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May 6, 1998

The Emerging Tobacco Epidemic in China—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(17):1346-1348. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-17-jbk0506

In Reply.—We agree with Dr Cheng that the results from both Shanghai1 and Xian2 serve as a very serious warning of the increasing tobacco epidemic in China, and possibly in other Asian countries with rising smoking prevalence.

We also agree with Dr Jay about the problem in the estimation of risks due to smoking using nonsmokers, never-smokers, or ex-smokers as the reference and assuming that these subjects have not been exposed to ETS. In the "Comment" section of our article, we state that "if many nonsmokers in the reference group were exposed to passive smoking, the RRs from active smoking would be underestimated."2

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