Second hand smoke attributable disease burden in 204 countries and territories, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021

Abstract Background We aimed to estimate the changes in, second hand smoke (SHS) and potential drivers of its health outcome from 1990 to 2021 worldwide. Methods The data was derived from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, which covered 204 countries and terr...

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Main Authors: Zheng Su, Ying Xie, Zhenxiao Huang, Anqi Cheng, Xinmei Zhou, Min Wang, Xin Xia, Tingfen Ji, Liang Zhao, Zhao Liu, Dan Xiao, Chen Wang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Respiratory Research
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Online Access:https://doi.org/10.1186/s12931-025-03228-3
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author Zheng Su
Ying Xie
Zhenxiao Huang
Anqi Cheng
Xinmei Zhou
Min Wang
Xin Xia
Tingfen Ji
Liang Zhao
Zhao Liu
Dan Xiao
Chen Wang
author_facet Zheng Su
Ying Xie
Zhenxiao Huang
Anqi Cheng
Xinmei Zhou
Min Wang
Xin Xia
Tingfen Ji
Liang Zhao
Zhao Liu
Dan Xiao
Chen Wang
author_sort Zheng Su
collection DOAJ
description Abstract Background We aimed to estimate the changes in, second hand smoke (SHS) and potential drivers of its health outcome from 1990 to 2021 worldwide. Methods The data was derived from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, which covered 204 countries and territories. We reported SHS changes by sex, year and sociodemographic index (SDI) level (a summary measure that identifies where countries or other geographic areas sit on the spectrum of development) from 1990 to 2021. We analyzed the risk-outcome pairs among all age groups to estimate disease burden attributable to SHS exposure and also did a decomposition method to attribute changes in all-cause SHS attributable deaths or disability-adjusted life years (DALYs) to population growth, population aging, and mortality change. Results Worldwide, the age-standardized summary exposure values (SEV) of SHS exposure in 2021 was 30.6% (28.9 to 31.6) for males and 38.0% (35.5 to 39.0) for females, with a percentage change of −0.2 (−0.2 to −0.1) and −0.3 (−0.3 to −0.2), respectively, since 1990. Among the top 10 countries with the highest SEV, there were mainly high-middle SDI countries for male and low-middle SDI and middle SDI countries for female, respectively. Secondly, about 1.29 million deaths (0.68–1.90) and 34.90 million DALYs (17.95–52.21) were attributable to SHS exposure, and about half of them took place in two countries (China and India). Ischemic heart disease (IHD) (29.67%), chronic obstructive pulmonary disease (COPD) (19.04%), and lower respiratory infections (LRIs) (10.87%) were the three leading causes of SHS associated deaths. Lastly, since 2010, the number of SHS related death significantly increased due to population growth and population aging, despite a decrease in mortality attributable to SHS exposure. Conclusion Globally, the age-standardized SEV of SHS exposure decreased from 1990 to 2021. Since 2010, the increased number of deaths attributable to SHS exposure was mainly attributable to population growth and aging.
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spelling doaj-art-7aa5128a77964c028dfc736f3c8f1d7a2025-08-20T02:15:28ZengBMCRespiratory Research1465-993X2025-05-0126113010.1186/s12931-025-03228-3Second hand smoke attributable disease burden in 204 countries and territories, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021Zheng Su0Ying Xie1Zhenxiao Huang2Anqi Cheng3Xinmei Zhou4Min Wang5Xin Xia6Tingfen Ji7Liang Zhao8Zhao Liu9Dan Xiao10Chen Wang11Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship HospitalAbstract Background We aimed to estimate the changes in, second hand smoke (SHS) and potential drivers of its health outcome from 1990 to 2021 worldwide. Methods The data was derived from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, which covered 204 countries and territories. We reported SHS changes by sex, year and sociodemographic index (SDI) level (a summary measure that identifies where countries or other geographic areas sit on the spectrum of development) from 1990 to 2021. We analyzed the risk-outcome pairs among all age groups to estimate disease burden attributable to SHS exposure and also did a decomposition method to attribute changes in all-cause SHS attributable deaths or disability-adjusted life years (DALYs) to population growth, population aging, and mortality change. Results Worldwide, the age-standardized summary exposure values (SEV) of SHS exposure in 2021 was 30.6% (28.9 to 31.6) for males and 38.0% (35.5 to 39.0) for females, with a percentage change of −0.2 (−0.2 to −0.1) and −0.3 (−0.3 to −0.2), respectively, since 1990. Among the top 10 countries with the highest SEV, there were mainly high-middle SDI countries for male and low-middle SDI and middle SDI countries for female, respectively. Secondly, about 1.29 million deaths (0.68–1.90) and 34.90 million DALYs (17.95–52.21) were attributable to SHS exposure, and about half of them took place in two countries (China and India). Ischemic heart disease (IHD) (29.67%), chronic obstructive pulmonary disease (COPD) (19.04%), and lower respiratory infections (LRIs) (10.87%) were the three leading causes of SHS associated deaths. Lastly, since 2010, the number of SHS related death significantly increased due to population growth and population aging, despite a decrease in mortality attributable to SHS exposure. Conclusion Globally, the age-standardized SEV of SHS exposure decreased from 1990 to 2021. Since 2010, the increased number of deaths attributable to SHS exposure was mainly attributable to population growth and aging.https://doi.org/10.1186/s12931-025-03228-3Second hand smokeSecular trendsDisease burdenWorldwide
spellingShingle Zheng Su
Ying Xie
Zhenxiao Huang
Anqi Cheng
Xinmei Zhou
Min Wang
Xin Xia
Tingfen Ji
Liang Zhao
Zhao Liu
Dan Xiao
Chen Wang
Second hand smoke attributable disease burden in 204 countries and territories, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021
Respiratory Research
Second hand smoke
Secular trends
Disease burden
Worldwide
title Second hand smoke attributable disease burden in 204 countries and territories, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021
title_full Second hand smoke attributable disease burden in 204 countries and territories, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021
title_fullStr Second hand smoke attributable disease burden in 204 countries and territories, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021
title_full_unstemmed Second hand smoke attributable disease burden in 204 countries and territories, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021
title_short Second hand smoke attributable disease burden in 204 countries and territories, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021
title_sort second hand smoke attributable disease burden in 204 countries and territories 1990 2021 a systematic analysis from the global burden of disease study 2021
topic Second hand smoke
Secular trends
Disease burden
Worldwide
url https://doi.org/10.1186/s12931-025-03228-3
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