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To the Editor: In debunking the notion that smoking causes more than 400,000 deaths each year, Ms Marimont and I¹ were critical of studies that failed to control for confounding variables like alcohol consumption, exercise, diet, occupation, and income. In response, Dr Thun and colleagues² purport to have controlled for the first 4 of those variables plus race and education. Thun et al conclude that "federal estimates of deaths caused by smoking are not substantially altered by adjustment for behavioral and demographic factors."

That conclusion is entirely unjustified. Indeed, Thun et al acknowledge the major defect of their research: "Smokers and lifelong nonsmokers are more similar with respect to socioeconomic and educational status in our study than in the contemporary United States." Then they inexplicably gloss over that defect as if it were inconsequential, when, in fact, it hopelessly compromises the validity of their results.

The study by Thun et . . . [Full Text of this Article]

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