Passive smoking and heart disease

doi:10.1136/bmj.317.7154.344

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See Editorial by SmithEducation and debate p). 333

Authors need to analyse the same data

Maurice E LeVois, Senior scientist*,
Maxwell W Layard, Principal scientist*

Environmental Health Resources, PO Box 301, Tiburon, CA 94920, USA
Layard and Associates, 2241 San Antonio Avenue, Alameda, CA 94501, USA
^*M E LeVois and M W Layard hold outside consultancies with the Tobacco Institute, 1901 K Street, Washington, DC 20001, USA.
^*Sutton, Surrey SM2 5DA^*Peter Lee acts as a consultant to the tobacco industry.
Philip Morris Europe, Scientific Affairs/EEMA Regions, 2003 Neuchâtel, Switzerland
Thame Thrombosis and Haemostasis Research Foundation, Thame, Oxfordshire OX9 3NY
Department of Environmental and Preventive Medicine, Wolfson Institute of Medicine, St Bartholomew's and The Royal London School of Medicine, London EC1M 6BQ

EDITOR—In their meta-analysis Lawet al).1 reject results we published).2).3 on environmental tobacco smoke and coronary heart disease, using data from the twolarge cancer prevention studies by the American Cancer Society and the national mortality followback survey. They reject our results because they disagree with our interpretation of data from other studies and because our analysis was funded by the tobacco industry (table 1).

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Table 1.

Data rejected by Law et al for their meta-analysis of spousal smoking and mortality from coronary heart disease in cancer prevention study I.2 Values are relative risks (95% confidence intervals)

By excluding our results Law et al discard 16 280 relevant deaths from coronary heart disease with spousal smoking data and retain 6600 cases. They give no hint that their meta-analysis includes under a third of the available published data. The reasons for rejecting so many data should be considered. If Law et al believe we have misrepresented the data, they should analyse the same data from the American Cancer Society and the national mortality followback survey, and report their results.

Law et al's argument that our data from the second cancer prevention study disagree appreciablywith data reported by Steenland et al).4 is wrong.).5 They incorrectly compare our results for ever-smoking spouse exposure with Steenland et al's results for current-smoking spouse exposure. Both studies present comparable results for subjects in the second cancer prevention study who are married to a current smoker. We calculate the relative risk for men to be 1.30 (95% confidence interval 1.11 to 1.51), for women 1.08 (0.89 to 1.32), and for both sexes combined 1.21 (1.07 to 1.37). These results are similar to those reported by Steenland et al (men 1.22 (1.07 to 1.40), women 1.10 (0.96 to 1.27))).4 which we have combined to give a …