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that the data necessary to perform an adequate quantitative risk assessment for causes of death other than lung cancer do not exist.)

In discussions of the health effects of ETS exposure, one should consider the effect on exsmokers of breathing other people’s cigarette smoke, since exsmokers have given up smoking, presumably to protect their health. Therefore, in Section D-4 we estimate, for exsmokers, the lifetime risk of death from lung cancer attributable to breathing other people’s cigarette smoke.

The sections D-1 to D-4 give nontechnical expositions of the issues. A separate Technical Discussion Section provides additional technical support and mathematical background.

In order to make quantitative estimates of the lung cancer risk attributable to ETS, numerical values must be chosen for a large number of parameters. When there are either no data or inconsistent data as to the magnitude of an important parameter, results are reported for a range of plausible values (i.e., a sensitivity analysis is performed).

Summary of Main Results Under the Assumption That the Summary Rate Ratio of 1.3 Is Causal

We summarize our main results. We caution the reader that the proper interpretation of these results requires that one read Section D-1 to D-4 and the discussion section that follows.

The estimated true relative risk for “exposed” individuals lies between 1.41 and 1.87. For “unexposed” individuals, the estimated true relative risk lies between 1.09 and 1.45. The number of (actively smoked) cigarettes effectively inhaled by a nonsmoker living with a smoking spouse lies in the range of 0.36–2.79 cigarettes/day. If the spouse is a nonsmoker, however, the estimated number lies between 0.12 to 0.93 cigarettes/day.

Of the roughly 7,000 lung cancer deaths estimated to have occurred among lifelong nonsmoking women in 1985, between 1,770 and 3,220 may be attributable to ETS. Of the roughly 5,200 lung cancer deaths estimated to have occurred among lifelong nonsmoking males in 1985, between 720 and 1,940 may be attributable to ETS.

The estimated lifetime risk of lung cancer attributable to ETS in a nonsmoker with moderate ETS exposure lies between 390 and 990 in 100,000. The estimated lifetime risk of lung cancer attributable to other people’s cigarette smoke for an exsmoker who



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