Passive Smoking Could Cause 1.9 Million Excess Deaths From COPD In China

Dr Peymané Adab and Professor K K Cheng, University of Birmingham, UK and colleagues from the Hong Kong School of Public Health and Guangzhou 12th Hospital used data from the Guangzhou Biobank Cohort Study to do their research. They studied 20,430 men and women over age 50 years recruited between 2003-06. A total of 15379 never smokers were included in this analysis.

They found that people exposed to high levels of passive smoking (equivalent to 40 hours a week for more than five years) were on average 48% more likely to develop COPD. There were significant associations between reported respiratory symptoms and increasing passive smoking exposure (a 16% increased risk for any symptom).

Over 60% of adults in China are never smokers, and few restrictions exist to prevent high levels of passive smoking. The authors conclude: “If our risk estimates are correct, and assuming that current mortality and passive smoking exposure patterns continue, of the 240 million people aged over 50 years alive today in China, high exposure to passive smoking would result in about 1.9 million excess deaths* from COPD among never smokers.

“This finding has serious implications for population health, health services, and the economy, and lends further support to strong measures to ban smoking in public places and workplaces, and to increase availability of smoking cessation services in this region.”

In an accompanying Comment, Dr Ana Menezes and Dr Pedro Hallal, Universidade Federal de Pelotas, Brazil, say: “These results suggest that future anti-smoking policies should, in addition to targeting active smoking. also consider addressing passive smoking. Cheng, Adab, and colleagues estimate that, if the association is causal, 1.9 million excess deaths from COPD are attributable to passive smoking in the Chinese population. Their findings, added to what is already known about the harmful effects of passive smoking, suggest that urgent strategies to reduce this exposure are needed.”