Department of Community Health and Prevention Research Center, Saint Louis University School of Public Health, Salus Center, 3545 Lafayette Avenue, St Louis, Missouri, MO 63104, USA

Correspondence to: R Brownson, E-mail: brownson@slu.edu

The health hazards due to exposure to environmental tobacco smoke (ETS) are increasingly established. ETS contains thousands of chemicals including 43 known carcinogens. One of the most important known health effects of ETS exposure is lung cancer in non-smokers, based on epidemiologic evidence and knowledge of the uptake and metabolism of ETS. Epidemiologic studies need to carefully take into account confounding and potential errors in exposure assessment. More research is needed to understand the genetic factors that influence ETS-induced lung cancer. Studies of the patterns of ETS exposure suggest higher rates of exposure in people employed as blue collar workers, in service occupations, earning lower incomes, and among the less educated. Certain racial/ethnic groups (e.g. Blacks, American Indians) may be at higher risk of ETS exposure. Despite substantial progress in protecting individuals from ETS exposure, additional efforts are needed in improving and enforcing policies to reduce exposure.

Oncogene (2002) 21, 7341-7348. doi:10.1038/sj.onc.1205809

environmental tobacco smoke; lung neoplasms; socioeconomic level; tobacco smoke pollution