Intended for healthcare professionals


Passive smoking: history repeats itself

BMJ 1997; 315 doi: (Published 18 October 1997) Cite this as: BMJ 1997;315:961

Strong public health action is long overdue

  1. Ronald M Davis (, Editor, Tobacco Controla
  1. a Director, Center for Health Promotion and Disease Prevention, Henry Ford Health System, One Ford Place, 5C, Detroit, Michigan 48202-3450, USA

    In 1962 and 1964 the Royal College of Physicians in London and the surgeon general of the United States released landmark reports documenting the causal relation between smoking and lung cancer.1 2 During the next quarter century, extensive research confirmed that smoking affects virtually every organ system. By 1990, the surgeon general concluded that “smoking represents the most extensively documented cause of disease ever investigated in the history of biomedical research.”3

    The history of research on passive smoking followed a parallel course. The 1982 surgeon general's report on smoking and cancer reviewed the first three epidemiological studies published on the relation between passive smoking and lung cancer. Each showed an increased risk of lung cancer in non-smoking women whose husbands smoked. But because the evidence was not yet abundant, the report's conclusions were cautious.4

    In 1986 the surgeon general devoted an entire report to the topic of involuntary (passive) smoking.5 It reviewed 13 “spousal studies” on passive smoking and lung cancer, 11 of which showed a positive association. The surgeon general was now able to conclude that “involuntary smoking is a cause of disease, including lung cancer, in healthy non-smokers.” Also in 1986, four other reports from authoritative bodies in the United States, Britain, France, and Australia came to similar conclusions.6 7 8 9

    The next …

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