Passive smoking blamed for one in 100 deaths

More than 600,000 deaths a year are caused by passive smoking, 165,000 of which are among children, researchers said today.

The first study to assess the global impact of second-hand smoke has been written by Dr Annette Prüss-Ustün and colleagues, of the World Health Organisation, shows that about one in 100 deaths worldwide each year is due to passive smoking.

Authors used figures from 2004, the last year to have comprehensive data across the 192 countries studied, for the report in The Lancet.

Estimating both deaths and years lost of life in good health (DALYs), they calculated that worldwide, 40 per cent of children, 33 per cent of male non-smokers and 35 per cent of female non-smokers were exposed to second-hand smoke in 2004.

This exposure was estimated to have caused 379,000 deaths from ischaemic heart disease, 165,000 from lower respiratory infections, 36,900 from asthma, and 21,400 from lung cancer, a total of 603,000 or one per cent of worldwide mortality.

Breaking it down further, the authors found that 47 per cent of deaths from second-hand smoke occurred in women, 28 per cent in children, and 26 per cent in men.

DALYs lost because of exposure to second-hand smoke amounted to 10.9 million – about 0.7 per cent of total worldwide burden of diseases in DALYs in that year.

In children under five, the largest disease burdens were from lower respiratory infections; in older children it was asthma; and in adults it was ischaemic heart disease and asthma.

Two-thirds of deaths occurred in Africa and South Asia, the authors say.

“Children’s exposure to second-hand smoke most likely happens at home. The combination of infectious diseases and tobacco seems to be a deadly combination for children in these regions and might hamper the efforts to reduce the mortality rate for those aged younger than 5 years as sought by Millennium Development Goal 4,” they write.

In a linked comment, Dr Heather L Wipfli and Dr Jonathan M Samet, Department of Preventive Medicine, Keck School of Medicine of USC, USC Institute for Global Health, University of Southern California, California, USA, say: "There can be no question that the 1.2 billion smokers in the world are exposing billions of non-smokers to second-hand smoke, a disease-causing indoor-air pollutant.

“Few sources of indoor-air pollution can be completely eliminated. However, smoking indoors can be eliminated—with substantial benefits, as shown by this new set of estimates."

The Lancet November 26 2010

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