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Disease burden of adult lung cancer and ischaemic heart disease from passive tobacco smoking in China
  1. Quan Gan,
  2. Kirk R Smith,
  3. S Katharine Hammond,
  4. Teh-wei Hu
  1. School of Public Health, University of California, Berkeley CA, USA
  1. Quan Gan, PhD, Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Ave, Suite 366, San Francisco, CA 94143-1390, USA; quan.gan{at}


Objective: To address the health hazards tobacco smoking imposes upon non-smokers in China, this paper estimates the burden of diseases in adults from passive tobacco smoking for two major diseases—lung cancer and ischaemic heart disease (IHD).

Methods: The disease burden was estimated in terms of both premature mortality and disability adjusted life years (DALYs), a measure that accounts for both the age at death and the severity of the morbidity.

Results: Passive smoking caused more than 22 000 lung cancer deaths in 2002 according to these estimates. When the toll of disability is added to that of mortality, passive smoking was responsible for the loss of nearly 230 000 years of healthy life from lung cancer. Using the evidence from other countries that links IHD to passive smoking, we estimated that approximately 33 800 IHD deaths could be attributable to passive smoking in China in 2002. Passive smoking is also responsible for the loss of more than one quarter of a million years of healthy life from IHD. Although most of the disease burden caused by active smoking occurs among men, women bear nearly 80% of the total burden from passive smoking. The number of deaths among women caused by passive smoking is about two-thirds of that caused by smoking for the two diseases we examined.

Conclusion: Even without considering the passive smoking risks for other diseases and among children that have been documented in other countries, passive smoking poses serious health hazards for non-smokers, especially for adult female non-smokers in China, adding more urgency to the need for measures to be taken immediately to protect the health of non-smokers and curb the nation’s tobacco epidemic.

  • China
  • passive smoking
  • lung cancer
  • ischaemic heart disease

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  • Funding: This study was supported by a grant from the US National Institutes of Health Fogarty International Center (RO1-TW05938).

  • Competing interests: none.

  • Abbreviations:
    disability adjusted life years
    health adjusted life year
    ischaemic heart disease
    lower respiratory infection
    relative risk
    secondhand tobacco smoke
    Western Pacific Regional Office
    years of life lost from living with disability
    years of life lost from mortality