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November 7, 1977

Smoking and Cancer-Reply

JAMA. 1977;238(19):2015. doi:10.1001/jama.1977.03280200027006

In Reply.—  The inverse relationship between smoking and lung cancer incidence among chloromethyl methyl ether (CME) workers was indeed a surprising finding. It is inconsistent with observations in asbestos workers and uranium miners. However, it is a valid observation. My responses to the questions raised by Miller and Schumaker are as follows:

  1. Some biometricians might consider the chi-square test inappropriate for a 2×2 table in which the expected number for one cell is less than five, but my consultant in biometrics assured me that this rule is no longer considered valid by some statisticians. In any case, the finding of three men who never smoked among 11 with lung cancer is biologically, if not statistically, impressive.

  2. In view of the fact that exsmokers of cigarettes and pipe-cigar smokers have lower risks of lung cancer than current cigarette smokers, one could reasonably group them with nonsmokers. In any case,