title: Passive smoking and lung cancer: a cumulative meta-analysis.
abstract: OBJECTIVE
  To review the epidemiological evidence for the association between passive smoking and lung cancer.
  
  
  METHODS
  Primary studies and meta-analyses examining the relationship between passive smoking and lung cancer were identified through a computerised literature search of Medline and Embase, secondary references, and experts in the field of passive smoking. Primary studies meeting the inclusion criteria were meta-analysed.
  
  
  RESULTS
  From 1981 to the end of 1999 there have been 76 primary epidemiological studies of passive smoking and lung cancer, and 20 meta-analyses. There were 43 primary studies that met the inclusion criteria for this meta-analysis; more studies than previous assessments. The pooled relative risk (RR) for never-smoking women exposed to environmental tobacco smoke (ETS) from spouses, compared with unexposed never-smoking women was 1.29 (95% CI 1.17-1.43). Sequential cumulative meta-analysed results for each year from 1981 were calculated: since 1992 the RR has been greater than 1.25. For Western industrialised countries the RR for never-smoking women exposed to ETS compared with unexposed never-smoking women, was 1.21 (95% CI 1.10-1.33). Previously published international spousal meta-analyses have all produced statistically significant RRs greater than 1.17.
  
  
  CONCLUSIONS
  The abundance of evidence in this paper, and the consistency of findings across domestic and workplace primary studies, dosimetric extrapolations and meta-analyses, clearly indicates that non-smokers exposed to ETS are at increased risk of lung cancer.
  
  
  CONCLUSIONS
  The recommended public health policy is for a total ban on smoking in enclosed public places and work sites.
authors.affiliation: Department of Public Health and Community Medicine, Faculty of Medicine, The University of Sydney, New South Wales. richardt@health.usyd.edu.au
authors.forename: R
authors.initials: R
authors.lastname: Taylor
authors.forename: R
authors.initials: R
authors.lastname: Cumming
authors.forename: A
authors.initials: A
authors.lastname: Woodward
authors.forename: M
authors.initials: M
authors.lastname: Black
mesh_terms: D019049:Developed Countries / Q000706:statistics & numerical data; D016021:Epidemiologic Studies; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D012307:Risk Factors; D018454:Spouses; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data
chemical_list: D014028:Tobacco Smoke Pollution