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ASSESSNENT OF THE ASSOCIATION OETNEEN IASSIVE SMOKING AND LUNG CANCER VARELA, LUIS I. DEGREE DATR: 19e7 DWndedon ~. V 1T11 ktbRnarion SwNos zs~%lsczo%

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VSS~ZSEzU?' 1 •\ Ordv Nnmhu •.O1ee2 Asse.sment of tLe assoclatioo b.t.veen passive smoking and luaE cancer Vat.la, Luis R., Ph.D. Yal. U.i...ey, 1,t'/ U•M•I 3OU N. Zece R`' N. Max. Ae .e ~ ae

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k.S5fSS?QrC aP 2fiE As.90QJ1rSClv BElMifM PASiIVC 9MOSUM A!D I.m CAMM A Dissertation Presentrd to the tacvlty of the Craduate Sc3hoo1 of Yale fhiversity in Grtiidaey for tt+e D.qree of dovwr of Philosqhy bY Lui: R. varela Pby 1987

A2 '??aT kSSFS-'M:T OF TftT_ ASa3C'.A?ICO9 9c:.AM1 PASSIVB -SA)KI1~I'. .1z ::JWG :AtLR Lu.is R. Varela Yale University 1987 A ma-C-Aad ase-control study .ea carned out to evalua,e the assocAtian betx+m eQon:re to ervitQmentil tobacco smohe (psss:w saokLno) and lLnq caror.r risk. 1he study Qcpulatian was eospraed of 439 caees of lunq wriw d:aqnoeed anooq nrn-anduers. All of theso. mses .e-e cliruolly and histolaqically oenfiswad. The eorresponding cortrols wnre drawn froe the Nev York State Oeper*neM of Mot.uc Vehicles and .are ;ndividuslly .etened to the caxs an aqe. sex, county of residence ard previous sindcinq history. A facrto-face interview .ns nf{+!ied to obtain infocn.tion x+ esq+oeure to envirvmntel tobecmo smnke. tb inaease in risk was foud associater! with expoaure to three measucesents of apouse anokinq, or with e3qesum to oo-rarkers' snokinq. Corversely, ex¢»nue to the sroke of otlxrs in t1w" houxhold was fc+iud ,.c affect tlr risk of lur:q cwJoer. Ebr an w. osure to 1SC persoNyaers ,)f sookina the adds ratio %as foud to be 1.86. tfiis effect se~ to 5e iarQer for epioertaid and anull oell tuors (Ctt-2.a7) ahan for adem~oas and other tuRrs (0lti1.42). LAcs.sirq togoaure to rassa+K aaouu+q in sorial situitiar was fourid to be inversely .suri.tad with ;he risk of luq canoer. 'L•+e laptidtion of this (i.^dinq -.-- at odds with ^rerrian results - is discissed. SSC7C, kSL,C.V% m= . .AbPIY I am qreat!y indebted to Dr. Urioht T. Janericri for providuiq rre with the apportunity to participate in the pro)ec; frt.n .fuch the neterial for this d+•...t.tion .ws derived. wbrkinq .r'th him was not only intellectually suaula•+nq, but alsq a scurae of gtatifyinq profeasinnai and prrsory; intarxtjon. Ib the M.K. Kellog Ftxandat.ion I am grateful for providing sr vith the firancia.i assiscance to cvduct sy doetorat studies. 7b friends end em,h,e_s of the Facllty of the Departvent of 6idemioloqy I.m tlrrr;ful for thnit ,-mrat_4xi.n help and support, ii

TAB1E E1F f3oFf~.`JI5 C.'wyn uNE. LPIIItATI9tE R.SVIDr.. 1 B~7tID 2 v`IDF?40U.CSC SI[mIES 3 QRt4R S'RIDIIS 4 UBOitAT7R2 I*N5CIG14TQ6 A.YTW'1. E>0'ERII4271'S 5`DlCMG /N.D i{.TS![I=C TrtiE OP 111iG CJdiZER 5 QIAPPI.°. T1Q. tET`.c05. 1 ^BJICT.'t/ES 2 JN4.:. SIZE 3 tck-A2TGN OP (t8 SiIAY 4 r'SfA81.:..'ifi01l' GF 'fHr t.ASES RFC'FIIT7G SlSIY74 S n.ILIBIL24'! Cp.ITEit1A FOft CASES ti ~i. SICtJ Cc Cr7rIq01S ~s8z~s~zoz iii x 1 1 S 16 20 25 26 30 31 33 34 34 35 i7 iv 7 DATA CO1LECTI312 ...........:......... 8 FQSIYIlJfY FEVII31 ..................... 9 EKP06G1tC VJ1RIdH[ES ..................... 9.1 SPOUS'E 9MD.--NG 1tABTIS 9.2 D0576t,RE 'ie PASSIVE 9M0KDdG IYJ 2HE 1DUSEHOID 9.3 PASS2VE 9MOPcINC IN YW _-..................... MDRRPLIa 9.4 P14SSIVE ST7CIQPC IN 90QAL CI72CVSDW= ..................... 10 PV['IIrtui,LY CLlE'WlOIlG ..................... . ..vARUB[ES 11 MALYSIS 11.1 t!)G:SPIC RE2tlS,.S:CN cVR ..................... l1AIC28ED CA''iE-CONML S'ISJOIE.' S11.2 DO?06'M AS CJ1'1mORIGL ..................... VMIan1ES 11.3 E7Q06tmE ,1S a0t3PIMJOtS ..................... _ VARSAB[E LMAP.ER Tt4tIE. RES'JLTS. 1 OESQtIPT;OM or "_1L 59SIF7Y ..................... SMPL,£ MiD DISiRIH(fPION OF 'i40 l1h1Q3Zt+lc vARLAB(ES 2 DIS[RIP[JI^_Q1 OP PO'[EMUILLY .................. O:aJEQ[RmIHG vARtAR[.FS 3 ISSa44M OF IfBS f.2FY7C.7C'R" .................... OF PASSIVE 947FSlG ON ILI& f.'APLaR RISKS 38 39 40 41 42 43 44 45 47 48 so 54 55 59 61

