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Passive smoking killing thousands

Globally, more than 600,000 deaths every year are caused by passive smoking (1 percent of all deaths) and around 165,000 of those killed are children, according to research published this week in the world’s leading medical journal The Lancet.

The University of Auckland’s Professor Alistair Woodward was a co-author of this study, the first to describe the health effects of second-hand smoke world-wide.

“The 1.2 billion smokers around the world are not only putting themselves at risk; they are harming the health of billions of non-smokers, and it is children who suffer most,” said Professor Woodward.

The authors gathered information from 192 countries, and estimated the effects of passive smoking on both deaths and years lost of life in good health (DALYs).

Worldwide, they estimated 40 percent of children, 33 percent of male non-smokers, and 35 percent of female non-smokers were regularly exposed to second-hand smoke in 2004.

Professor Woodward and his colleagues estimate this exposure led to approximately 379,000 deaths from ischaemic heart disease, 165,000 from lower respiratory infections, 36,900 from asthma, and 21,400 from lung cancer.

In total, 603,000 deaths were attributable to second-hand smoke. 47 percent of those deaths occurred in women, 28 percent in children, and 26 percent in men.

DALYs lost because of exposure to second-hand smoke amounted to 10.9 million, which was about 0.7 percent of total worldwide burden of diseases in DALYs in 2004.

Women suffered most from second-hand smoke as they are 60 percent more likely to be non-smokers than men (men are more often “first-hand” smokers) and women are 50 percent more likely to be exposed to second-hand smoke than men.

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Children were more heavily exposed to second-hand smoke than any other age-group, and they are not able to avoid the main source of exposure — mainly their close relatives who smoke at home. In terms of years of life in good health lost due to passive smoking, children were most affected. This is a result of pneumonia and other acute respiratory illnesses that are much more common amongst children living with adults who smoke.

“Passive smoking is a global health issue,” said Professor Woodward. “We have made great progress in New Zealand and many other high income countries. But billions of people are still exposed, needlessly, to second-hand smoke. This paper puts a figure on the cost, globally, in premature deaths and loss of good health. We hope our findings will spur policy-makers to take action. We know what works in tobacco control – what is needed is leadership and political commitment.”

The authors made three key recommendations.
• The immediate enforcement of WHO’s Framework Convention on Tobacco Control.
• The inclusion for complementary educational strategies, like voluntary smoke-free home policies for those countries which already have smoke-free laws.
• The need to dispel the myth that developing countries can wait to deal with tobacco-related diseases until they have dealt with infectious diseases. Together, tobacco smoke and infections lead to substantial, avoidable death and loss of active life-years of children.


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