  1. 1Tisch Cancer Institute and Institute for Transitional Epidemiology, Mount Sinai School of Medicine, New York, NY, USA
  2. 2International Prevention Research Institute, Lyon, France
  1. paolo.boffetta{at}

Probably, especially when smoking starts early in life

In many countries, because of changes in smoking habits in the past decades, the burden of tobacco related morbidity and mortality is shifting from men to women.1 The addition of breast cancer to the list of diseases causally related to active or secondhand tobacco smoking would probably be a powerful argument for women to stop smoking or avoid taking it up. Although the effect on tobacco control would be welcome, the strength of the evidence of the association must be carefully assessed.

The linked study by Luo and colleagues (doi:10.1136/bmj.d1016), which is based on the observational arm of the Women’s Health Initiative Study,2 adds clarity to whether active tobacco smoking and secondhand exposure to tobacco smoke cause breast cancer. The study found that active smoking and extensive passive smoking were associated with a significantly increased risk of breast cancer in postmenopausal women. The results support the conclusions of two recent expert panels that the breast should be added to the list of target organs of tobacco carcinogenicity.3 4 However, other panel reviews were more …

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