Table 4

Summary of results and conclusions of Californian EPA review

OutcomeOdds ratiosConclusions
Lower respiratory disease in young children1.5–2ETS 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 exacerbationNarrativeDisease severity increased by ETS
Respiratory symptoms in childrenNarrativeAssociated with parental smoking
Lung growth and developmentNarrativeEvidence not wholly consistent but suggestive of small effects
AtopyNarrativeSeveral studies have shown an increased risk of atopy in children of smoking mothers, though the evidence regarding this issue is mixed
Middle ear infectionNarrative; OR = 1.62Risk of both acute and chronic middle ear infection increased
Sudden infant deathNarrativeAdequate 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.