The Pharmaceutical Journal
Vol 270 No 7250 p713
24 May 2003

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Passive smoking risk might have been overstated, study suggests

Passive smoking might not be as harmful as previously thought, research suggests.

American researchers studied Californian participants in the American Cancer Society study who were followed for 39 years. They focused on the 35,561 people who had never smoked but who had a spouse with known smoking history.

Exposure to environmental tobacco smoke was not significantly associated with the death rate for coronary heart disease, lung cancer or chronic obstructive pulmonary disease. However, the relative risks for chronic obstructive pulmonary disorder suggested an association. The adjusted relative risks for male never-smokers with a spouse who had ever smoked were 0.93 for coronary heart disease, 0.63 for lung cancer and 1.20 for chronic obstructive pulmonary disorder. The figures for female never-smokers were 0.99, 0.94 and 1.16, respectively. The study did find a strong relation between active cigarette smoking and deaths from all three conditions.

The researchers conclude that the findings "do not support a causal relation between exposure to environmental tobacco smoke and tobacco related mortality, although they do not rule out a small effect". They add: "It seems premature to conclude that environmental tobacco smoke causes death from coronary heart disease and lung cancer." (BMJ 2003:326:1057.)

The British Medical Association — which is campaigning for smoke-free public places — condemned the study as "fundamentally flawed". The BMA says the study failed to collect detailed data on passive smoking. Dr Vivienne Nathanson, head of science and ethics at the BMA, commented: "There is overwhelming evidence, built up over decades, that passive smoking causes lung cancer and heart disease, as well as triggering asthma attacks."