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vu laole No '.. 81 A{1T...S':M WTII9t!5S. ODOG RA12^-5. At0 C'.3JFIDM= i.IM1:5 " A DLFFTAf37I^_AI. D! EXPOSIRE 'lU SPCJI $E SMOCTL OP 10 YsA4S. Zbble No 8. m ESPDiA1f5. CLC16 eVl:I06 AND 951 C!?$"DE.~G L..~~TS FC7R DQmRE ?0 FIVE CJ1'ILu3iLTS Je 1VfA1. NlHEP. OF Q:.ARL.":FS 30lDD EY :?E SPOl,SE151 dJRING bpRR1FZ .I1=. Table No 9. ........................................ Vl61C.1US1M E5fIIW15S. COOf R!1?SE'S. A!D C33WII3B+= LU~QTS FaR A DIFf7PEMAI. OP F]6CStRE 'LO SPOUSE ST•DlQK'i OF 200.J00 QGAREE"=. 'hwle Ne 10 . ........................................ AD,ft1STED FSTIl9I2FS. CC06 11A?TO6. AND COWIDENg LIIL*TS Eait A DIFY17MPL1L OF AlOS(1tE 10 SPQJSE SP01Qti:, OF 200,000 CIGdRrIFS. Table No 11. ........................................ FSTIN11t£5. OD[b FATIrIS ArD 951 COWIDEPCE . LDi^^S EOR E>0309IFtE tt7 ElIIfP GMX]tIFS CF 33DRTNG IN 24fl 1pf)ScMID. '[lble No 12. L1NADJtJS14D FSPII+911FS. C0~6 aAM6 AND CONFIDFSCE LIIVf5 F'it A OIf'FF1i8rCLkL OF FM76T3tE 1t) 150 PpL4Q4/YIARS SFOIQME 1N 'I7$ H(XJSLM:J. 'iab:e ND 13 ACJ1J''ffD fSTIIRtES. ODDS 9ATI06 AM CQgTJENCE :.MITS FOP A OIFTMEM'.AL OF OGaCStRE 10 130 PM90t:.f'FAFS STOKING IV 71{E HQlSF}IOIL. Z9sztisczo7 85 90 95 96 1C1 viii Table No 14 . . ........................................... kSi9MA'IES. CQ14 IIAZT06 AND ?51 QWIDEltCE LII4TfS FVR DPO6ME 10 EIC21T 01TIICORIfS OF 9lkQNG IN ZNE NQt9}J(D. Table No 15. Ute1Q7U311'b tSTIP91'S. ODLUS W1TI06 APD OfMliENCE LIIQTS FUN A DIFFF3tf9rP1AL OP E>POSLItE 'lp 150 pEpg?I/YFARS 5lUIQNG IN 'fHE HRJSEHMD. - "Pable No 16 . ......................................... ..An7lb'3M GSl'Ih/12LS. OD06 MTIOS AND CUWIILMLM LIICTS flJR A DIFFEREM'.IAL OF E7G"061fiE '!O 150 PQt9_Ii/Yf71R5 9MOIQNC, IN 7lfl: F171ISEHOED. Table No 17 . ........................................ ES1'IIyAM, aDDis M'IIOB AND 951 cII*'B7QL2 LII44'S FOlt Dff'QRJRE 'IO EI(MII' GClM3Mm Or SDRNC IN Z!M W74MJ1M. . 'lable tb 1t. ............ .............................. GlD1nftlSlm lSTIH1TES.. 0006 MtIDS AND Ct1NF1ENCE LIIQTS tt)R A DIFEt31?NITAL OF DO?CM+ RE 10 150 pERSQ1WyEK(t.5 st7lDNC IN `PF!£ 1E3i1Q+IJ1CE Table No 19 . ........................................ AQ1Ib't!D 1STIIe1ZSe. 000B RICPiEB 1MCI Q]NrIDENiZ LITSIZS FaR A DiMRF]7PIJU. DF 19aa06IRE 10 150 PpZqRNjyf7lRS 9MDIQNG IN 'RE IORKPiJ1C'E - - - Table No 20 . ........................................ EMIIA'lf5. Ct0U6 NATl06 1WD 9S1 C'Efk'IDQWM LIlQTS ZFOR E70?06UtE TO [IC3fP CJ11~~S OE' PASSIVE SPM3G IN 90CIAL ST3[AITOi6. 103 104 109 111 112 117 120