Global, Regional, and National Burden of COPD Attributable to Secondhand Smoke from 1990 to 2021: Findings from the Global Burden of Disease Study 2021.

Authors

Hang Su, Yuning Huang, Yanmei Lin, Wuping Bao, Yuchen Lin, Min Zhang

Published in

COPD. Volume 23. Issue 1. Pages 2657479. Apr 18, 2026. Epub Jun 25, 2026.

Abstract

Chronic obstructive pulmonary disease (COPD) is a leading global cause of death and disability, with a disproportionate burden in low- and middle-income countries. Secondhand smoke (SHS) contributes substantially to the COPD burden through toxic mechanisms. Current evidence on the COPD burden attributable to SHS remains limited.
Disability-adjusted life years (DALYs) were estimated using data from the Global Burden of Disease (GBD) 2021 study (1990-2021) by age, sex, and Socio-Demographic Index (SDI). Temporal trends were assessed using estimated annual percentage change, health inequality analyses were conducted across SDI groups, and projections were performed with Bayesian age-period-cohort models.
In 2021, 7.09% of global COPD DALYs were attributable to SHS, highest in Oceania and South Asia, lowest in Latin America and high-income Asia. From 1990 to 2021, the age-standardized DALY rate of COPD attributable to SHS declined in Europe, North America, Sub-Saharan Africa, and the Middle East, with pronounced reductions in both sexes. In Asia, Latin America, and the Caribbean, declines slowed, projected to rise after 2021. DALYs showed age- and sex-specific patterns, males higher in high- and low-SDI regions, females in others, peak burden at 70-74, varying across SDI levels. DALYs were negatively associated with SDI, with regional variations and persistent health inequalities, increasingly concentrated in higher-SDI regions.
The global COPD-SHS burden varies by socioeconomic status, geography, age, and sex. Despite overall declines, it remains high in Asia and North Africa, disproportionately affecting older adults and economically underdeveloped regions, highlighting the need for targeted interventions.

PMID:
42343700
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.

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