Tobacco Documents Online

Butler, T.L., The Relationship of Passive Smoking to Various Health Outcomes Among Seventh-Day Adventists in California, Ph.D. Thesis, University of California, 1988. This dissertation reports on data gathered from two subgroups of the Adventist Health Study Cohort (Seventh-Day Adventists (SDAs) are a religious group; their teachings proscribe smoking and alcohol consumption, and some SDAs maintain a vegetarian diet and avoid caffeine). Two cohorts were selected from the ongoing study: the "spouse pairs"' cohort (11,060 married couples) and the "AHSMOG" cohort (6,467 subjects involved in an ongoing air pollution study). ETS exposure was ascertained as husband's smoking status for the spouse pairs cohort and as number of years lived with or worked with a smoker for the AHSMOG group. Despite the large numbers of individuals enrolled in the study, Butler had very few lung cancer cases in the relevant analyses. In the spouse pairs cohort, there were eight cases among nonsmoking women and only three of these were married to smokers. For husband having ever smoked, Butler reported an RR of 2.04 (95% CI 0.54-7.65). In the AHSMOG cohort, there were six female and seven male cases. Only three of the females and two of the males had ever lived~ with a smoker; moreover, some cases were exsmokers, and Butler fails to present an analysis restricted to nonsmokers. The extremely small sample size of the spousal smoking analyses is a major flaw of this study. While some confounders, including dietary factors, were apparently addressed in the study, Butler does not discuss them in detail.