Mortality among Lifelong Nonsmokers Exposed to Secondhand Smoke at Home: Cohort Data and Sensitivity Analyses

Sarah Hill, Tony Blakely, Ichiro Kawachi, Alistair Woodward

Research output: Contribution to journalArticlepeer-review


Evidence is growing that secondhand smoke can cause death from several diseases. The association between
household exposure to secondhand smoke and disease-specific mortality was examined in two New Zealand
cohorts of lifelong nonsmokers (‘‘never smokers’’) aged 45–77 years. Individual census records from 1981 and
1996 were anonymously and probabilistically linked with mortality records from the 3 years that followed each
census. Age- and ethnicity-standardized mortality rates were compared for never smokers with and without home
exposure to secondhand smoke (based on the reported smoking behavior of other household members). Relative
risk estimates adjusted for age, ethnicity, marital status, and socioeconomic position showed a significantly greater
mortality risk for never smokers living in households with smokers, with excess mortality attributed to tobaccorelated
diseases, particularly ischemic heart disease and cerebrovascular disease, but not lung cancer. Adjusted
relative risk estimates for all cardiovascular diseases were 1.19 (95% confidence interval: 1.04, 1.38) for men and
1.01 (95% confidence interval: 0.88, 1.16) for women from the 1981–1984 cohort, and 1.25 (95% confidence
interval: 1.06, 1.47) for men and 1.35 (95% confidence interval: 1.11, 1.64) for women from the 1996–1999 cohort.
Passive smokers also had nonsignificantly increased mortality from respiratory disease. Sensitivity analyses indicate
that these findings are not due to misclassification bias.
Original languageEnglish
Pages (from-to)530-540
Number of pages11
JournalAmerican Journal of Epidemiology
Issue number5
Publication statusPublished - 2007


  • cohort studies
  • mortality
  • myocardial ischaemia
  • neoplasms
  • New Zealand
  • respiratory tract diseases
  • Tobacco Smoke Pollution


Dive into the research topics of 'Mortality among Lifelong Nonsmokers Exposed to Secondhand Smoke at Home: Cohort Data and Sensitivity Analyses'. Together they form a unique fingerprint.

Cite this