Secondhand smoke: the invisible killer that continues to cause death and disease

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With the introduction of smokefree regulations in public places, peoples’ homes have become a major source of exposure to secondhand smoke (SHS), particularly for children. According to new WHO data, in some countries of the WHO European Region, up to 60% of children are exposed to SHS at home, making it a significant public health concern. SHS exposure was responsible for 171 000 deaths and contributed to 4.3 million Disability-Adjusted Life Years (DALYs) in the Region in 2019, according to the Global Burden of Disease study. These alarming figures highlight the need for effective legislation to protect people from the dangers of SHS and for increased efforts to promote smokefree environments, both in public spaces and at homes. Why smoke-free homes? Exposure to SHS, which contains around 7000 chemicals, including 70 carcinogens, increases the risk of a range of harmful health conditions for children, pregnant women, and adults. In children, these include sudden infant death syndrome, lower respiratory infections, ear infections, and more severe asthma. Pregnant women may experience harm to the fetus, preterm birth, and low birth weight. Adults face increased risks of stroke, lung and breast cancer, coronary heart disease, chronic obstructive pulmonary disease, asthma, and diabetes mellitus. Secondhand aerosol from electronic cigarettes also contains harmful chemicals that pose health risks to those exposed. Only a home that is 100% smokefree effectively protects the health of all household members. Making a home smokefree offers numerous benefits, including: improved health for all individuals, especially children and pregnant womenreduced fire risks associated with smoking encouragement for smokers to quit or smoke less support for recent quitters to avoid lapsing. Successful campaigns and legislation In response to startling statistics of death and disease caused by SHS exposure, several countries have launched successful campaigns and implemented legislation to address the issue, and this is already showing results. For instance, a recent study has revealed that fewer children are being hospitalized for asthma-related issues in Scotland, following a successful media campaign that promoted smokefree homes since 2014. In Atlanta, United States of America, an intervention to promote smokefree homes in low-income settings was found to be effective, with 40% of households adopting a full smoking ban at home 6 months after receiving it. In Finland, it is prohibited by law to smoke in shared indoor areas of housing corporations – for example, on staircases, in basements and roof areas – a measure supported by at least half of the population, including 66% of people who have never smoked and 11–24% of smokers. As more campaigns and legislation around the world aim to create smokefree environments and make smokefree homes the norm, global health outcomes can be significantly improved, saving countless lives and reducing the burden of disease.