Janet Ogundepo
About 2.71 billion people were exposed to second-hand smoke globally in 2023, with more than 2.26 billion women and children, including 1.49 billion women and 767 million children under 15, a new study published in The Lancet Public Health has found.
The study reported that second-hand smoke exposure accounted for 1.66 million deaths and 44.8 million disability-adjusted life years worldwide in 2023, highlighting its continuing contribution to premature deaths and disability.
According to the study, children accounted for more than 12 per cent of the health burden associated with second-hand smoke, with lower respiratory infections responsible for the greatest burden among children.
The study, published on September 7, also found that women in some countries had exposure rates nearly 1.8 times those of men, despite a global decline in exposure prevalence since 1990.
PUNCH Healthwise earlier reported that children and teenagers exposed to secondhand smoke, also known as passive smoking, have a higher risk of peptic ulcer disease.
SHS exposure in children also puts them at risk of frequent and severe asthma attacks, respiratory tract infections, decreased lung function ear infections and cognitive and behavioural issues.
Pregnant women exposed to SHS are at risk of birthing babies with low birth weight and depression.
The study also found that 33.9 per cent of the global population was exposed to second-hand smoke in 2023, while exposure prevalence reached 48.4 per cent in Southeast Asia, East Asia and Oceania.
The findings showed that the number of people exposed to second-hand smoke has remained largely unchanged despite the decline in exposure rates globally.
In sub-Saharan Africa, the number of people exposed has nearly doubled since 1990, while North Africa and the Middle East recorded a 72.1 per cent increase.
The study further found that ischaemic heart disease accounted for 12.0 million disability-adjusted life years attributable to second-hand smoke in 2023, making it the leading contributor to second-hand smoke-related health loss.
Second-hand smoke exposure was also assessed in relation to nine health outcomes, including cardiovascular diseases, cancers, chronic obstructive pulmonary disease, lower respiratory infections, type 2 diabetes, otitis media and asthma.
The researchers said the study was the first dedicated Global Burden of Disease study to assess second-hand smoke as a global risk factor across 204 countries and territories from 1990 to 2023, providing estimates by age, sex, geography and time.
The study found that China, India and Indonesia accounted for nearly half of the world’s population exposed to second-hand smoke, with 664 million, 444 million and 142 million people exposed respectively in 2023.
The researchers defined exposure as current exposure to smoke from combustible tobacco products at home or in the workplace. Exposure occurring exclusively in other settings, including bars, restaurants, public transport and private vehicles, was not captured.
They noted that about 70 per cent of the world’s population was not protected by comprehensive smoke-free laws, while domestic settings, where exposure can be prolonged, remained largely unregulated.
The researchers called for accelerated implementation and enforcement of comprehensive smoke-free legislation, alongside broader tobacco control measures to reduce active smoking.
“The rising numbers of people exposed to second-hand smoke, paired with persistent gaps between regions, highlight an urgent need for countries to enforce tobacco control laws more strongly,” the researchers said.
It noted that achieving lasting reductions in the global burden of second-hand smoke would require wider adoption and sustained enforcement of evidence-based tobacco control measures.
They also stressed the importance of voluntary smoking restrictions in homes and private vehicles, particularly to protect women and children from exposure.
In an earlier interview with PUNCH Healthwise, a Consultant Paediatrician at the Federal Teaching Hospital, Katsina State, Dr Abdurrazzaq Alege, affirmed that exposure to cigarette smoke, even indirectly, could predispose adolescents to ulcers.
He said, “Even before adolescence, children may be constantly exposed to smoke. A passive smoker may be getting all the smoking in the house, and this has also been associated with ulcers.”
Alege noted that such exposure puts stress on the body and weakens the immune system.
He added, “Some of their behaviours or exposures, such as passive smoking, have been associated with ulcers. A child constantly exposed to smoke in the home is at risk, and they are even more vulnerable than adults.”
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