Burden of disease attributable to second-hand smoke exposure: A systematic review



Carreras G, Lugo A, Gallus S, Cortini B, Fernández E, López MJ, Soriano JB, Nicolás ÁL, Semple S, Gorini G, O'Donnell R & Dobson R (2019) Burden of disease attributable to second-hand smoke exposure: A systematic review. Preventive Medicine, 129, Art. No.: 105833.

Our aim was to provide a systematic review of studies on the burden of disease due to second-hand smoke (SHS) exposure, reviewing methods, exposure assessment, diseases causally linked to SHS, health outcomes, and estimates available to date. A literature review of studies on the burden of disease from SHS exposure, available in PubMed and SCOPUS, published 2007–2018 in English language, was carried out following the PRISMA recommendations. Overall, 588 studies were first identified, and 94 were eligible. Seventy-two studies were included in the systematic review. Most of them were based on the comparative risk assessment approach, assessing SHS exposure using mainly surveys on exposure at home/workplaces. Diseases more frequently studied were: lung cancer, ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma and breast cancer in adults; lower respiratory tract infection, otitis media, asthma, sudden infant death syndrome and low birth weight in children. The SHS exposure assessment and the reported population attributable fractions (PAF) were largely heterogeneous. As an example, the PAF from lung cancer varied between 0.6% and 20.5%. Moreover, PAF were estimated applying relative risks and SHS exposures with no consistent definitions or with different age classes. The research gap on the SHS exposure burden is shrinking. However, estimates are not yet available for a number of countries, particularly the Middle Eastern and African countries, and not all diseases with the strongest evidence of causation, such as sudden infant death syndrome, have been explored. Moreover, in some cases the applied methodology revealed relatively low quality of data.

Systematic review; Second-hand smoke; Burden of disease; Population attributable fraction; Tobacco

Additional co-authors: TackSHS Project Investigators - Yolanda Castellano, Marcela Fu, Montse Ballbè, Beladenta Amalia, Olena Tigova, Xavier Continente, Teresa Arechavala, Elisabet Henderson, Alessandra Lugo, Xiaoqiu Liu, Cristina Bosetti, Enrico Davoli, Paolo Colombo, Luke Clancy, Sheila Keogan, Hannah Byrne, Panagiotis Behrakis, Anna Tzortzi, Constantine Vardavas, Vergina Konstantina Vyzikidou, Gerasimos Bakellas, George Mattiampa, Roberto Boffi, Ario Ruprecht, Cinzia De Marco, Alessandro Borgini, Chiara Veronese, Martina Bertoldi, Andrea Tittarelli, Simona Verdi, Elisabetta Chellini, Marta Trapero-Bertran, Daniel Celdrán Guerrero, Cornel Radu-Loghin, Dominick Nguyen, Polina Starchenko, Julio Ancochea, Tamara Alonso, María Teresa Pastor, Marta Erro, Ana Roca, Patricia Pérez

Preventive Medicine: Volume 129

FundersHorizon 2020
Publication date31/12/2019
Publication date online07/09/2019
Date accepted by journal05/09/2019

People (2)


Dr Rachel O'Donnell

Dr Rachel O'Donnell

Senior Research Fellow, Institute for Social Marketing

Professor Sean Semple

Professor Sean Semple

Professor, Institute for Social Marketing