Original research article introductionThe benefits of giving up smoking have been constantly stressed, especially in the case of women, among whom smoking rates have been increasing.1 Two-thirds of all deaths of women smokers in the United Kingdom are caused by smoking in their 50s, 60s, and 70s, 1 and the figures are likely to be similar in other industrialized countries.2 Breast cancer was recently included among the 30 most common specific causes of death among smokers, 1 and it is emerging that smoking before first childbirth may also be one of the specific risk factors involved.3 Breast cancer is by far the most frequent form of cancer occurring among women-it accounts for 23% of all cases of cancer in womenand ranks second overall (10.9% of all cases of cancer in both sexes combined).2 In female BRCA1/2 carriers, smoking may increase the risk of breast cancer, especially when the mutations are located in specific sites. [4][5][6] Several authors have studied the effects of the disclosure of BRCA1/2 genetic test results on specific strategies for preventing breast/ovarian cancer, such as breast cancer screening and prophylactic surgery. 7-9 Although women's screening practices have been found to correlate with their families' history of breast cancer, the lifestyle risk factors seem to be similar to those of women with no family history of cancer.10,11 Little information is available about the lifestyle habits of BRCA1/2 carriers after the disclosure of genetic test results. Preliminary findings have shown that women applying for genetic testing may have better health-related practices than members of the general population.
12The aim of this prospective study was to measure the smoking habits of cancer-free women who applied for genetic testing because a BRCA1/2 mutation had been identified in their family and to identify the potential determinants of any changes in their smoking rates over time, such as their medical, genetic, sociodemographic, and psychological characteristics. To our knowledge, no previous studies have focused on this issue.
MAtEriALS And MEtHodS
Study population and study sampleIn the framework of the ongoing French national Gene Etude Prospective Sein Ovaire (GENEPSO) project, managed by the French Cancer Genetic Network, cancer-free BRCA1/2 mutation carriers were recruited in a routine consultation context at Purpose: This study aimed to measure patients' smoking patterns for 5 years after BRCA1/2 test result disclosure.
Methods:A national cohort consisting of 621 French cancer-free women from families with BRCA1/2 mutations (mean age (SD): 40.5 years (11.5 years)) were included from December 1999 to January 2006, before disclosure of genetic test results, and followed for 5 years. They completed self-administered questionnaires about their cigarette smoking behaviors before receiving their test results (baseline) and 6, 12, 24, and 60 months after disclosure. Multivariate statistical analyses of the changes in participants' smoking behaviors were performed using a zero-inflated Pois...