Paper

Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7398.1057 (Published 15 May 2003) Cite this as: BMJ 2003;326:1057

Secondhand Smoke Exposure and Disease: No Doubt Remains

The article “Environmental Tobacco Smoke and Tobacco Related
Mortality in a Prospective Study of Californians, 1960-98” and the
accompanying editorial in the May 17 issue of the British Medical Journal
suggest that the question of whether secondhand smoke exposure causes lung
cancer and heart disease remains an open one. The position of the U.S.
Department of Health and Human Services (DHHS) is that this question has
been conclusively settled, based on a strong body of scientific evidence.

In 2000, the National Institutes of Health’s National Toxicology
Program determined that secondhand smoke is a known human carcinogen. The
NIH’s Ninth Report on Carcinogens concluded that secondhand smoke exposure
is causally related to lung cancer. The Report found that secondhand
smoke exposure from a spouse’s smoking and at work were most strongly
associated with an increased lung cancer risk.

Likewise, the 2001 Surgeon General’s Report on Women and Smoking
found that secondhand smoke exposure is a cause of lung cancer among women
who have never smoked. The Report also found that epidemiologic and other
data support a causal relationship between secondhand smoke exposure from
a spouse and coronary heart disease mortality among nonsmoking women.

The U.S. Surgeon General has concluded that secondhand smoke is a
leading cause of disease and death in adult nonsmokers. DHHS estimates
that secondhand smoke causes at least 3,000 lung cancer deaths and more
than 35,000 heart disease deaths every year in the United States.

The position of DHHS is that secondhand smoke has been definitively
established as a cause of lung cancer and heart disease in nonsmokers.
There is a strong consensus among experts in the field and public health
authorities that this is the case. To suggest that this conclusion
remains in doubt is simply inaccurate.

Competing interests:  
None declared

Competing interests: No competing interests

10 July 2003
Terry F. Pechacek
Associate Director for Science
Stephen Babb
Centers for Disease Control and Prevention, Office on Smoking and Health, Atlanta, GA, USA, 30341
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