No significant increase was seen for childhood or workplace exposure, but an increase was seen for total exposure (RR = 1.22, 95% CI = 1.09–1.37).Ĭonclusions: Increases mainly derived from case-control studies are prone to recall bias. Dose–response findings were similarly heterogeneous. Risk was increased in premenopausal women (RR = 1.36, 95% CI = 1.15–1.60), but not postmenopausal women. The RR for eight prospective studies asking detailed questions was 1.003, 95% CI = 0.96–1.05. However, the estimates were heterogeneous: higher for Asian studies than for North American or European studies, higher for studies adjusting for fewer potential confounding variables, and close to 1.0 for prospective studies, regardless of whether or not they asked detailed questions on ETS exposure. Using an index for each study most closely equivalent to “spouse ever smoked”, a weak but significant association was seen (random-effects RR = 1.15, 95% CI = 1.07–1.23). Results: The update increased the number of studies from 22 to 47. Methods: We extracted study details, derived relative risk (RR) estimates with confidence intervals (CIs) for various ETS exposure indices, and conducted meta-analyses. Since then various studies and reviews have been published but opinion remains divided. Context: In 2006, we reviewed the evidence on environmental tobacco smoke (ETS) and breast cancer in nonsmoking women.

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