Environmental tobacco smoke and ischemic heart disease.
Cohort and case control studies show a 30% excess risk of ischemic heart disease in nonsmokers whose spouses smoke compared with that in nonsmokers whose spouses do not smoke. There is a nonlinear dose-response; the excess risk from actively smoking 20 cigarettes/day is only 80%. Large cohort studies of active smoking support the nonliner dose-response (the excess risk in smokers of 5 cigarettes/day is about 50%). Animal studies show a pronounced vascular effect of environmental tobacco smoke. In experimental studies passive and active smoking have similar effects on platelet aggregation. The collective evidence supports a significant effect of low dose tobacco smoke exposure in causing ischaemic heart disease.
Law
Malcolm R
MR
Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, University of London, London, UK.
Wald
Nicholas J
NJ
D000818:Animals; D002986:Clinical Trials as Topic; D016021:Epidemiologic Studies; D006801:Humans; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology*; D012306:Risk; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
D014028:Tobacco Smoke Pollution