BMJ 1999;318:1554 ( 5 June )

Letters

Emerging tobacco hazards in China

    Is assumption of no association between smoking and other causes of death valid?
    Double standards apply with importation of tobacco into developing countries
    UK authors' reply

Is assumption of no association between smoking and other causes of death valid?

The first 150 words of the full text of this article appear below.

EDITOR---Liu et al used the term "proportional mortality study" to describe their method of comparing the smoking habits of 0.7 million adults who died of neoplastic, respiratory, or vascular causes with those of a reference group of 0.2 million who died of other causes in China.1 The term can be confusing as it is used only for proportional mortality ratio analysis in standard epidemiology textbooks.2 We suggest that the study can be more easily understood if it is described as a case-control mortality study.

An important assumption in such analyses is that the other causes of death should be unrelated to the exposure "not only in the sense of causation but also in terms of `self-selection' for the exposure and the diagnosis and certification of the underlying cause of death."3 Liu et al validated this assumption by showing that the smoking rates of the male and female reference groups were . . . [Full text of this article]
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Relevant Article

Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths
Bo-Qi Liu, Richard Peto, Zheng-Ming Chen, Jillian Boreham, Ya-Ping Wu, Jun-Yao Li, T Colin Campbell, and Jun-Shi Chen
BMJ 1998 317: 1411-1422. [Abstract] [Full Text] [PDF]

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