SmokeHaz: Systematic Reviews and Meta-analyses of the Effects of Smoking on Respiratory Health

Chest. 2016 Jul;150(1):164-79. doi: 10.1016/j.chest.2016.03.060. Epub 2016 Apr 19.


Background: Smoking tobacco increases the risk of respiratory disease in adults and children, but communicating the magnitude of these effects in a scientific manner that is accessible and usable by the public and policymakers presents a challenge. We have therefore summarized scientific data on the impact of smoking on respiratory diseases to provide the content for a unique resource, SmokeHaz.

Methods: We conducted systematic reviews and meta-analyses of longitudinal studies (published to 2013) identified from electronic databases, gray literature, and experts. Random effect meta-analyses were used to pool the findings.

Results: We included 216 articles. Among adult smokers, we confirmed substantially increased risks of lung cancer (risk ratio (RR), 10.92; 95% CI, 8.28-14.40; 34 studies), COPD (RR, 4.01; 95% CI, 3.18-5.05; 22 studies), and asthma (RR, 1.61; 95% CI, 1.07-2.42; eight studies). Exposure to passive smoke significantly increased the risk of lung cancer in adult nonsmokers and increased the risks of asthma, wheeze, lower respiratory infections, and reduced lung function in children. Smoking significantly increased the risk of sleep apnea and asthma exacerbations in adult and pregnant populations, and active and passive smoking increased the risk of tuberculosis.

Conclusions: These findings have been translated into easily digestible content and published on the SmokeHaz website.

Keywords: health risks; lung diseases; meta-analysis; passive smoking; policymakers; public awareness; respiratory diseases; smoking; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Public Health
  • Respiratory Tract Diseases* / epidemiology
  • Respiratory Tract Diseases* / psychology
  • Risk Factors
  • Smoking* / adverse effects
  • Smoking* / epidemiology