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This is an authorized facsimile, made from the microfilrn master copy of the onginal dissertation or masters thesis published: by UMI. The bibliogTaphic information for this thesis is contained in UbiI's Dissertation Abstracts database, the onlvi central source for accessing almost every doctoral dissertation accepted in North America since 1861. U-1 `'1~I ~Dn'formation Service tlnwe!6.tv M.Crotdris rntemat*na~ A ben & r,oweu tntonrat-on Cornoany 300 N Zeeo Roac Ann ArOot M cn,qan 48105 H0D-521-0600 0R 313 76;-4700 Prnnte&in 1991 by xerographic process on actd4ree paper 3266

Ordv Numbe Nz7aza Tbe relationtbiD of Dassiv:.mokint to vazious baaltb outcomes amon= Srventb-day Adventlitu in CalSformia Butla, Tcrreace LsLe, Dr.P.E. Uainnic7 of Caliloraia, Ls /l.,ta.., 19U Coyyriot &1G6s by ButJar, Tarrsace Les]le. .W rigDCj rser..d. IJ-IWI -I 300 N:,2=b Rd Mn Anxx. MI a! ) 06

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UNWERSf7Y OF Cau.lFpFwtA Lora Anp.im TM Raaoons,ttip ot Pass+v Smokinq to Yarnous Health Qutcomes amonq Sav.ntn-4ay ADv.nests in Caleonua A *ssartairon submmad'in parnaJ'saestact,on of ttw requresnvtts ta tt* Ceqr" Doctor of Pubbc Hsatm; by T.rrsnc• Lcstie Butten 1988

7h. dusarunon ol'7.rtw~t. L"r ButSer s apQrowd. S"ur Grsensano wil,am shorvck '--~ Hlenny GonO Murray Jarrk ( ,~c~.-~..-- Barbara Vmscher, Commaue Chat Unrversrsy of CalAorrua. Los Mqeles 1988

© Coarnqnt by Terrenee Lesh. Butl.r. 1988

Dodxstod to U. mvmory of rrry mocf*r Saran Joan Sulor (1922-1987) A his ol immeuurlbS qualwes 7

TASLE OF CONTENTS Ljst:o/ Figures List ol Tab+es Atknowl.tlqeyn.nts Yrta. Pudicauons and Pr.s.ntat,ons Page v. ..i :v+ :a Abttra _t =a CJsapter 1 IPlTROOUCTION 1 1 1.1 2adkQounO 1. 1.2 Research Hypotheses 3 1.3 Sp.cfic Ob}ectrv.s 4 1.4 DetMUt,ons anO~Classdintron a T.nns 5 1.5 SiSpvficanc..,Relevance and RationaW 8 1.6 Organ¢inon oi Th.sts 9 Cttapter 2 UTERATURE REYIEIW 1 t 2.1 IntroCucDon 1 1 22 COmpansm ol Atanstrearn anC S+Qestream Srrroke 13 2:3 Measurernent ot Passrre 5mobng Exposure 15 2:a General Healtn En.cts 20 2.5 Plavsrbbty o1 a Healtri Eftect 22 2.6 lung,CYncen 23 IV

Pape 2.7 Otner Cancers 32 2.8 Hrart Disaase 36 2.9 IU!! Cau.s. Mortabry 40 2.10 Summary 40 Chapter 3 METHJDS 43 3.1 Bacdcqrountl ot Study 43 32 Study Desiqn 52 3.3 Descr+ptwn of th. Study Popul1nons 52 3-4 Data Descnption 58 3.5, Outcorne Ascertorun.nt Ptoceoures 61 3.6 Passrve Smok,nq Ezposure Ass9ssment 65 3:7 DeIrtaions of Omer~ Exposure Vanab+ps 70 3.8 Data Anaysrs anC Stat:stiut Matroos 76 3.9 LUrrvtations antl Prntnnal Prob+sms of Study 79 Crnapter 4 DESCRIPTIVE STATISTICS 81 4.1 Spouse Pars Demogapwc Data 81, 4.2 Smokinq Exposure B2 4.3 AHSMQG Conon DemoQrapnic Data 90 v

Page Chaatef 5 LUNG CANCER RESULTS 97 5.1 Spouse Pars Cohort 97 52 Al-tSMOG Cotiort 105 5.3 Summary 112 Chapter 6 SMO/rJNG RELATED CANCER RESULTS 114 6_1 Spouse Pars Cohaa 114 62 AHSMOG Cohort 131 6.3 Summary 135 Chapter, 7 ALL INCIDENT CANCER RESULTS 140 71 Spouse Pars Cohort Ihotlent Cancers 140 72 AHSMOG Cohort AJIIlncident Cancers 145 7.3 Sumrttary 149 Chapter 8 MORTAUTI' RESULTS 153 8.1 Spouse Pairs Cohort - Alt Cause Mortabty, Resutts 153 82 Spouse Pars Cohcrt • isrhemic Hean Disease Monatrty Resutts 160 8.3 AHSMOG Cohort - AA Cause Monabty Results t 63 8.4 AHSMOG Cohon - Iuhemt Hean Dtsaase Mortaiity Results 173 N