News | Secondhand Smoke Costs Children Over 8.4 Million Years of Healthy Life Annually, Largest Global Study Finds
A global study presented at the European Respiratory Society (ERS) Congress in Amsterdam, the Netherlands, found that children under age 14 worldwide lose about 8.45 million years of healthy life each year from exposure to secondhand smoke, also known as passive smoking. Children in socioeconomically disadvantaged areas are affected most severely.
The study was led by Dr. Siyu Dai, assistant professor at the School of Clinical Medicine, Hangzhou Normal University, and honorary researcher in the Department of Paediatrics at The Chinese University of Hong Kong. She emphasized: ‘Secondhand smoke is a major cause of preventable illness and death in children, and there is no safe level of exposure. It is closely linked to chest infections, cardiovascular disease, and neurodevelopmental disorders, and it significantly worsens asthma symptoms. Young children are especially vulnerable because their bodies and lungs are still developing and they have little control over their environment.’
According to the World Health Organization, secondhand smoke causes about 1.2 million deaths each year, including 65,000 children under 15. Dr. Dai noted that many more children become ill because of other people’s smoking: ‘By quantifying the disease burden globally and regionally, we hope to provide scientific evidence for countries to develop more targeted tobacco-control policies.’
First Global Study of the Disease Burden of Secondhand Smoke in Children
Using data from the Global Burden of Disease Study, the researchers systematically analyzed disease data from 1990 to 2021 for children aged 0 to 14 in more than 200 countries and territories. Total health loss was measured in disability-adjusted life years (DALYs), the years of healthy life lost to illness or premature death.
In 2021, healthy life lost among children because of secondhand smoke exposure included:
3.79 million DALYs from lower respiratory infections, such as acute bronchitis and pneumonia;
800,000 DALYs from ear infections;
3.86 million DALYs from other chest infections and tuberculosis.
Overall, respiratory diseases and tuberculosis alone accounted for 8.45 million years of healthy life lost.
Children in Low-Income Regions Face a Greater Health Burden
The study also found that the lower the socioeconomic conditions, the greater the burden of disease from secondhand smoke. Using the Socio-demographic Index (SDI) to measure development, lower respiratory infections caused 7.64 DALYs lost per 100,000 children in high-SDI regions, compared with 302.43 DALYs in low-SDI regions;
For respiratory infections and tuberculosis, the figures were 10.25 DALYs in high-SDI regions and 305.40 DALYs in low-SDI regions.
Dr. Siyu Dai said: ‘This reflects global health inequality—children in some resource-poor areas are harmed more severely by secondhand smoke. Possible reasons include limited public awareness of its risks, crowded and poorly ventilated homes, and weak enforcement of tobacco-control policies. Together, these factors significantly increase children’s exposure.’
She added: ‘In 2021 alone, children lost nearly 8.45 million years of healthy life to respiratory infections and tuberculosis related to secondhand smoke. This is an entirely preventable health disaster if children are effectively protected from other people’s smoke.’
Experts Call for Stronger Child Protection and Global Tobacco-Control Policies
Dr. Filippos Filippidis, chair of the European Respiratory Society’s Tobacco Control Committee and a public health expert at Imperial College London who was not involved in the study, commented: ‘Hundreds of millions of people worldwide still smoke, and countless children are forced to breathe secondhand smoke. Their lungs are not fully developed, and they cannot choose to avoid smoke, making them the greatest victims.’
He emphasized: ‘This study quantifies the enormous global health damage that secondhand smoke causes children. It is a warning that must be taken seriously. Governments should enact and strictly enforce smoke-free laws in homes, schools, and places where children spend time to reduce exposure at its source. The fundamental solution is to reduce smoking across the population, thereby lowering the likelihood that children will be exposed.’
Dr. Filippidis also noted that as tobacco companies promote e-cigarettes and heated tobacco products, future research should examine the potential effects of secondhand aerosols from these ‘new tobacco products’ on children’s health.
