Does environmental tobacco smoke (ETS) cause adverse health effects in susceptible individuals? A critical review of the scientific literature: I. Respiratory disorders, atopic allergy and related conditions

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Abstract
The epidemiological data with respect to long‐term effects of ETS exposure on adult asthmatics are inconclusive. Experimental studies of acute effects of ETS exposure in asthmatic adults have produced equally inconclusive results. A small subset of individuals with asthma may react adversely to ETS exposure. The basis of these reactions remains to be determined. The data with respect to potential effects of exposure to ETS on COPD and other chronic respiratory disorders are virtually non‐existent. Studies consistently have failed to find any correlation between subjective complaints of sensitivity to tobacco smoke and either skin or serologic tests of immunologic reactivity to tobacco‐related antigens. ETS can cause annoyance, most likely related to odor perception, and eye and upper respiratory irritation, most likely on a nonspecific, non‐immunologic irritant basis. It has not been convincingly demonstrated that certain individuals are particularly hypersensitive or susceptible to such effects on any physiological basis. Exposure to ETS has been included among the various exposures alleged to precipitate symptoms or perpetuate chronic illness in individuals said to suffer from so‐called MCS. However, the unscientific nature of these “data”;, make it very difficult to conclude that individuals said to have MCS are more susceptible to claimed health risks of exposure to ETS than the general population.