A population-based case-control study was conducted in Shanghai, China, to investigate the associations between exposures to various non-dietary variables and risk of nasopharyngeal carcinoma (NPC). A total of 935 NPC patients and 1,032 community controls were included. Active cigarette smoking was a moderate risk factor for NPC [odds ratio (OR) = 1.28, 95% confidence interval (CI) 1.02-1.61]. Results were highly consistent between men and women. It is estimated that 12% of NPC cases in Shanghai, China, can be attributable to cigarette smoking. Among lifelong nonsmokers, there was a strong and statistically significant positive association between NPC risk and exposure to substantial secondhand smoke as a child or as an adult in women. However, the associations among lifelong nonsmoking men were weaker and not statistically significant. The gender differences in risk associated with passive smoking were either statistically significant or almost so. There were excess numbers of NPC patients compared with control subjects who had a history of chronic ear and nose disease (OR = 1.96, 95% CI 1.56-2.46) and a family history of NPC (OR = 7.47, 95% CI 2.14-12.88).