To the Editor.
—Dr Larry R. Kirkland1 objected to pipe smokers "being lumped with cigarette smokers." Similarly, we take issue with "passive" smokers being lumped with true nonsmokers in epidemiological studies of active smoking. Most nonsmokers are smokers—at second hand.Kirkland focuses almost all of his attack against Tuteur2 on his use of the word "intermediate" by referring to one dictionary's definition of that word. From this one subjective definition, Kirkland launched a discussion as to whether secondhand smoke from pipes causes a large increase of risk for lung cancer or heart disease. Tuteur was answering the question, "Have there been any studies showing that pipe smokers have more lung disease or heart disease than nonsmokers?" This was answered succinctly. There are risks for pipe smokers and some of these risks probably arise from inhalation of sidestream smoke from their pipes since many pipe smokers do not inhale
Whidden P. The Risk of Sidestream Smoke From Pipes. JAMA. 1993;269(2):212. doi:10.1001/jama.1993.03500020046016
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