Deaths from secondhand smoke exposure in the United States: economic implications

Am J Public Health. 2012 Nov;102(11):2173-80. doi: 10.2105/AJPH.2012.300805. Epub 2012 Sep 20.


Objectives: We estimated the number of deaths attributable to secondhand smoke (SHS), years of potential life lost (YPLL), and value of lost productivity for different US racial/ethnic groups in 2006.

Methods: We determined the number of SHS-related deaths among nonsmokers from 2 adult and 4 infant conditions using an epidemiological approach. We estimated adult SHS exposure using detectable serum cotinine. For each death, we determined the YPLL and the value of lost productivity. Results. SHS exposure resulted in more than 42 000 deaths: more than 41 000 adults and nearly 900 infants. Blacks accounted for 13% of all deaths but 24% to 36% of infant deaths. SHS-attributable deaths resulted in a loss of nearly 600 000 YPLL and $6.6 billion of lost productivity, or $158 000 per death. The value of lost productivity per death was highest among Blacks ($238 000) and Hispanics ($193 000).

Conclusions: The economic toll of SHS exposure is substantial, with communities of color having the greatest losses. Interventions need to be designed to reduce the health and economic burden of smoking on smokers and nonsmokers alike and on particularly vulnerable groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cotinine / blood
  • Female
  • Humans
  • Infant
  • Life Expectancy
  • Male
  • Middle Aged
  • Mortality*
  • Prevalence
  • Racial Groups / statistics & numerical data
  • Risk
  • Sex Factors
  • Smoking / mortality
  • Tobacco Smoke Pollution / economics
  • Tobacco Smoke Pollution / statistics & numerical data*
  • United States / epidemiology
  • Young Adult


  • Tobacco Smoke Pollution
  • Cotinine