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Arch Pediatr Adolesc Med. 2000;154:850.

	Since this article does not have an abstract, we have provided the first 131 words of the full text and any section headings.

The article about recurrent pneumonia by Owayed et al¹ was very instructive. It would be interesting to know if the authors had any information regarding passive smoking, either from patient histories or cotinine levels. Passive smoking is a well-described risk factor for many pulmonary diseases and is much more common than some of the rare illnesses that the authors performed tests for.² When considering risk factors for pediatric respiratory disease, especially potentially preventable risk factors, it is important to remember environmental tobacco smoke exposure.

Editor's Note: The authors of the study agree that passive smoke exposure is a risk factor for recurrent/chronic lung disease. However, this was not the focus of their study.—Alain Joffe, MD

C. Andrew Aligne, MD
Rochester General Hospital
1425 Portland Ave, Box 238
Rochester, NY 14621-3095

1. Owayed AF, Campbell DM, Wang EL. Underlying causes of recurrent pneumonia in children. Arch Pediatr Adolesc Med. 2000;154:190-194. FREE FULL TEXT 2. Aligne CA, Stoddard JJ. Tobacco and children: an economic evaluation of the medical effects of parental smoking. Arch Pediatr Adolesc Med. 1997;151:648-653. ABSTRACT