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July 1, 1998

Population Health

Author Affiliations

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

JAMA. 1998;280(1):32-33. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-1-jbk0701

In Reply.— Our study showed that active smoking increases the rate of atherosclerotic progression by approximately 50%, past smoking by 25%, and exposure to ETS by 20%, and that the effects of all types of cigarette smoke appear amplified among persons with diabetes and hypertension. We agree with Dr Duenas that the impact of diabetes on the relationship between smoking and atherosclerosis requires further investigation. Similar concerns exist for the amplified harmful effects of smoking among people with hypertension. Furthermore, because of the high population prevalence of these diseases (12% of the population is diabetic, 10% is hypertensive), smoking in public places affects large numbers of highly susceptible people.