The shocking effects of passive smoking

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Tobacco consumption is the second leading cause of death worldwide, contributing to 6 million deaths each year. However, the harmful associations of tobacco smoking with health are not limited only to smokers, but also to people exposed to passive smoking (PS). The most convincing evidence is that exposure to passive smoking is responsible for the deaths of over 880,000 people worldwide each year. Compared to those who do not come into contact with cigarette smoke, children exposed to PS have an increased risk of sudden death, acute respiratory infections, acoustic dysfunction and asthma exacerbation. Even low exposure to PS has been shown to be associated with platelet activation, endothelial dysfunction and adverse effects on the cardiovascular system. Exposure to passive smoking was also associated with more widespread coronary heart disease and with a 20-30% increase in cardiovascular events, compared to individuals without exposure. Similarly, lung cancer has been reported among people exposed to PS, compared to those who don’t smoke at all.

Globally, a 15% lower rate of myocardial infarction has been reported after the first year of smoking bans which, after being introduced in most countries, have led to significant health benefits. For example, introduction of smoking restriction has reduced the number of asthma emergencies among children by 11,000 annually, in Scotland alone.

The purpose of the current study was to better understand the extent of the harm caused to people exposed to passive smoking, on a global scale and in different regions. For this purpose, the Passive Smoking Index was calculated, which measures the number of smokers, correlated with the death of a non-smoker. The study also calculated the index that measures the number of years of smoking of a person, correlated with the death of a person who does not smoke, but is exposed to passive smoking.

Another important purpose of this study was to provide a better understanding of passive smoking effects on non-smokers, in order to help decision makers implement protective measures for non-smokers, especially kids. Secondly, it was aimed at raising the awareness of the general public about the magnitude and damage associated with exposure to passive smoking.

Based on the global data obtained from the study, it was reported that 52.3 persons who smoked for 24 years were associated with the death of an individual who did not smoke. Since 1990, this initial number has gradually increased from 31.3 people who smoked, to 52.3 who smoked, in 2016. This change probably reflects the partial effectiveness of anti-smoking measures. However, the indicator of 52.3 persons should be considered alarming, especially since a substantial proportion of the deaths caused by exposure to passive smoking are children.

It was noted that in regions where smoking bans were widely adopted, for example North America, this indicator was more favourable than in areas with minimal or no exposure to PS, such as the Middle East and North Africa. Therefore, this indicator could become a tool used by governmental and non-governmental organizations to determine the level of protection that non-smoking measures can provide. In addition, our data showed that the adoption of anti-smoking legislation in some regions was associated with a significant increase for the SHSI indicator, suggesting that it could be used to measure the success of anti-smoking legislation or campaigns. Finally, studies have shown that these two measures are strongly associated with the reduction of tobacco consumption.

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