Objective To measure the relation between environmental tobacco smoke ("second hand smoke" sic), as estimated by smoking in spouses, and long term mortality from tobacco related disease.

Design Prospective cohort study covering 39 years.

Setting Adult population of California, United States.

Participants 118,094 adults enrolled in 1959 American Cancer Society cancer prevention study were followed until 1998. Particular focus is on the 35,561 never smokers who had a spouse in the study with known smoking habits.

Main outcome measures Relative risks and 95% confidence intervals for deaths from coronary heart disease, lung cancer, and chronic obstructive pulmonary disease related to smoking in spouses and active cigarette smoking.

NO SIGNIFICANT ASSOCIATIONS WERE FOUND
for current or former exposure to environmental tobacco smoke before or after adjusting for seven confounders and before or after excluding participants with pre-existing disease.

NO SIGNIFICANT ASSOCIATIONS WERE FOUND
during follow up periods of 1960-5, 1966-72, 1973-85, and 1973-98.

CONCLUSIONThe results do not support a causal relation between environmental tobacco smoke and tobacco related mortality, although they do not rule out a small effect. The association between exposure to environmental tobacco smoke and coronary heart disease and lung cancer may be CONSIDERABLY WEAKER THAN IS NOW GENERALLY BELIEVED.

SOURCE

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