In the search for risk factors involved in the etiology of lymphoproliferative malignancies there is still inconsistent evidence regarding effects of smoking tobacco, and the role of smokeless tobacco is poorly investigated. New evidence indicates that excess body weight increases the risk of NHL and HD. To determine if tobacco use of various forms and high Body Mass Index (BMI) affect the occurrence of these neoplasms, we conducted a prospective cohort study on over 330,000 Swedish construction workers included in the Construction Industry Working Environment and Health program. Information on smoking, snuff dipping, height and weight was gathered by self administered questionnaires together with personal interviews. Cancer incidence was ascertained through the year 2000 by record linkage to the nationwide Swedish Cancer Registry, Migration Registry and Cause of Death Registry. At the end of follow up, 1,309 subjects had been diagnosed with NHL (including chronic lymphocytic leukemia) and 205 with HD respectively. Age adjusted incidence rate ratios were computed using Cox proportional Hazard regression modeling. Smoking cigarette, pipe or cigar was not associated with NHL or HD. There was no evidence indicating a relation between quantity and duration of smoking and NHL or HD risk. No link was found between NHL and usage of smokeless tobacco. Having a BMI of 30 or higher did not convey excess risk of developing NHL or HD compared to normal weight ). We conclude that tobacco smoking and high BMI do not entail an increased risk of NHL and HD. Our findings of a relation between the duration of snuff dipping and HD need further investigation. ' 2005 Wiley-Liss, Inc.Key words: non-Hodgkin's lymphoma; Hodgkins disease; smokingtobacco; moist snuff; body mass index Over the past decades, there has been controversy regarding the impact of tobacco use on the development of lymphatic malignancies. Although studies conducted within this area are not sparse, results have been largely inconsistent. In part, the conflicting results might reflect the various designs and sizes of the studies, study type and subjects, interview compliance and if information was obtained from study subjects or their next of kin.Tobacco smoke is known to comprise a number of components, including benzene, lead and polonium 1-3 affecting the immune system by means such as increasing mean leukocyte counts, [4][5] most strongly correlated to neutrophils and CD41 cells, 5 and altered T-cell function. 6 Moreover smoking has been correlated to lowered levels of immunoglobulins, lysozyme as well as a decrease in the total number of NK-cells in long time smokers.
7Whereas several studies have suggested smoking to be associated with NHL [8][9][10][11]8,12 others have failed to confirm these results. [13][14][15][16][17][18][19] More recent studies have indicated this relation to be particularly strong for follicular lymphoma and high grade lymphomas. 9,17,20 Overweight and obesity has become a globally accelerating health issue related to increased morbidi...