ORIGINAL RESEARCH article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1609230
This article is part of the Research TopicEmerging Global Population Health Risks: From Epidemiological Perspectives Volume IIView all 3 articles
Global, regional and national burden of lung cancer attributable to second-hand smoke from 1990 to 2021: a systematic analysis based on the global burden of disease study 2021
Provisionally accepted
Zheng Zhang1,2*
Xiao-Hui Zhang3
Rong Huang1,2Jia-Jia Fan1,2Xue-Jiao Ma1,2Zi-Han Jin2
Qin Wang1,2Yu-Long Li1,2Fei Su2*- 1Beijing University of Chinese Medicine, Beijing, China
- 2China-Japan Friendship Hospital, Beijing, Beijing Municipality, China
- 3China Press of Traditional Chinese Medicine Co.Ltd, Beijing, China
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Introduction: Second-hand smoke (SHS) exposure significantly contributes to lung cancer 14 development, yet its global burden remains poorly quantified. Method: Using data from the Global Burden of Disease Study 2021, we analyzed SHS-related lung cancer deaths, disability-adjusted life years (DALYs), and corresponding age-standardized rates (ASRs) across different regions and countries, stratified by gender, age, and Socio-Demographic Index (SDI). The estimated annual percentage changes (EAPCs) in the ASRs were calculated to determine the temporal trends spanning from 1990 to 2021. We also quantified the relationship between the SDI and the age-standardized rates of lung cancer caused by SHS. Results: In 2021, SHS accounted for approximately 0.10 million lung cancer deaths and 2.37 million DALYs worldwide, with a male-to-female mortality ratio of 1.38. The age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) manifested a trend of decline, with EAPC of -0.88 (95% UI: -0.94 to -0.82) and -1.25 (95% UI: -1.31 to -1. 19), respectively. The ASMR or ASDR peaked in middle and high-middle SDI regions, with a lower burden in other SDI regions. Nevertheless, the ASMR and ASDR in the high SDI region witnessed the most significant decline. Men bear a heavier burden of lung cancer attributable to SHS compared with women. The sexual disparity is more conspicuous among the elderly. Conclusion: During the past 32 years, the global burden of lung cancer attributable to SHS has revealed a downward tendency, concomitant with a decline in SHS exposure. The rise in absolute deaths and DALYs is driven by population growth and aging despite falling ASRs. Persistent epidemiological disparities across genders, age groups, and regions underscore the need for targeted interventions, particularly in middle and high-middle SDI settings.
Keywords: Second-hand smoke, lung cancer, Epidemiology disease burden, Mortality, Disability-adjusted life years
Received: 10 Apr 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Zhang, Zhang, Huang, Fan, Ma, Jin, Wang, Li and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zheng Zhang, Beijing University of Chinese Medicine, Beijing, China
Fei Su, China-Japan Friendship Hospital, Beijing, 100029, Beijing Municipality, China
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