Environmental Tobacco Smoke and Lung Cancer: A Case-Control Study in Germany

Author: Michaela Kreuzer, Martin Krauss, Lothar Kreienbrock, et al.
Content Contributor: Abramson Cancer Center of the University of Pennsylvania
Last Reviewed: November 01, 2001

Reviewers: Li Liu, MD
Source: American Journal of Epidemiology, Volume 151:241-250, (February) 2000

Précis: Nonsmokers' exposure to tobacco smoke in public places associated with increased lung cancer risk


During the last 2 decades, epidemiologic studies have been conducted on the association between exposure to environmental tobacco smoke and lung cancer. Several researchers and regulatory agencies have concluded that a causal link has been established (Cancer Causes Control 1997 May;8(3): 333-45). In this study, the researchers assessed the risk of lung cancer among exposed nonsmokers.


A total of 292 lifelong nonsmokers with lung cancer and 1,338 nonsmoking controls were interviewed. The subjects answered questions about the level of exposure to tobacco smoke during childhood, from their spouse, at work, and in transportation and social settings.

  • A correlation between lung cancer and exposure to high levels of tobacco smoke at the workplace, in vehicles and from all sources combined was found.
  • No correlation was found between lung cancer and tobacco exposure during childhood or from spouses.

In this study, exposure to high levels of second hand tobacco smoke on the job and at other public places correlates with an increased risk of lung cancer in nonsmoking men and women. This study along with many others clearly demonstrates the association between exposure to tobacco smoking and lung cancer. The best way to prevent lung cancer is to not smoke or be around people who do. People should not start smoking, and those who already smoke should quit. Everyone should avoid breathing in other people's smoke.


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