Deaths due to passive smoking in India up 50% compared to 1990: Lancet study

Deaths in India due to second-hand smoke increased nearly 50 per cent in 2023, compared to 1990, even as death rates improved by about 30 per cent, according to a global analysis published in The Lancet Public Health journal.

The estimates also suggest that while the population exposed to second-hand smoke increased from 375 million in 1990 to 444 million in 2026 — up by 18.4 per cent — age-standardised prevalence dropped from 43.2 per cent in 1990 to 30.6 per cent in 2023 in India.

Age-standardised prevalence is a statistical adjustment made to data to allow a fair comparison of prevalence across age groups.

An international team of researchers forming the ‘Global Burden of Disease (GBD) 2023 Second-hand smoke Collaborators’ estimated prevalence of exposure to passive smoking and the disease burden it contributes to across 204 countries and territories.

“In 2023, an estimated 2.71 billion people worldwide were exposed to SHS (second-hand smoke), including 767 million children aged 0-14 years,” the authors wrote.

Globally, exposure prevalence was 33.9 per cent in 2023. China, India, and Indonesia accounted for nearly half of the world’s exposed population, with 664 million, 444 million, and 142 million people exposed, respectively, in 2023, they found.

However, “age-standardised prevalence was highest in Southeast Asia, East Asia, and Oceania (48.4 per cent), with female individuals in some countries experiencing nearly 1.8 times the exposure prevalence of male individuals,” the team said.

In India, absolute deaths in 1990 due to passive smoking were 2,17,700, while those in 2023 were 3,25,600 — death rates or deaths per hundred thousand population, however, fell from 46.1 in 1990 to 30 in 2023, down by 35 per cent, the findings show.

“The numbers mean that despite a fall in the adjusted rates, the absolute number of people exposed to passive smoking is still increasing. This can have long-lasting effects across multiple organ systems, not just the respiratory system,” Dr Neetu Jain, pulmonologist and senior consultant at Pushpawati Singhania Hospital and Research Institute, New Delhi, said.

“Second-hand smoke exposure is associated with an increased risk of several diseases, including cardiovascular and respiratory conditions. The effects of passive smoking can also be particularly concerning in people with conditions such as coronary artery disease,” she said.

Children were found to account for more than 12 per cent of the world’s health burden from second-hand smoke, with lower respiratory infections causing the greatest burden, according to the study.

“Passive smoking is avoidable if smokers take steps to prevent exposing others to tobacco smoke. Smoking outside the home and away from enclosed spaces can reduce exposure to second-hand smoke, particularly among family members and children.  Children are especially vulnerable because their lungs are still developing, and exposure to tobacco smoke can adversely affect their respiratory health,” Dr Jain said.

“The effects tend to be greatest among those who are least aware of what passive smoking is and the health risks associated with it,” the pulmonologist said.

“However, we should encourage smokers to quit and focus on bringing down smoking across the country through effective tobacco-control measures, including higher tobacco prices and taxes,” she said.