TOBACCO-RELATED DISEASES: CHRONOLOGICAL REVIEW OF SCIENTIFIC EVIDENCE, AND METHODOLOGY FOR DETERMINING CAUSATION IN INDIVIDUAL CASES

A METHOD HAS BEEN DEVELOPED TO HELP LEGAL PROFESSIONALS INVOLVED WITH PRODUCT LIABILITY CASES EVALUATE THE ADVERSE HEALTH EFFECTS ATTRIBUTABLE TO TOBACCO USE. IN PHASE I ONLYTWO OF THE MANY WELL DOCUMENTED DISEASE AND TOBACCO ASSOCIATIONS ARE EXPLORED: (1) ACTIVE SMOKING AND LUNG CANCER, AND (2) ACTIVE SMOKING AND CORONARY HEART DISEASE (CHD). THE PROPOSED METHODOLOGY CONSISTS OF (1) DOCUMENTINGTHE CHRONOLOGICAL HISTORY OF SCIENTIFIC KNOWLEDGE OF THE CAUSAL RELATIONSHIP BETWEEN TOBACCO USE AND DISEASE INCIDENCE, (2) HAVING SCIENTIFIC EXPERTS REVIEW AND EVALUATETHE CURRENT EPIDEMIOLOGICAL EVIDENCE, AND (3) DEVELOPING A QUANTITATIVE PROCEDURE TO ESTIMATE THE LIKELIHOOD THAT TOBACCO USERS WHO DEVELOP DISEASES WHICH ARE CAUSALLY ASSOCIATED WITH TOBACCO WOULD NOT HAVE DEVELOPED THOSE DISEASES HAD THEY NOT USED TOBACCO. THESE CALCULATIONS INVOLVE THE USE OF ASSIGNED SHARE THEORY RECENTLY PUBLISHED IN A NAS REPORT. THIS THEORY HAS NOT PREVIOUSLY BEEN APPLIED TO THE MANY SMOKING RELATED DISEASES. AFTER THIS METHODOLOGY HAS BEEN TESTED, REFINED AND APPLIED IN PHASE I,IT WOULD BE APPLIED TO THE REMAINING DISEASES ASSOCIATED WITH TOBACCO USE IN PHASE II. THE MATERIALS ON EACH DISEASE TYPE WILL BE PUBLISHED PERIODICALLY AND AS SEPARATE CHAPTERS IN A COMPREHENSIVE MANUAL.