Lung cancer and passive smoking

doi:10.1136/bmj.321.7270.1221

BMJ 2000;321:1221 ( 11 November )

Letters

Lung cancer and passive smoking

Turning over the wrong stone

Increased risk is not disputed

Nothing new was said

Scales for visual test of publication bias are unfair

Authors' reply

Turning over the wrong stone

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

EDITOR $---$ In their reanalysis of the epidemiological evidence on lung cancer and smoking Copas and Shi¹ assert that afterallowing for publication bias the apparent average excess riskof lung cancer from passive smoking² would drop from 24% to15%. Despite the lack of supporting data,³ we are asked tobelieve solely on the basis of statistical inference that suchdata must be hiding under a stone. They are, however, turningover the wrongstone.

More important than publication bias is the underestimation of risk that occurs when these studies assess exposure solelyon the basis of whether non-smokers either lived or did not livewith a smoker,² when other exposureexists.

Where other exposure is common $---$ for example, in childhood, in social situations, or in the workplace $---$ the risk of lung cancermay be seriously underestimated. Spouses of non-smokers exposedin other circumstances will be misclassified as non-exposed, . . . [Full text of this article]

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