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Cigarette Smoking As a Cause of Lung Cancer and Coronary Heart Disease. A Study of Smoking-Discordant Twin Pairs

Published online by Cambridge University Press:  01 August 2014

J. Kaprio  and
M. Koskenvuo
J. Kaprio*
Affiliation:
Department of Public Health, University of Helsinki, Finland
M. Koskenvuo*
Affiliation:
Department of Public Health, University of Turku, Finland
*
Department of Public Health, University of Helsinki, Haartmaninkatu 3, 00290 Helsinki, Finland
Department of Public Health, University of Helsinki, Haartmaninkatu 3, 00290 Helsinki, Finland

Abstract

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Despite increasing scientific evidence for a causal role of tobacco smoking in lung cancer and coronary heart disease, an alternative hypothesis was put forward several decades ago. The constitutional hypothesis has stated that there are genetic or other common factors, which predispose both to smoking and disease. A critical test of this hypothesis was considered the pattern of occurrence of disease in monozygotic (MZ) twin pairs in which one is a smoker and the other never has been a smoker. Initial twin studies found only small differences in the mortality of smoking and nonsmoking twins of discordant pairs. In the Finnish Twin Cohort, a population-based panel of adult like-sexed twin pairs, a questionnaire study carried out in 1975 permitted identification of 2488 twin pairs discordant for cigarette smoking. Analyses of total mortality and mortality due to coronary heart disease and lung cancer indicate that the smoking members of discordant MZ pairs are at higher risk than their nonsmoking cotwins; increased mortality of smoking cotwins was also found on 21-year follow-up of smoking-discordant pairs in Sweden. Incidence data and noninvasive studies of atherosclerosis in the Finnish sample provide confirmatory evidence for the causal role of smoking in the etiology of coronary heart disease and lung cancer.

Keywords

TwinsSmokingMortalityCoronary heart diseaseLung cancerProspective studiesCausality
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 39 , Issue 1 , January 1990 , pp. 25 - 34
Copyright
Copyright © The International Society for Twin Studies 1990

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