Broughton and colleagues¹ state that consideration should be given to the use of prophylactic palivizumab to infants born at less than 32 weeks in the case of maternal smoking or even if they have siblings. However, the authors present no data from their own or other studies to indicate that this would be in any way cost effective or justified. Certainly the word “consider” is fortunate, given the stated funding provided to one author by the manufacturer.

The study demonstrated a relationship between lower respiratory morbidity from respiratory syncytial virus (RSV) and smoking which has been widely shown elsewhere. The numbers of …