News | Secondhand Smoke Costs Children Over 8.4 Million Years of Healthy Life Annually, Largest Global Study Finds
News | Secondhand Smoke Costs Children Over 8.4 Million Years of Healthy Life Annually, Largest Global Study Finds
A global study presented at the European Respiratory Society (ERS) Congress in Amsterdam, the Netherlands, found that children under age 14 worldwide lose about 8.45 million years of healthy life each year from exposure to secondhand smoke, also known as passive smoking. Children in socioeconomically disadvantaged areas are affected most severely.
The study was led by Dr. Siyu Dai, assistant professor at the School of Clinical Medicine, Hangzhou Normal University, and honorary researcher in the Department of Paediatrics at The Chinese University of Hong Kong. She emphasized: ‘Secondhand smoke is a major cause of preventable illness and death in children, and there is no safe level of exposure. It is closely linked to chest infections, cardiovascular disease, and neurodevelopmental disorders, and it significantly worsens asthma symptoms. Young children are especially vulnerable because their bodies and lungs are still developing and they have little control over their environment.’
According to the World Health Organization, secondhand smoke causes about 1.2 million deaths each year, including 65,000 children under 15. Dr. Dai noted that many more children become ill because of other people’s smoking: ‘By quantifying the disease burden globally and regionally, we hope to provide scientific evidence for countries to develop more targeted tobacco-control policies.’
First Global Study of the Disease Burden of Secondhand Smoke in Children
Using data from the Global Burden of Disease Study, the researchers systematically analyzed disease data from 1990 to 2021 for children aged 0 to 14 in more than 200 countries and territories. Total health loss was measured in disability-adjusted life years (DALYs), the years of healthy life lost to illness or premature death.
In 2021, healthy life lost among children because of secondhand smoke exposure included:
3.79 million DALYs from lower respiratory infections, such as acute bronchitis and pneumonia;
800,000 DALYs from ear infections;
3.86 million DALYs from other chest infections and tuberculosis.
Overall, respiratory diseases and tuberculosis alone accounted for 8.45 million years of healthy life lost.
Children in Low-Income Regions Face a Greater Health Burden
The study also found that the lower the socioeconomic conditions, the greater the burden of disease from secondhand smoke. Using the Socio-demographic Index (SDI) to measure development, lower respiratory infections caused 7.64 DALYs lost per 100,000 children in high-SDI regions, compared with 302.43 DALYs in low-SDI regions;
For respiratory infections and tuberculosis, the figures were 10.25 DALYs in high-SDI regions and 305.40 DALYs in low-SDI regions.
Dr. Siyu Dai said: ‘This reflects global health inequality—children in some resource-poor areas are harmed more severely by secondhand smoke. Possible reasons include limited public awareness of its risks, crowded and poorly ventilated homes, and weak enforcement of tobacco-control policies. Together, these factors significantly increase children’s exposure.’
She added: ‘In 2021 alone, children lost nearly 8.45 million years of healthy life to respiratory infections and tuberculosis related to secondhand smoke. This is an entirely preventable health disaster if children are effectively protected from other people’s smoke.’
Experts Call for Stronger Child Protection and Global Tobacco-Control Policies
Dr. Filippos Filippidis, chair of the European Respiratory Society’s Tobacco Control Committee and a public health expert at Imperial College London who was not involved in the study, commented: ‘Hundreds of millions of people worldwide still smoke, and countless children are forced to breathe secondhand smoke. Their lungs are not fully developed, and they cannot choose to avoid smoke, making them the greatest victims.’
He emphasized: ‘This study quantifies the enormous global health damage that secondhand smoke causes children. It is a warning that must be taken seriously. Governments should enact and strictly enforce smoke-free laws in homes, schools, and places where children spend time to reduce exposure at its source. The fundamental solution is to reduce smoking across the population, thereby lowering the likelihood that children will be exposed.’
Dr. Filippidis also noted that as tobacco companies promote e-cigarettes and heated tobacco products, future research should examine the potential effects of secondhand aerosols from these ‘new tobacco products’ on children’s health.
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Collected online