Hôpitaux Iris Sud Brussels, Belgium
Correspondence to: Bernard Hanson, MD, Hôpitaux Iris Sud (HIS), 142 Rue Marconi, Brussels B 1190, Belgium; e-mail: firstname.lastname@example.org
We read with interest the article in CHEST by Au et al (June 2003)1
on the risk of inhaled β-adrenoreceptor agonists in patients with left ventricular systolic dysfunction.
However, we were astonished not to see tobacco consumption among the recorded risk factors for death or degradation. Tobacco use remains the most preventable cause of death and disability in the United States.2
Far and away the most important cause of lung cancer is exposure to tobacco smoke through active or passive smoking.3–
It also is a leading cause of COPD. Tobacco smoking also has been involved in terms of the rate of cardiac death.4–
In 2000, Envangelista et al5
demonstrated, using a retrospective analysis of Veterans Affairs hospital records, that noncompliance with smoking restriction was a main risk factor for multiple hospital readmissions of patients with heart failure.
We would urge the authors of any study dealing with lung-related or heart-related morbidity or mortality to include tobacco usage as part of the variables assessed.
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