Mortality attributable to secondhand smoke exposure in the autonomous communities of Spain

INTRODUCTION AND OBJECTIVES

Exposure to secondhand smoke (SHS) causes cardiovascular disease, respiratory disease, and cancer. The aim of this study was to estimate the mortality attributed to SHS in people aged ≥ 35 years in Spain and its autonomous communities (AC) by sex from 2016 to 2021.

METHODS

Estimates of SHS-attributable mortality were calculated by applying the prevalence-dependent method where SHS exposure was derived from the adjustment of small-area models and based on the calculation of population-attributed fractions. Sex, age group, AC, and cause of death (ischemic heart disease and lung cancer) were included. The estimates of attributed mortality are presented with their 95% confidence interval (95%CI). Crude and age-standardized rates were estimated for each sex and AC.

RESULTS

From 2016 to 2021, SHS exposure caused 4,970 (95%CI, 4,787-5,387) deaths, representing 1.6% of total mortality for ischemic heart disease and lung cancer. The burden of attributed mortality differed widely among the AC, with Andalusia having the highest burden of attributed mortality (crude rate: 46.6 deaths per 100 000 population in men and 17.0/100 000 in women). In all the AC, the main cause of death in both sexes was ischemic heart disease. The highest burden of mortality was observed in nonsmokers.

CONCLUSIONS

The burden of SHS-attributable mortality was high and varied geographically. The results of this study should be considered to advance tobacco control legislation in Spain.

[Impact of the Spanish smoking laws on the exposure to environmental tobacco smoke in Galicia (2005-2011)]

OBJECTIVE

Prevalence of exposure to environmental tobacco smoke is a valuable index to assess the impact of the laws for tobacco control. The objective of this work is to analyse variations in the prevalence of exposure to environmental tobacco smoke in Galicia (Spain) between 2005, before the Law 28/2005, and 2011, after the law 42/2010.

METHODS

Data were obtained from five population-based independent cross-sectional studies, telephone surveys, developed in Galicia between 2005 and 2011 among population aged 16 to 74 (n=34.419). Self-reported exposure among population aged between 16 and 74 was analysed by setting and tobacco consumption by prevalence with 95% confidence intervals.

RESULTS

Environmental tobacco smoke exposure decreased dramatically in Galicia between 2005 and 2011. In 2005, before the Law 28/2005, 95% of the population reported exposure to environmental tobacco smoke compared to 28% in 2011, after the Law 42/2010. Decrease was greater in workplaces in 2006 and in leisure time venues in 2011. After an initial decrease in 2006, exposure at home remains unchanged.

CONCLUSIONS

An important reduction in self-reported exposure to environmental tobacco smoke occurred in Galicia in the period 2005-2011, specially after the introduction of Laws 28/2005 and 42/2010. Nevertheless, one in four of the population aged 16 to 74 remained exposed in 2011.