BMJ 2002;325:1413-1416 ( 14 December )

Education and debate

How the tobacco industry responded to an influential study of the health effects of secondhand smoke

Mi-Kyung Hong, public administration analyst, Lisa A Bero, professor. 

Department of Clinical Pharmacy and Institute for Health Policy Studies, University of California, Box 0613, San Francisco, CA 94143-0613, USA

Correspondence to: L A Bero Bero@medicine.ucsf.edu

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

In 1981 an influential Japanese study showed an association between passive smoking and lung cancer. This article documents the tobacco industry's attempts to refute this study by producing a credible alternative study

In 1981 Japanese investigator Takeshi Hirayama published a cohort study examining the association of passive smoking and lung cancer among non-smoking wives of smokers in Japan.¹ The study concluded that wives of heavy smokers had up to twice the risk of developing lung cancer as wives of non-smokers and that the risk was dose related. The Hirayama study was influential because it launched an extraordinary amount of critical debate ^{2 3} and has been one of the most frequently cited studies in regulatory proceedings, ^{4 5} risk assessments,⁶ and the media.⁷

The tobacco industry has used a variety of tactics to maintain scientific debate about whether secondhand smoke has any harmful effects. ^{5 6 8-14} We identify and analyse internal tobacco industry documents that describe the industry's . . . [Full text of this article]

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