Second-hand smoke exposure in sub-Saharan Africa nearly doubles since 1990

The number of people exposed to second-hand smoke in sub-Saharan Africa has nearly doubled since 1990, in contrast to significant progress in reducing exposure in high income countries.

The region saw the largest increase anywhere in the world, with the number of people exposed rising by 98.5 per cent between 1990 and 2023.

Second-hand smoke was also linked to an estimated 84,000 deaths in the region in 2023 and 3.9 million years of healthy life lost, as well as 1.66 million deaths globally.

The analysis, published in The Lancet Public Health journal looked at second-hand smoke exposure across 204 countries and territories over more than three decades.

Exposure has fallen sharply in wealthier countries, as smoking rates have declined and smoke-free laws have become more widespread. The proportion of people exposed fell by about a third between 1990 and 2023.

In contrast, some 234 million people in sub-Saharan Africa were exposed in 2023, up from 118 million three decades earlier.

The Middle East and North Africa also saw a large increase at over 72 per cent. Qatar saw the largest increase in the absolute number of people exposed, at a huge 558.9 per cent, with the United Arab Emirates at 343.1 per cent.

The report, the Global Burden of Disease Study, does not give a detailed analysis of whether this meant more people were smoking. In many regions, the proportion of people exposed to second-hand smoke has declined since 1990, but population growth means more people are exposed.

However, the exposure does broadly mirror patterns of active smoking, with many low- and middle-income countries still seeing persistently high numbers of smokers.

Second-hand smoke is smoke inhaled by people who are near someone using tobacco products. The leading cause of death associated with adult exposure to it was Ischemic heart disease, according to the report, with 5.2 million years of healthy life lost to lower respiratory infections.

Globally, the proportion of people exposed to second-hand smoke has fallen substantially since 1990, but 2.7 billion people were still exposed in 2023, including 767 million children.

High-income countries have made significant gains, with countries such as Denmark and Norway seeing the proportion of people exposed to second-hand smoke fall by almost half since 1990. Canada also fell by 40 per cent, with Latin America and the Caribbean also seeing a steep decline.

The report said second-hand smoke remains a major global health risk and called for stronger tobacco-control measures to protect people, particularly women and children.