Quantifying environmental health impacts

Worldwide burden of disease from exposure to second-hand smoke

Global burden of disease from second-hand smoke

A no tobacco sign

Key findings

More than 600 000 death per year worldwide are caused by second-hand smoke (SHS) - this is more than 1% of all deaths. 165 000 of these deaths are among children.

Smokers are not only putting themselves at risk, but also 1.8 billion non-smokers. In 2004, 40% of children, 33% of male non-smokers and 35% of female non-smokers were exposed to SHS worldwide. This exposure led to:

  • 379 000 deaths from ischaemic heart disease
  • 165 000 deaths from lower respiratory infections
  • 36 900 deaths from asthma
  • 21 400 deaths from lung cancer.

Women and children are disproportionally affected by exposure to SHS.

Of the 603 000 deaths, 47% occurred in women, 28% in children, and 26% in men. Women suffer more from the impacts of SHS as they are 50% more likely to be non-smokers than men. In terms of years of life lost, children are by far the most affected from SHS, as most of their SHS deaths occur from respiratory infections during the first few years of life.

Regional variations of exposure and disease burden from SHS are wide.

The highest exposures to SHS are found in Eastern Europe, the Western Pacific, and South-East Asia, with more than 50% of some population groups exposed. About 60% of child deaths occurred in Africa and South-East Asia combined. This is a result of respiratory infections being more common in children living with adults who smoke. Eastern Europe, South-East Asia and the Eastern Mediterranean region are the most affected from exposure to SHS in terms of total deaths per capita.

Policy makers should take action to protect the population against exposure to SHS. Effective policies are available. Only 7.4% of the world lives in jurisdictions with comprehensive smoke-free laws at present.

The authors' three key recommendations are:

  • immediate enforcement of WHO's Framework Convention on Tobacco Control to create complete smoke-free environments in all indoor workplaces, public places and public transport;
  • the inclusion of complementary educational strategies, like voluntary smoke-free home policies, for countries which already have smoke-free laws;
  • the need to dispel the myth that developing countries can wait to deal with tobacco-related diseases until they have dealt with infectious diseases. Together, tobacco smoke and infections lead to substantial, avoidable mortality and loss of active life years.

Original article

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