Burden of respiratory disease attributable to secondhand smoke exposure at home in children in Spain (2015)

Prev Med. 2019 Jun;123:34-40. doi: 10.1016/j.ypmed.2019.02.028. Epub 2019 Feb 25.


This study aimed to estimate the number of incident cases and hospital admissions attributable to secondhand smoke (SHS) exposure at home for asthma, otitis media (OM), and lower respiratory infections (LRI) in children in Spain. The burden of respiratory disease caused by SHS exposure was estimated in terms of incident cases and hospitalized cases for asthma, OM, and LRI. Estimates were calculated using the population attributable fraction. The age-specific (0-1 year, 0-4 years, 5-11 years, and 0-11 years) prevalence of SHS exposure in children was estimated through a telephone survey performed in a representative sample of Spanish households with children in 2016. The risk estimates for all diseases were selected from international meta-analyses. The number of hospitalized cases was obtained for each disease from the Hospital Minimum Data Set provided by the Ministry of Health of Spain. Incident cases were obtained from the Global Health Data Exchange. In 2015, SHS exposure caused an estimated total of 136,403 incident cases of the following respiratory diseases: 9058 (8.5%) cases of asthma, 120,248 (8.5%) of OM, and 7097 (13.5%) of LRI in children aged 0-14 years old in Spain. Likewise, SHS exposure caused a total of 3028 hospitalized cases, with 379 (8.5%) for asthma and 167 (8.5%) for OM in children 0-11 years old, and 2482 (11.6%) for LRI in children <2 years old. The high burden of respiratory disease attributed to SHS exposure supports the need to improve protection of children against SHS exposure by extending smoke-free regulations to homes and cars.

Keywords: Child; Hospitalization; Morbidity; Respiratory tract diseases; Tobacco smoke pollution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Asthma / chemically induced*
  • Asthma / epidemiology*
  • Child
  • Child, Preschool
  • Environmental Exposure / adverse effects
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Otitis Media / chemically induced*
  • Otitis Media / epidemiology*
  • Prevalence
  • Respiratory Tract Infections / chemically induced*
  • Respiratory Tract Infections / epidemiology*
  • Spain / epidemiology
  • Surveys and Questionnaires
  • Tobacco Smoke Pollution / adverse effects*


  • Tobacco Smoke Pollution