. Smoking outside the home and away from enclosed spaces can reduce exposure to second-hand smoke, especially among family members and children | Image used for illustrative purposes only | Photo credit: File Photo
According to a global analysis published in Public Health Lancet magazine.
Estimates also show that while the population exposed to secondhand smoke increased from 375 million in 1990 to 444 million in 2026 (an increase of 18.4%), the age-standardized prevalence in India decreased from 43.2 percent in 1990 to 30.6 percent in 2023.
Age-standardized prevalence is a statistical adjustment to data that allows a fair comparison of prevalence across different age groups.
The international team of researchers who compiled the 2023 Global Burden of Disease (GBD) on Secondhand Smoking estimated the prevalence of secondhand smoke and the burden of disease it contributes to in 204 countries and territories.
“In 2023, approximately 2.71 billion people worldwide were exposed to second-hand smoke (second-hand smoke), including 767 million children aged 0 to 14 years,” the authors write.
In 2023, the worldwide prevalence of exposure was 33.9 percent. China, India and Indonesia accounted for almost half of the world’s exposed population, with 664 million, 444 million and 142 million people exposed respectively in 2023, they found.
However, “age-standardized prevalence was highest in Southeast Asia, East Asia and Oceania (48.4 percent), with women in some countries exposed at nearly 1.8 times the rate of men,” the team said.
In India, the absolute death rate due to secondhand smoke was 2,17,700 in 1990 and 3,25,600 in 2023. However, the mortality rate or deaths per hundred thousand population has come down from 46.1 in 1990 to 30 in 2023, a decline of 35%, the results show.
“These figures mean that despite the decline in adjusted rates, the absolute number of people exposed to secondhand smoke is still increasing. This can have long-term effects on many organ systems, not just the respiratory system,” Neetu Jain, pulmonologist and senior consultant at Pushpavati Singhania Hospital and Research Institute in New Delhi, told PTI.
“Exposure to secondhand smoke is associated with an increased risk of developing a number of diseases, including cardiovascular and respiratory diseases. The effects of secondhand smoke can also be particularly harmful for people with conditions such as coronary heart disease,” she said.
Children account for more than 12% of the global burden of secondhand smoke, with lower respiratory tract infections causing the greatest burden, according to the study.
“Secondhand smoke can be avoided if smokers take steps to prevent others from being exposed to tobacco smoke. Smoking outside the home and away from enclosed spaces can reduce exposure to second-hand smoke, especially among family members and children. Children are particularly vulnerable as their lungs are still developing and exposure to tobacco smoke can negatively impact their respiratory health,” said Dr Jain.
“The effects tend to be most pronounced among those who are least aware of what secondhand smoke is and the health risks associated with it,” the pulmonologist said.
“However, we must encourage smokers to quit and focus on reducing smoking across the country through effective tobacco control measures, including increasing tobacco prices and taxes,” she said.
Published – September 8, 2026 6:10 pm EST.