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To the Editor: The results of the study by Dr Eisner and colleagues¹ addressing the effects of workplace environmental tobacco smoke (ETS) exposure on respiratory symptoms and lung function show a change in both respiratory symptoms and measures of spirometric assessment. Among all study participants, they detected a change in mean forced expiratory volume in 1 second (FEV₁) of 0.039 L (95% confidence interval [CI], -0.030 to 0.107 L), which was not statistically significant. When the subgroup with complete cessation of workplace ETS was analyzed, a greater and statistically significant increase in FEV₁ of 0.142 L (95% CI, 0.020-0.264 L) was noted.

While these findings contribute to the authors' claim of an improvement in lung function after cessation of heavy ETS exposure, the link between statistically significant differences in lung function improvement and its clinical importance may not be that clear. Indeed, in a study of more than 100 . . . [Full Text of this Article]

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