Tobacco Wars

Is passive smoking harmful?

The campaign to ban cigarette smoking in public places received a big boost last January when Epidemiologist Takeshi Hirayama of Japan's National Cancer Center published the results of a 14-year study of 265,000 Japanese. He found that nonsmoking wives of heavy smokers had a higher risk of developing lung cancer than nonsmoking women married to men who did not smoke.

But now that conclusion is being challenged by an analysis of lung cancer deaths published last month in the Journal of the National Cancer Institute. Epidemiologist Lawrence Garfinkel of the American Cancer Society studied data collected over twelve years on 176,739 nonsmoking women and concluded that those wed to smokers did not run a greater risk of dying from lung cancer than those married to nonsmokers. Garfinkel notes, however, that neither his study nor Hirayama's provides "definitive information" on the effects of passive smoking. "Classifying nonsmoking women on the basis of the smoking habits of their husbands is not an accurate measure of their degree of passive smoking," he says, since they may be exposed to varying amounts of smoke outside the home.

For his part, Hirayama notes, "There are bound to be discrepancies between Japan and the U.S. for the clear-cut reason that the ways of life are different." For example, divorce in the U.S. is much more common, he says, so researchers should consider the smoking habits of ex-husbands as well as current spouses. American women are also more likely to have jobs and work in smoky offices.

The Japanese findings were already disputed by the Tobacco Institute, the industry's lobbying organization. The institute says that three U.S. statisticians who were asked to review the report discovered an error in how the data were analyzed and judged the study's conclusions "invalid." But one of the statisticians, Nathan Mantel of George Washington University, says that while his review raised questions about the study, it did not draw any firm conclusions. Says he: "The institute has put words in my mouth."

The dustup over the Japanese study is the latest round in an ongoing debate. Other studies have indicated that passive smoking can exacerbate symptoms in people with allergies and heart disease and impair lung functioning in healthy adults. Some research has found that children whose parents smoke suffer more respiratory-tract illness. Only one thing is certain: where there's tobacco smoke, there's bound to be fire.

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