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This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
The IARC Monographs series publishes authoritative independent assessments by international experts of the carcinogenic risks posed to humans by a variety of agents, mixtures and exposures. They are a resource of information for both researchers and national and international authorities. This volume is particularly significant because tobacco smoke not only causes more deaths from cancer than any other known agent; it also causes more deaths from vascular and respiratory diseases. This volume contains all the relevant information on both direct and passive smoking. It is organised by first looking at the nature of agent before collecting the evidence of cancer in humans. This is followed by carcinogenicity studies on animals and then any other data relevant to an evaluation.