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To the Editor: Dr Otsuka and colleagues¹ found that passive smoking has harmful effects on the coronary endothelial function in healthy young nonsmoking adults after as few as 30 minutes. We are disappointed, however, that the secondhand smoke exposure was not more clearly quantified. Apart from describing the size of the smoking room and the fact that some individuals were smoking, the authors did not estimate the amount of exposure to environmental tobacco smoke. They did not describe the number of smokers or the number of cigarettes smoked in the room before or when the subjects were exposed. They similarly gave no information about the ventilation system.

Furthermore, only air concentrations of carbon monoxide, not nicotine or particulate levels, were measured. To gauge the bioavailability of environmental tobacco smoke compounds, the authors measured the subjects' plasma carboxyhemoglobin level. Measuring other biomarkers such as nicotine and cotinine could have provided additional . . . [Full Text of this Article]

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Acute Effects of Passive Smoking on the Coronary Circulation in Healthy Young Adults
Ryo Otsuka, Hiroyuki Watanabe, Kumiko Hirata, Kotaro Tokai, Takashi Muro, Minoru Yoshiyama, Kazuhide Takeuchi, and Junichi Yoshikawa
JAMA. 2001;286(4):436-441.
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