Cancer Causes & Control

, Volume 24, Issue 12, pp 2207–2215 | Cite as

A prospective study of smoking and breast cancer risk among African-American women

  • Lynn RosenbergEmail author
  • Deborah A. Boggs
  • Traci N. Bethea
  • Lauren A. Wise
  • Lucile L. Adams-Campbell
  • Julie R. Palmer
Original paper



Active smoking and passive smoking have been associated with increased risk of breast cancer. The purpose of the present study was to prospectively assess associations of smoking with breast cancer and identify subgroups at higher risk among African-American women.


Based on 1,377 incident cases identified during 14 years of follow-up in the Black Women’s Health Study, we assessed active and passive smoking in relation to breast cancer incidence by menopausal status, estrogen receptor status, and other factors. Incidence rate ratios (IRR) and 95 % confidence intervals (CI) for categories of smoking relative to no active or passive smoking were calculated from Cox proportional hazards models, controlling for breast cancer risk factors.


Active smoking was associated with increased risk of premenopausal breast cancer. The IRR was 1.21 (95 % CI 0.90–1.62) for premenopausal breast cancer overall and 1.70 (95 % CI 1.05–2.75) for premenopausal breast cancer associated with beginning smoking before age 18 together with accumulation of ≥20 pack years. The positive association with premenopausal breast cancer was most apparent for estrogen-receptor-positive cancer. Passive smoking was also associated with increased risk of premenopausal breast cancer (IRR = 1.42, 95 % CI 1.09–1.85), based on information on passive smoking at home and work. Neither active nor passive smoking was associated with increased risk of postmenopausal breast cancer.


These results strengthen the evidence that both active and passive smoking increase the incidence of premenopausal breast cancer.


African-American Female Breast cancer Smoking 



This work was supported by National Cancer Institute Grant R01 CA058420. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA), and results reported do not necessarily represent their views. Dr. Rosenberg had full access to all the data and takes responsibility for the integrity of the data and the accuracy of the data analysis. The authors are grateful to the BWHS participants and staff.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Lynn Rosenberg
    • 1
    Email author
  • Deborah A. Boggs
    • 1
  • Traci N. Bethea
    • 1
  • Lauren A. Wise
    • 1
  • Lucile L. Adams-Campbell
    • 2
  • Julie R. Palmer
    • 1
  1. 1.Slone Epidemiology Center at Boston UniversityBostonUSA
  2. 2.Lombardi Comprehensive Cancer CenterGeorgetown UniversityWashingtonUSA

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