Passive smoking

Editor—The reviews of the paper by Enstrom and Kabat and the responses to them raise serious concerns about this paper,¹ strengthened by what has since emerged about one of the author's links to the tobacco industry. As an editor who has been misled by an ostensibly independent scientist later found to be a consultant for the tobacco industry, I am hesitant to criticise others who may find themselves in a potentially similar position as discovering the full story can be lengthy and painful.² One must consider not just the scientific merits of what was published but also the many analyses that could be but were not. One must also scrutinise carefully statements that could be genuine differences of interpretation but may reflect other motives. Especially where passive smoking is concerned, it is essential to examine the background to the study, given the unprecedented resources used by the tobacco industry in their attempts to create uncertainty.³

What should happen now? The BMJ often responds to controversial papers by simply counting responses for and against. This is insufficient, given the many unanswered questions raised by industry documents about the part played by senior tobacco industry executives and their consultants in this paper.⁴ When faced with similar questions about a paper we published on passive smoking we undertook a full investigation, producing evidence that was subsequently used successfully in a legal action in Switzerland.⁵ Without prejudging the outcome, such a review would, prima facie, also seem to be justified in this case.