Cigarette smoking, leukemia, and multiple myeloma.

To evaluate previously reported associations with cigarette smoking, the incidence of leukemia and multiple myeloma was determined with follow-up of up to 24 years of 57,224 never-smokers, 20,928 former smokers, and 64,839 current cigarette smokers who received multiphasic health checkups. Cigarette smoking was associated with the development of acute nonlymphocytic leukemia in men only (relative risk, 2.8; 95% confidence interval, 1.2 to 6.4). Chronic myeloid leukemia showed an association with smoking of borderline significance in men only. Chronic lymphocytic leukemia and multiple myeloma were not related to cigarette smoking. In the men with acute nonlymphocytic leukemia there was a suggestion of a dose-response relation but it was not statistically significant. The association of cigarette smoking with acute nonlymphocytic leukemia was not explained by alcohol or coffee consumption or exposure to occupational hazards. This study adds to the growing body of evidence that cigarette smoking predisposes to acute nonlymphocytic leukemia in men.