Second-hand smoke 
kills 600,000 a year

In the first study to assess the global impact of second-hand smoke, WHO experts found that children are more heavily exposed to second-hand smoke than any other age-group, and around 165,000 of them a year die because of it.

“Two-thirds of these deaths occur in Africa and south Asia,” the researchers, led by Annette Pruss-Ustun of the WHO in Geneva, wrote in their study.

Children’s exposure to second-hand smoke is most likely to happen at home, and the double blow of infectious diseases and tobacco “seems to be a deadly combination for children in these regions”, they said.

Commenting on the findings in the Lancet journal, Heather Wipfli and Jonathan Samet from the University of Southern California said policymakers try to motivate families to stop smoking in the home.

“In some countries, smokefree homes are becoming the norm, but far from universally,” they wrote.

The WHO researchers looked at data from 192 countries for their study. To get comprehensive data from all 192, they had to go back to 2004. They used mathematical modelling to estimate deaths and the number of years lost of life in good health.

Worldwide, 40 per cent of children, 33 per cent of non-smoking men and 35 per cent non-smoking women were exposed to second-hand smoke in 2004, they found.

This exposure was estimated to have caused 379,000 deaths from heart disease, 165,000 from lower respiratory infections, 36,900 from asthma and 21,400 from lung cancer.

For the full impact of smoking, these deaths should be added to the estimated 5.1 million deaths a year attributable to active tobacco use, the researchers said.

While deaths due to passive smoking in children were skewed towards poor and middle-income countries, deaths in adults were spread across countries at all income levels.

In Europe’s high-income countries, only 71 child deaths occurred, while 35,388 deaths were in adults. Yet in the countries assessed in Africa, an estimated 43,375 deaths due to passive smoking were in children compared with 9,514 in adults.

Pruss-Ustun urged countries to enforce the WHO’s Framework Convention on Tobacco Control, which includes higher tobacco taxes, plain packaging and advertising bans, among other steps.

“Policy-makers should bear in mind that enforcing complete smoke-free laws will probably substantially reduce the number of deaths attributable to exposure to second-hand smoke within the first year of its implementation, with accompanying reduction in costs of illness in social and health systems,” she wrote.

Only 7.4 per cent of the world population currently lives in jurisdictions with comprehensive smoke-free laws, and those laws are not always robustly enforced.

In places where smoke-free rules are adhered to, research shows that exposure to second hand smoke in high-risk places like bars and restaurants can be cut by 90 per cent, and in general by 60 per cent, the researchers said.

Studies also show such laws help to reduce the number of cigarettes smoked by smokers and lead to higher success rates in those trying to quit.

TOBACCO IMPACT

υ Tobacco kills up to half of its users. The World Health Organisation describes tobacco use as “one of the biggest public health threats the world has ever faced”.

υ The annual death toll linked to tobacco is more than five million, and could rise to more than eight million by 2030 unless action is taken to control the tobacco epidemic.

υ More than 80 per cent of the world’s one billion smokers live in low- and middle-income countries.

υ Total consumption of tobacco products is increasing globally, although it is decreasing in some wealthier nations.

υ There are more than 4,000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer.

υ Second-hand smoke can cause various serious illnesses in adults, including cardiovascular and respiratory diseases like coronary heart disease and lung cancer. In babies, it can cause sudden death and in pregnant women low birth weight.

υ Second-hand smoke causes 600,000 premature deaths per year.

υ Only 7.4 per cent of the world population currently lives in jurisdictions with comprehensive smoke-free laws, and those laws are not always robustly enforced.

υ Almost half of children regularly breathe air polluted by tobacco smoke and more than 40 per cent of children have at least one smoking parent.