{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:41:29Z","timestamp":1785451289212,"version":"3.56.0"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,5,29]],"date-time":"2013-05-29T00:00:00Z","timestamp":1369785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2013,11,15]]},"abstract":"<jats:p>It is unclear why successful quitting at time of breast cancer diagnosis should remove risk from a significant lifetime of smoking. Studies concluding this may be biased by how smoking is measured in many epidemiological cohorts. In the late 1990s, a randomized trial of diet and breast cancer outcomes enrolled early\u2010stage female breast cancer survivors diagnosed within the previous 4 years. Smoking history and key covariate measures were available at study entry for 2,953 participants. Participants were followed for an average of 7.3 years (96% response rate). There were 10.1% deaths (83% from breast cancer). At enrollment, 55.2% were never smokers, 41.2% former smokers and 4.6% current smokers. Using current smoking status in a Cox regression, there was no increased risk for former smokers for either all\u2010cause mortality [hazard ratio (HR)\u2009=\u20091.11; 95% confidence interval (CI)\u2009=\u20090.87\u20131.41; <jats:italic>p<\/jats:italic>\u2010value\u2009=\u20090.42) or breast cancer mortality. However, when we categorized on extensive lifetime exposure, former smokers with 20+ pack\u2010years of smoking (25.8%) had a significantly higher risk of both all\u2010cause (HR\u2009=\u20091.77; 95% CI\u2009=\u20091.17\u20132.48; <jats:italic>p<\/jats:italic>\u2010value\u2009=\u20090.0007) and breast cancer\u2010specific mortality (HR\u2009=\u20091.62; 95% CI\u2009=\u20091.11\u20132.37; <jats:italic>p<\/jats:italic>\u2010value\u2009=\u20090.01). Lifetime smoking exposure, not current status, should be used to assess mortality risk among former smokers.<\/jats:p>","DOI":"10.1002\/ijc.28241","type":"journal-article","created":{"date-parts":[[2013,5,3]],"date-time":"2013-05-03T16:58:46Z","timestamp":1367600326000},"page":"2493-2497","source":"Crossref","is-referenced-by-count":39,"title":["Mortality risk in former smokers with breast cancer: Pack\u2010years <i>vs<\/i>. smoking status"],"prefix":"10.1002","volume":"133","author":[{"given":"Nazmus","family":"Saquib","sequence":"first","affiliation":[{"name":"Stanford Prevention Research Center Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia L.","family":"Stefanick","sequence":"additional","affiliation":[{"name":"Stanford Prevention Research Center Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loki","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Division of Population Sciences, Moores UCSD Cancer Center University of California San Diego La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Division of Population Sciences, Moores UCSD Cancer Center University of California San Diego La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2005.00581.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0b013e32833b4828"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23747"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22575"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2006.11.004"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/110241500447227"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116939"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27617"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.10.3168"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-012-2276-1"},{"key":"e_1_2_6_12_1","unstructured":"USDHHS.How tobacco smoke causes disease: the biological and behavioral basis for smoking\u2010attributable disease: a report of the surgeon general. 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