Second-Hand Smoke Remains a Major Public Health Threat in India
Second-hand smoke remains a major public health concern in India.
While age-standardised exposure declined from 43.2% in 1990 to 30.6% in 2023, population growth pushed the number of exposed people from 375 million to 444 million.
Deaths attributed to passive smoking also increased, from around 217,700 in 1990 to 325,600 in 2023. The exposure was estimated to account for approximately 9.28 million disability-adjusted life-years (DALYs) lost in 2023, highlighting its substantial health burden.
Children and Women Particularly Vulnerable
Household exposure is a particular concern for women and children. In children, second-hand smoke is associated with a higher risk of lower respiratory infections, recurrent wheezing, asthma and sudden infant death.
Because children’s lungs are still developing, they are especially sensitive to tobacco toxins. Maintaining smoke-free homes is therefore an important step in protecting them from avoidable exposure.
Effects Extend Beyond Respiratory Health
The impact of passive smoking extends beyond the lungs. It is associated with ischaemic heart disease, stroke, lung cancer, chronic obstructive pulmonary disease (COPD), breast cancer and type 2 diabetes.
Tobacco smoke can trigger oxidative stress and inflammation, impair blood-vessel function, activate platelets and contribute to insulin resistance. These effects can increase cardiovascular and metabolic risks even among people who do not smoke themselves.
Need for Routine Screening and Family-Based Support
Healthcare providers should routinely ask patients about exposure to tobacco smoke at home and in the workplace, particularly those with respiratory disease, premature cardiovascular disease or unexplained symptoms.
There is no safe level of second-hand smoke exposure. Reducing the burden therefore requires smoke-free homes, routine screening, household counselling and family-centred smoking-cessation support.
Stronger preventive measures can help protect vulnerable populations and reduce the growing health burden of passive smoking in India.
