The Hazards of Active and Passive Smoking

To the Editor: Chilmonczyk et al. (June 10 issue) 1 demonstrated a dose-response relation between exacerbations of asthma in children and exposure to environmental tobacco smoke, and validated parental reports of exposure by measuring urine cotinine levels. There have been direct studies demonstrating that deliberate exposure to environmental tobacco smoke resulted in “shortness of breath,” “tightness in the chest,” and “wheezing” and that these symptoms were twice as frequent in subjects with asthma (25 percent) as in nonasthmatic subjects (12 percent) 2 , 3 . These direct studies add validity to the conclusions of larger retrospective investigations. Previous research suggests a possible interaction . . .