We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

What's So Passive About Passive Smoking?  Secondhand Smoke as a Cause of Atherosclerotic Disease

Rachel M. Werner; Thomas A. Pearson, MD, PhD
JAMA. 1998;279(2):157-158. doi:10.1001/jama.279.2.157.
Text Size: A A A
Published online


Cigarette smoking represents the single most important preventable cause of death in the United States.1 Studies that document the effect of cigarette smoke on the progression of the atherosclerotic process add to the overwhelming evidence that tobacco smoke is an atherogenic agent. The morbidity and mortality secondary to tobacco smoke have been dismissed by the tobacco industry because smokers have a choice in whether they smoke and are generally aware of the risks associated with smoking. However, this argument does not extend to the millions of people who are exposed to tobacco smoke not as active smokers but by inhalation of environmental tobacco smoke (ETS). The public health impact of ETS is thought to be considerable. Of the estimated 480000 smoking-related deaths that occur every year in the United States, 53000 have been attributed to ETS, making passive smoke the third leading preventable cause of death, after active smoking and alcohol use.2 Recent epidemiologic evidence shows that never smokers exposed to ETS have an increased risk not only of lung cancer but also of cardiovascular disease (CVD). Two recent prospective trials3,4 and meta-analyses2,5 estimate the relative risk for CVD at 1.2 to 1.3 for individuals exposed to ETS. Of the deaths caused by ETS, the number of deaths from heart disease is about 3 times the number of noncardiac deaths.2

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

10 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles