Second-hand tobacco exposure in children: evidence for action

Tobacco is one of the leading risk factors for disease burden and death in world. This related to both tobacco consumption second-hand exposure. Children are particularly exposed; 2019, it was estimated that passive smoking responsible 50 000 deaths 4 500 disability-adjusted life-years among children younger than 14 years.1GBD 2019 Risk Factors CollaboratorsGlobal 87 204 countries territories, 1990–2019: a systematic analysis Global Burden Disease Study 2019.Lancet. 2020; 396: 1223-1249Summary Full Text PDF PubMed Scopus (968) Google Scholar Over last two decades, especially following WHO's Framework Convention on Control 2003, comprehensive control policies (including bans) have been promoted internationally implemented many worldwide. These proven be effective reducing prevalence.2Flor LS Reitsma MB Gupta V Ng M Gakidou E The effects global prevalence.Nat Med. 2021; 27: 239-243Crossref (23) In addition, these associated with substantial benefits children's health.3Faber T Kumar A Mackenbach JP et al.Effect perinatal child health: review meta-analysis.Lancet Public Health. 2017; 2: e420-e437Summary (95) exposure decreased by 80% years between 1990 2019.1GBD this context, question arises exposures received little or no consideration national strategies, which mainly focused indoor public spaces workplaces. Such environments include outdoor areas (eg, parks), semi-private places community buildings), private cars). Numerous local initiatives reduce exposures;4Martínez C Guydish J Robinson G Martínez-Sánchez JM Fernández Assessment smoke-free regulation WHO European Region.Prev 2014; 64: 37-40Crossref (18) however, they still substantial.5Jeong SH Jang BN Kang Joo JH Park EC Association parents' status school-age children: assessment using major urine biomarkers.Sci Rep. 114536Google Scholar, 6Henderson Continente X al.Secondhand smoke other signs at entrances primary schools 11 countries.Sci Total Environ. 743140743Crossref (6) Data their effectiveness needed support implementation. Evaluating strategies health focus meta-analysis Márta Radó colleagues Lancet Health.7Radó MK Mölenberg FJM Westenberg LEH respiratory (published online July 15.)https://doi.org/10.1016/S2468-2667(21)00097-9Summary (5) research important because measures can challenging implement, given rely individual collective behaviours, social acceptability low.8Boderie NW FJ Sheikh al.Assessing extending beyond enclosed workplaces: protocol meta-analysis.BMJ Open. 11e040167Crossref (4) study even more relevant currently as COVID-19 pandemic safety probably led an increase domestic exposure.9Alla F Berlin I Nguyen-Thanh al.Tobacco COVID-19: crisis within crisis?.Can 111: 995-999Crossref Additionally, main collateral victims crisis.10Phumaphi Mason Alipui NK al.A accountability women's, children's, adolescents' health.Lancet. 222-224Summary On basis seven studies considered sufficient quality, showed were reduction cars (n=5 studies) school grounds (n=1), policy decrease hospital attendance tract infections (n=1). results emphasise value such measures. Communities states should encouraged continue efforts smoke. Nevertheless, colleagues' also shows available data scarce heterogeneous present low level evidence. Thus, strengthening evaluative area clearly needed. We need methodologically robust studies, comparative, quasi-experimental, experimental valid outcomes. Furthermore, from perspective, crucial measure total across all rather specific It cannot ruled out there could some adverse policies; example, displacement places, inside home, would harmful children.11Faber Mizani MA Reiss IK Been JV Investigating effect England's vehicle changes quasi-experimental study.Lancet 2019; 4: e607-e617Summary (13) To date, conflicting evidence topic. Results well conducted useful implement policies, improve measures, behaviour. declare competing interests. Effect meta-analysisSmoke-free car reductions reported TSE cars, translate into benefits. Few additional assessed regulating findings, governments consider including protect health. Full-Text Open Access