Second-hand smoke is emerging as a major public health concern in India. A new study reveals that deaths linked to passive smoking have increased by nearly 50% since 1990. According to a study published in The Lancet Public Health, an estimated 3,25,600 people in India died due to exposure to second-hand smoke in 2023, compared with about 2,17,700 deaths in 1990. This increase highlights the serious health risks faced by people who do not smoke but regularly breathe in tobacco smoke from others.

The report also found that India had the world's second-highest number of people exposed to second-hand smoke in 2023, after China. Around 444 million Indians were estimated to have been exposed to tobacco smoke from other people. Globally, about 2.71 billion people were exposed to second-hand smoke in 2023, including around 767 million children. These numbers show that passive smoking is not simply an issue affecting smokers, it can also expose families and communities to harmful substances and increase the risk of serious diseases.

What Is Second-Hand Smoke?

Second-hand smoke is the smoke a person breathes in from another person's cigarette, bidi, cigar or other tobacco product. It can come directly from the burning tobacco or from smoke exhaled by the person who is smoking. Unlike active smokers, people exposed to second-hand smoke have no control over how much smoke they inhale. Exposure can happen at home, in workplaces, restaurants, public spaces or other areas where smoking occurs.

The danger comes from the toxic chemicals present in tobacco smoke. Regular exposure can affect the lungs, heart and blood vessels and may contribute to serious diseases over time.

Why Have Deaths Increased?

One important finding of the study is that the rise in deaths occurred even though the proportion of people exposed to second-hand smoke has declined over the past three decades. Researchers estimate that the age-standardised prevalence of exposure in India fell from 43.2 per cent in 1990 to 30.6 per cent in 2023. However, population growth meant that the number of people exposed increased from about 375 million to 444 million. This means that a smaller percentage of the population can still represent a very large number of people when the overall population increases.

The number of deaths increased among both men and women. Deaths among women rose from about 1,13,400 in 1990 to 1,56,900 in 2023, while deaths among men increased from around 104,300 to 168,700.

How Can Passive Smoking Affect Health?

Second-hand smoke can damage the cardiovascular and respiratory systems. Long-term exposure has been linked with an increased risk of heart disease, stroke, chronic respiratory diseases and lung cancer. The effects are particularly concerning for people who already have health problems. Regular exposure can worsen breathing difficulties and may increase the risk of complications in people with existing lung or heart conditions.

Children can also be especially vulnerable. Their lungs and immune systems are still developing, and exposure to tobacco smoke can increase the risk of respiratory infections and other breathing problems. The global study estimated that millions of children were exposed to second-hand smoke in 2023. Pregnant women exposed to tobacco smoke may also face health risks.

How Can Second-Hand Smoke Be Prevented?

The most effective way to prevent exposure is to avoid smoking around other people. Homes and cars should be completely smoke-free, particularly when children, pregnant women or older adults are present.

People who smoke can also seek professional help to quit. Healthcare professionals and tobacco-cessation programmes can provide guidance, counselling and, when appropriate, medicines that can make quitting easier.

Stronger enforcement of smoke-free public places and greater awareness about the dangers of passive smoking can also help reduce exposure.

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