Summary of results and conclusions of Californian EPA review
| Outcome | Odds ratios | Conclusions |
|---|---|---|
| Lower respiratory disease in young children | 1.5–2 | ETS exposure clearly confers an increased risk of acute lower respiratory disease in young children |
| Asthma “induction”4-150 | 1.75–2.25 in summary (n = 37), RR = 1.45 for household exposure, RR = 1.6 for maternal smoking | Compelling evidence of an effect |
| Asthma exacerbation | Narrative | Disease severity increased by ETS |
| Respiratory symptoms in children | Narrative | Associated with parental smoking |
| Lung growth and development | Narrative | Evidence not wholly consistent but suggestive of small effects |
| Atopy | Narrative | Several studies have shown an increased risk of atopy in children of smoking mothers, though the evidence regarding this issue is mixed |
| Middle ear infection | Narrative; OR = 1.62 | Risk of both acute and chronic middle ear infection increased |
| Sudden infant death | Narrative | Adequate epidemiological evidence of a causal relationship between maternal smoking and SIDS. Compelling evidence that postnatal ETS exposure is an independent risk factor |
ETS = environmental tobacco smoke; SIDS = sudden infant death syndrome.
↵4-150 Some of the studies included are cross sectional studies of asthma prevalence and thus the conclusion of an effect applies in part to prevalence, not to incidence. Difficult to understand why summary differs from text—in particular from meta-analysis.