Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Apr 26, 2017; 5(2): 14-40
Published online Apr 26, 2017. doi: 10.13105/wjma.v5.i2.14
Environmental tobacco smoke exposure and heart disease: A systematic review
Peter N Lee, Barbara A Forey, Jan S Hamling, Alison J Thornton
Peter N Lee, Barbara A Forey, Jan S Hamling, P.N. Lee Statistics and Computing Ltd., Sutton, Surrey SM2 5DA, United Kingdom
Alison J Thornton, Independent Consultant in Statistics, Okehampton, Devon EX20 1SG, United Kingdom
Author contributions: Lee PN and Forey BA planned the study; Thornton AJ and Hamling JS carried out the literature searches, assisted by Lee PN and Forey BA; Forey BA, Hamling JS and Thornton AJ carried out the data entry which was independently checked by one of these or Lee PN; Lee PN and Forey BA discussed any difficulties in interpreting published data or in the appropriate methods for derivation of RRs; Forey BA and Hamling JS conducted the main statistical analyses along lines discussed and agreed with Lee PN; Lee PN drafted the paper which was critically reviewed by the other authors.
Conflict-of-interest statement: Lee PN, Director of P.N. Lee Statistics and Computing Ltd., is an independent consultant in statistics and an advisor in the fields of epidemiology and toxicology to a number of tobacco, pharmaceutical and chemical companies including the sponsors of this study; Forey BA and Hamling JS are employees of, and Thornton AJ, a consultant to, P.N. Lee Statistics and Computing Ltd.
Data sharing statement: Supplementary File 1 provides a description of the reasons for rejection of some papers. Supplementary File 2 gives full details of the meta-analyses conducted. Supplementary File 3 gives full details of the stepwise multiple regression analysis. Supplementary File 4 gives some results for less commonly used indices of ETS exposure. Copies of the database files are available on request from the corresponding author at peterLee@pnlee.co.uk.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Peter N Lee, MA, Director, P. N. Lee Statistics and Computing Ltd., 17 Cedar Road, Sutton, Surrey SM2 5DA, United Kingdom. peterlee@pnlee.co.uk
Telephone: +44-20-86428265 Fax: +44-20-86422135
Received: October 7, 2016
Peer-review started: October 9, 2016
First decision: December 29, 2016
Revised: January 10, 2017
Accepted: February 28, 2017
Article in press: March 2, 2017
Published online: April 26, 2017
Core Tip

Core tip: We present an up-to-date meta-analysis of the evidence relating environmental tobacco smoke (ETS) exposure to heart disease risk in never smokers. An association is evident for smoking by the spouse (or nearest equivalent) with the relative risk estimated as 1.18 (95%CI: 1.12-1.24), and also with some other indices of ETS exposure. Though the findings suggest a causal relationship, data limitations and bias limit interpretation.