Exposure to environmental tobacco smoke and risk of lung cancer: the epidemiological evidence

Exposure of nonsmokers to environmental tobacco smoke (ETS) is widespread in European countries, the most serious exposures occurring at home and in the workplace. Epidemiological studies available up to 1986 have been reviewed by several international and national authorities, which agreed in concluding that ETS exposure is causally related to lung cancer. A number of epidemiological studies have been published since then, and have confirmed this association. The possibility of positive results due to bias has been envisaged; it seems, however, that such bias could not explain the whole excess of lung cancer. Few data are available on confounders, such as diet and previous history of lung disease, that might be responsible for the association; however, there is no evidence that they play an important role. Moreover, the biological plausibility of a causal association is supported by the similarity of the composition of ETS and active smoke. The causal association between ETS exposure and lung cancer now seems well-established; however, its public health impact is still debated. Estimates are available from the United States, Canada, Australia, New Zealand and England.

This article has been cited by other articles:

				P. N. Lee, J. S. Fry, and B. Forey Revisiting the Association between Environmental Tobacco Smoke Exposure and Lung Cancer Risk: V. Overall Conclusions Indoor and Built Environment, March 1, 2002; 11(2): 59 - 82. [Abstract] [PDF]

				D. H. YATES, H. BREEN, and P. S. THOMAS Passive Smoke Inhalation Decreases Exhaled Nitric Oxide in Normal Subjects Am. J. Respir. Crit. Care Med., September 15, 2001; 164(6): 1043 - 1046. [Abstract] [Full Text] [PDF]

				R Chen, H Tunstall-Pedoe, and R Tavendale Environmental tobacco smoke and lung function in employees who never smoked: the Scottish MONICA study Occup. Environ. Med., September 1, 2001; 58(9): 563 - 568. [Abstract] [Full Text] [PDF]

				J. S. Fry and P. N. Lee Revisiting the Association between Environmental Tobacco Smoke Exposure and Lung Cancer Risk: I. The Dose-Response Relationship with Amount and Duration of Smoking by the Husband Indoor and Built Environment, November 1, 2000; 9(6): 303 - 316. [Abstract] [PDF]

				P.N. Lee and A.J. Thornton Review : A Critical Commentary on Views Expressed by IARC in Relation to Environmental Tobacco Smoke and Lung Cancer Indoor and Built Environment, May 1, 1998; 7(3): 129 - 145. [Abstract] [PDF]