Patterns of mortality from asthma

To the Editor: The long-term studies of morbidity from asthma by Silverstein et al.¹ and Lang and Polansky² (Dec. 8 issue) do not provide evidence of a history of either active or passive smoking that is based on explicit criteria. Silverstein et al. based their diagnosis of asthma in part on evidence of “no current smoking (for patients of 14 years or older).” Neither a history of passive smoking nor the prevalence of active cigarette smoking among adolescents and children less than 14 years of age is mentioned.³,⁴ Furthermore, the use of patients’ reports of cigarette consumption may be.