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Smoking is part of a causal chain
EDITOR,--Peter S Blair and colleagues suggest that over 60% of cases of the sudden infant death syndrome may be attributable to the effects of parental smoking.1 This depends on the assumption that the association described is causal.
While smoking is undoubtedly harmful to babies, the magnitude of the risk is less clear. The close correlation between adverse socioeconomic circumstances and smoking and between risk of the sudden infant death syndrome and deprivation requires that the analysis should take careful account of potential confounding. The importance of the association between the syndrome and deprivation is suggested by the univariate odds ratios associated with social factors quoted in the full report of this study2--for example, receipt of family income supplement, 6.27; income of <£200/ week, 3.57; living in rented accommodation, 3.81; and <0.5 rooms per person, 31.3. To avoid residual confounding, the measure of socioeconomic status used for adjustment in multivariate
Related Article
- Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy
- Peter S Blair, Peter J Fleming, David Bensley, Iain Smith, Chris Bacon, Elizabeth Taylor, Jem Berry, Jean Golding, and John Tripp
BMJ 1996 313: 195-198.[Abstract] [Full Text]
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