Tobacco Documents Online

Eniin,u.,. wul0urrn.nnnnIi. \,,I 11.r ii INh.~ Pnrt+cJ :r the I_»AII nchi, r:~rn:J EDITORIAL 1, S.IMI - IMI C"oInvrnlhi t Ivn, Piri. mom Prr.. PI; N'OTICE This ,.-.2tenal, may be prota •,A sy coFyrilsht ta++ `Ti„e 1' U.S, code). Cardiovascular Risks of Environmental Tobacco Smoke The adverse effects of En+•ironmental Tobacco Smoke (ETS) or passive smoking are being increasingly rec- oenized' by the scientific community. The detection of a considerable number of carcinosens at significant con- centrations in tobacco smoke lej to studies on risk as- sessment of ETS. There are numerous studies on the carcinoeenic impact of ETS, among them several pub- lishedi in Ent•r;•onmenr Inre>•narional. The reason for starting with carcinocenic risk was the availtibilitN of the needed methodology for carcinogenic risk assess- ment. These methods. initially developed for ionizing radiation. were applied to chemical carcinogens and physical agents, andlater on to mixtures. Despite their~ shortcomines. methods for cancer assessment have found acceptance by international organizations and by na- tional regulatorv aeencies and' are routinelv applied in the regulaton- process. ••In contrast to cancer assessment. the assessment of risk associated with the exposure to agents causing car- diovascular diseases is in its infancy. There are no con- vincing dose-response models for these diseases and available animal models do not readily lend themsel res to a quantification of cardiovascular risks. Available data: indicates that two to three times as many people die from, heart diseases as compared to those who die from cancer. If one takes into account the age of the affected individuals, this ratio is increased to about five to sevem In other words, the population in the indus- trialized nations lbses five to~ sevem times the number of years of lite to heart disease as compared to cancer. This issue of the Journal contains a paper on the potential risks associated with exposure to ETS. The paper by Wellk is an attempt to quantify this risk based on available statistical data. Because this paper is prob- ably the first of its kind, the editors were particularl~ concerned over the validity of the orieinal' data. their applicationito risk assessment. and the statistical treat- ment of the subject. The editors received recommendations from three reviewers. Two reviewers recommended publication subject to revisions recommended by them. A third reviewer recommended rejFction of the paper on the basis that the paper was too speculative. This latter reviewer did not provide any specific recommendation on how to improve the quality of the paper: Despite the "rrtixed" review, we chose to publish the paper. Given the current~ status of cardiovascular risk as- sessment. there is no doubt that the estimates provided by Wells will be less than accurate. However, there is no reasomto doubt that ETS may be associated~ with a considerable cardiovascular risk. The role of the scientific community, is to provide the societal decision makers with the best available sci- entific information. The availability of the paper on the health risks of ETS will provide these decision makers and the general public with the needed information. It is not unreasonable to expect that this new infortnation will become the basis for additionalrestnctions of smok- ing in public places. A. Alan Moghissii