Is second hand smoking associated with atrial fibrillation risk among women in Israel? A case-control study

Background: The first complete ban on indoor smoking in all public spaces (including bars and restaurants) occurred in 1994 in Israel, because of clear scientific evidence that SHS (Second Hand Smoking) is dangerous to non-smokers. Despite the smoking-ban law warning about the dangers of smoking, SHS remains in houses. The role of cigarette smoking on cardiac arrhythmia is less clearly defined and secondhand smoke (SHS) impact on the risk of atrial fibrillation (AF) remains unknown. The aim of this study was to evaluate the relationship between SHS and AF risk in Israeli women. Methods: This was a population-based case-control study consisting of never-smoking women aged 30–80 from Israel: 102 cases (diagnosed) of AF and 109 population- based controls. All participants were interviewed using a socio-demographic questionnaire that also related to past and current exposure to SHS. Results: SHS was associated with AF risk with adjusted odds ratio (OR) of 3.81 (95% confidence interval, CI 2.02–7.18). Higher exposure to SHS was associated with higher risk of AF compared to never-exposed women. Those exposed to SHS during one, two, or three life-periods (childhood, adolescence or adulthood) had an OR of 1.71 (95% CI 0.76–3.86), 2.87 (95% CI 1.25–6.56), and 9.14 (95% CI 4.09–20.44), respectively. Moreover, exposure to one pack/day increased the risk of AF by 2.89 times compared to ‘never exposed’ (95% CI 2.05–4.09). Conclusions: SHS exposure in women who never smoked is associated with increased risk for AF.