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Passive smoking causes 1 in 100 deaths

Passive smoking leads to 603,000 deaths a year globally

Louise Prime

Friday, 26 November 2010

Passive smoking causes 1% of all deaths globally – 603,000 a year, of which about 165,000 are in children, according to an article published online first today in The Lancet . The study, from the World Health Organization’s Tobacco-Free Initiative in Geneva, is the first assessment made of passive smoking’s impact worldwide.

The authors analysed 2004 data from 192 countries studied to estimate deaths and disability-adjusted life-years (DALYs – years lost of life in good health).

They found that worldwide, 40% of children, 33% of male non-smokers and 35% of female non-smokers were subjected to passive smoking. They estimated that in 2004 this caused:

  • 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

    They calculated that a total 603,000 deaths were caused by second-hand smoke in 2004, or about 1.0% of worldwide mortality. Almost half (48%) of all passive smoking deaths were in women and more than a quarter (28%) in children, with only 26% in men – because men are more likely to be active smokers themselves.

    Passive smoking also caused huge morbidity, the authors say. They found in 2004 it was responsible for 10.9m DALYs, or 0.7% of the total burden globally, and 61% of DALYs were borne by children. A high proportion of DALYs were from lower respiratory tract infections in the under-5s (54%), ischaemic heart disease in adults (26%) and asthma in adults (11%) and in children (6%).

    Most deaths in children caused by passive smoking occurred in low- or middle-income countries – only 71 occurred in the wealthier countries of Europe. But adult deaths from passive smoking were fairly evenly spread across all countries, irrespective of income.
    The authors point out that children suffer heavier exposure to second-hand smoke than any other age-group, and are also the group for which there is strongest evidence of harm from passive smoking.

    They argue that previous research has shown that comprehensive smoke-free laws cut passive smoking in places such as bars and restaurants by 90%, and overall by 60%, as well as raising the likelihood that would-be quitters are successful. They recommend immediate enforcement of WHO’s Framework Convention on Tobacco Control, which includes strategies such as higher tax on tobacco products, plain packaging and advertising bans.

    Authors of a Comment on the study 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.”

    Betty McBride, policy & communications director at the British Heart Foundation, said: “Breathing in other people’s tobacco smoke has deadly consequences. This study is ample proof that we were right to introduce the ban on smoking in public places in this country.

    “These figures should make smokers stop and think about the impact they’re having on other people’s health, particularly children’s. They should also serve as encouragement to government to go further and promote smoke-free homes and cars.”

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