Women, Children Bear Brunt as 2.71bn Face Second-Hand Smoke Exposure — Study

About 2.71 billion people worldwide were exposed to second-hand smoke in 2023, including more than 2.26 billion women and children, according to a new study published in The Lancet Public Health.

The study revealed that the affected population included approximately 1.49 billion women and 767 million children under the age of 15, highlighting the widespread impact of exposure to tobacco smoke among vulnerable groups.

Researchers estimated that exposure to second-hand smoke was responsible for about 1.66 million deaths and 44.8 million disability-adjusted life years (DALYs) globally in 2023, demonstrating its significant contribution to premature deaths and long-term health problems.

Children accounted for more than 12 per cent of the health burden linked to second-hand smoke, with lower respiratory infections identified as the leading cause of illness associated with exposure among children.

The research, published on September 7, also found that women in some countries experienced exposure rates nearly 1.8 times higher than men, despite an overall decline in global exposure prevalence since 1990.

Second-hand smoke, also known as passive smoking, has been linked to a range of health problems, particularly among children and adolescents.

These include frequent and severe asthma attacks, respiratory infections, reduced lung function, ear infections, and cognitive and behavioural difficulties.

Children exposed to tobacco smoke have also been associated with an increased risk of peptic ulcer disease, while pregnant women exposed to second-hand smoke face a higher risk of delivering babies with low birth weight.

The study found that 33.9 per cent of the world’s population was exposed to second-hand smoke in 2023.

Exposure was particularly high in Southeast Asia, East Asia and Oceania, where prevalence reached 48.4 per cent.

Although the global proportion of people exposed to second-hand smoke has declined, the researchers noted that the actual number of exposed people has remained largely unchanged because of population growth.

In sub-Saharan Africa, the number of people exposed to second-hand smoke has nearly doubled since 1990, while North Africa and the Middle East recorded a 72.1 per cent increase.

Ischaemic heart disease was identified as the largest contributor to health loss linked to second-hand smoke, accounting for 12 million disability-adjusted life years in 2023.

Researchers assessed the effects of second-hand smoke exposure across nine major health outcomes, including cardiovascular diseases, cancers, chronic obstructive pulmonary disease, lower respiratory infections, type 2 diabetes, middle-ear infections and asthma.

The researchers said the study was the first dedicated Global Burden of Disease analysis to examine second-hand smoke as a global risk factor across 204 countries and territories between 1990 and 2023, with estimates based on age, sex, location and time.
China, India and Indonesia were found to account for nearly half of the world’s population exposed to second-hand smoke.

In 2023, approximately 664 million people were exposed in China, compared with 444 million in India and 142 million in Indonesia.

The study defined exposure as contact with smoke from combustible tobacco products at home or in the workplace.

Exposure occurring exclusively in places such as bars, restaurants, public transportation and private vehicles was not included in the assessment.

The researchers also noted that around 70 per cent of the world’s population was not protected by comprehensive smoke-free laws.

They warned that homes, where exposure can be prolonged, remain largely unregulated in many countries.

They called for stronger implementation and enforcement of comprehensive smoke-free legislation, alongside broader tobacco-control measures aimed at reducing tobacco use.

According to the researchers, the growing number of people exposed to second-hand smoke, coupled with persistent regional inequalities, underscores the urgent need for governments to strengthen tobacco-control policies.

They stressed that achieving a sustained reduction in the global health burden caused by second-hand smoke would require wider adoption and consistent enforcement of evidence-based tobacco-control measures.

They also encouraged voluntary smoking restrictions in homes and private vehicles, particularly as a way of protecting women and children from prolonged exposure.

A Consultant Paediatrician at the Federal Teaching Hospital, Katsina State, Dr Abdurrazzaq Alege, had earlier warned that exposure to cigarette smoke, even indirectly, could increase the risk of ulcers among children and adolescents.

Alege explained that children could be exposed to tobacco smoke continuously in their homes, even when they did not smoke themselves.

He noted that passive smoking could place additional stress on the body and weaken the immune system, making children particularly vulnerable to health complications associated with prolonged exposure.

The latest findings therefore reinforce calls for stronger tobacco-control measures and greater protection for children, women and other vulnerable populations from the harmful effects of second-hand smoke.

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