Table 2.
Surgeon General’s report conclusions on active and passive smoking and various respiratory health effects
| Strength of Causal Inferences from Latest Available Evidence |
||||
|---|---|---|---|---|
| Sufficient | Suggestive but not sufficient | Inadequate | Suggestive of no causal relationship | |
| Active smoking | ||||
| Asthma | ||||
| Exacerbation among adults | X | |||
| Exacerbation among children | X | |||
| Incidence among adults | X | |||
| Incidence among children | X | |||
| COPD | X | |||
| Chronic respiratory symptoms (including cough, phlegm, wheeze, and dyspnea) | X | |||
| Acute respiratory illnesses | ||||
| Acute respiratory illnesses including pneumonia in persons without underlying smoking-related chronic obstructive lung disease | X | |||
| Acute respiratory infections among persons with preexisting COPD | X | |||
| Idiopathic pulmonary fibrosis | X | |||
| Lung cancer | X | |||
| Lung growth and pulmonary function | ||||
| Reduced lung function and impaired lung growth during childhood and adolescence | X | |||
| Early onset of lung function decline during late adolescence and early adulthood | X | |||
| Premature onset and accelerated age-related lung function decline | X | |||
| TB | ||||
| Increased risk of TB disease | X | |||
| Mortality due to TB | X | |||
| Recurrent TB | X | |||
| TB infection | X | |||
| Passive smoking | ||||
| Asthma | ||||
| Ever having asthma among children of school age | X | |||
| Childhood-onset asthma | X | |||
| Adult-onset asthma | X | |||
| Worsening of asthma control among adults | X | |||
| Chronic respiratory symptoms | ||||
| Cough, phlegm, wheeze, and breathlessness among children of school age due to parental smoking | X | |||
| Onset of wheeze illnesses in early childhood due to parental smoking | X | |||
| Cough, wheeze, chest tightness, and difficulty breathing among healthy adults and persons with asthma | X | |||
| COPD | X | |||
| Influenza, pneumonia, infections, and acute respiratory illnesses | ||||
| Lower respiratory illnesses in infants and children due to parental smoking | X | |||
| Increased frequency of lower respiratory tract illnesses during infancy due to maternal smoking during pregnancy | X | |||
| Lung cancer | X | |||
| Lung growth and pulmonary function in children | ||||
| Persistent adverse effects on lung function across childhood due to maternal smoking during pregnancy | X | |||
| Lower level of lung function during childhood due to secondhand smoke exposure after birth | X | |||
| Lung function in adults | ||||
| Acute decline in lung function among persons with asthma (short-term SHS exposure) | X | |||
| Acute decline in lung function among healthy persons (short-term SHS exposure) | X | |||
| Small decrement in lung function in general population (chronic SHS exposure) | X | |||
| Accelerated decline in lung function (chronic SHS exposure) | X | |||
| Middle ear disease and adenotonsillectomy in childhood | ||||
| Acute and recurrent otitis media and chronic middle ear effusion | X | |||
| Natural history of middle ear effusion | X | |||
| Adenoidectomy or tonsillectomy | X | |||
| Atopy (IgE-mediated allergy in children) | X | |||
| Odor and irritation | ||||
| Odor annoyance | X | |||
| Nasal irritation | X | |||
| Increased susceptibility to nasal irritation among persons with nasal allergies or history of respiratory illnesses | X | |||
Definition of abbreviations: SHS = secondhand smoke; TB = tuberculosis.