Breast Cancer Research and Treatment

, Volume 154, Issue 2, pp 213–224 | Cite as

Active and passive smoking and risk of breast cancer: a meta-analysis

  • Alina MacacuEmail author
  • Philippe Autier
  • Mathieu Boniol
  • Peter Boyle


Studies on active and passive tobacco smoking and breast cancer have found inconsistent results. A meta-analysis of observational studies on tobacco smoking and breast cancer occurrence was conducted based on systematic searches for studies with retrospective (case–control) and prospective (cohort) designs. Eligible studies were identified, and relative risk measurements were extracted for active and passive tobacco exposures. Random-effects meta-analyses were used to compute summary relative risks (SRR). Heterogeneity of results between studies was evaluated using the (I 2) statistics. For ever active smoking, in 27 prospective studies, the SRR for breast cancer was 1.10 (95 % CI [1.09–1.12]) with no heterogeneity (I 2 = 0 %). In 44 retrospective studies, the SRR was 1.08 (95 % CI [1.02–1.14]) with high heterogeneity (I 2 = 59 %). SRRs for current active smoking were 1.13 (95 % CI [1.09–1.17]) in 27 prospective studies and 1.08 (95 % CI [0.97–1.20]) in 22 retrospective studies. The results were stable across different subgroup analyses, notably pre/post-menopause, alcohol consumption adjustments, including/excluding passive smokers from the referent group. For ever passive smoking, in 11 prospective studies, the SRR for breast cancer was 1.07 (95 % CI [1.02–1.13]) with no heterogeneity (I 2 = 1 %). In 20 retrospective studies, the SRR was 1.30 (95 % CI [1.10–1.54]) with high heterogeneity (I 2 = 74 %). Too few prospective studies were available for meaningful subgroup analyses. There is consistent evidence for a moderate increase in the risk of breast cancer in women who smoke tobacco. The evidence for a moderate increase in risk with passive smoking is more substantial than a few years ago.


Breast cancer Environmental tobacco smoke Smoking Meta-analysis 



The authors thank Magali Boniol for the data extraction verifications.

Author contribution

A.M. and P.B. designed the study. A.M. did the literature search, extracted and analysed the data. All authors interpreted the results. A.M. wrote the report. All authors reviewed, revised and edited the report.


This work was founded by the International Prevention Research Institute.

Compliance with ethical standards

Conflict of interests

The authors declare that they have no conflict of interest.

Supplementary material

10549_2015_3628_MOESM1_ESM.pdf (566 kb)
Supplementary material 1 (PDF 566 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Alina Macacu
    • 1
    • 3
    Email author
  • Philippe Autier
    • 1
    • 2
  • Mathieu Boniol
    • 1
    • 2
  • Peter Boyle
    • 1
    • 2
  1. 1.International Prevention Research Institute (iPRI)LyonFrance
  2. 2.Strathclyde Institute of Global Public Health at iPRIEcully Ouest LyonFrance
  3. 3.International Prevention Research InstituteEcully Ouest LyonFrance

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