Health and second-hand smoke

This section presents statistics on selected health conditions that can be caused by exposure to second-hand smoke exposure. These conditions include sudden unexpected death in infancy (SUDI), asthma, bronchiolitis, pneumonia and middle ear infections. 

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Second-hand smoke and health
Burden of disease from second-hand smoke
SUDI (sudden unexpected death in infancy)
Asthma
Bronchiolitis
Pneumonia
Middle ear infections (otitis media)

Second-hand smoke and health

Second-hand smoke refers to the smoke breathed out by the smoker, and the smoke coming from the cigarette. When someone smokes in a confined area (such as in the home or car), it puts everyone’s health at risk. 

In infants and children, second-hand smoke increases the risk of [1]:

  • sudden unexpected death in infancy (SUDI)
  • asthma
  • lower respiratory tract infections
  • middle ear infections (otitis media)
  • low birth weight.

In non-smoking adults, second-hand smoke increases the risk of:

  • ischaemic heart disease
  • stroke
  • lung cancer.

Burden of disease from second-hand smoke

An estimated 104 people died from second-hand smoke exposure in New Zealand in 2010 [2].  

 About 1989 healthy years of life (DALYs) were lost due to second-hand smoke in 2010. Most of the health loss (84%) was due to premature death.

 Children and Māori were disproportionately affected by second-hand smoke exposure. Māori experienced five times as much health loss from second-hand smoke exposure as non-Māori in 2006.  

SUDI (sudden unexpected death in infancy)

Sudden Unexpected Death in Infancy (SUDI) is a term used to describe infants under one year of age who die without warning signs. SUDI is also known as cot death and SIDS (sudden infant death syndrome).

Second-hand smoke and having a mother who smokes are key risk factors for SUDI. Other risk factors include sleeping the infant on its side or tummy, and the infant bed-sharing with parents.   

  • The number of infants dying from SUDI has decreased over the past decade in New Zealand.
  • In 2010, 59 babies died of SUDI, compared with 84 in 2000 [3]. Part of this decrease is due to increased public awareness of sleeping infants on their backs and not bed-sharing with infants [4]. 
  • In 2009, SIDS rates were highest for younger mothers, Māori and mothers living in the most deprived areas (NZDep quintile 5) [5].

Asthma

Second-hand smoke exposure, and indoor dampness and mould, are among a number of asthma triggers. 

  • In 2012/13, 15 percent of children took medication for asthma (111,000 children aged 2–14 years), according to the New Zealand Health Survey [6]. Rates had not changed significantly since 2006/07.  Taking medication for asthma was more common among Māori children.
  • In 2006–2010 there were about 4,800 hospital admissions for asthma annually in children under 15 years (a rate of 6 per 1000) [7].
  • The hospital admission rate for asthma gradually increased between 2000 and 2010.
  • In 2006–2010, hospital admission rates for asthma were higher among children aged 1–3 years, Māori and Pacific children, and children living in more deprived areas.
  • On average, 5 children or young people die each year in New Zealand as a result of asthma.

Bronchiolitis

Bronchiolitis is a common lower respiratory tract infection in infants, mostly caused by the Respiratory Syncytial Virus (RSV). Second-hand smoke increases the risk of lower respiratory tract infections like bronchiolitis.

  • In infants under 1 year, there were about 4,800 hospital admissions and 1 death each year for bronchiolitis [7].
  • In 2006–2010, hospitalisation rates for bronchiolitis were much higher than the national rate (75 per 1000) in Pacific infants (169 per 1000), Māori infants (115 per 1000), and infants living in the most deprived decile (163 per 1000).

Pneumonia

Pneumonia is an inflammation of the air sacs (alveoli) in the lungs. Second-hand smoke increases the risk of lower respiratory tract infections like pneumonia.

  • On average, there were 3,400 hospital admissions for pneumonia each year in children aged 0–14 years (a rate of 4 per 1000) [7].
  • Trends from 2000 to 2010 showed a gradual decline in pneumonia hospital admission rates in New Zealand children.
  • Children aged 0–2 years had the highest hospitalisation rates for pneumonia.
  • Rates were twice as high among Māori children, and over four times as high among Pacific children, as in European children.
  • Rates were three times as high in more deprived areas than in less deprived areas.
  • Each year, 10–11 children or young people die from pneumonia.

Middle ear infections (otitis media)

Middle ear infections (otitis media) in children can be caused by second-hand smoke exposure. Children may be admitted to hospital for acute (unplanned) visit, or for planned (arranged / waiting list) visits for surgery to insert a grommet. Most children with acute otitis media don’t need hospital admission. 

  • From 2006–10, there was an average of 536 acute hospital admissions for otitis media each year (a rate of 0.60 per 1000 children) [7].
  • The rates of acute hospital admissions for otitis media were relatively stable from 2004–05 to 2010.
  • Acute hospital admissions for otitis media were more common among Māori and Pacific children, and children living in the most deprived areas.

Grommets can be surgically inserted to treat chronic otitis media with effusion.

  • In 2006–10, there was an average of 5011 hospital admissions for grommets each year (a rate of 5.6 admissions per 1000 children).
  • Trends from 2000 to 2010 showed fewer children were admitted to hospital for grommets over time.

References

1. US Department of Health and Human Services. 2014. The Health Consequences of Smoking – 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

2. Mason, K.M. (2016). The Burden of Disease from Second-hand Smoke in New Zealand. Wellington: Environmental Health Indicators Programme, Massey University. 

3. Ministry of Health. 2013. Fetal and Infant Deaths 2010 tables. Wellington: Ministry of Health.

4. Mitchell EA, Blair PS. 2012. SIDS prevention: 3000 lives saved but we can do better. New Zealand Medical Journal 125: 1359. 

5. Ministry of Health. 2012. Fetal and Infant Deaths 2008 and 2009. Wellington: Ministry of Health.

6. Ministry of Health. 2013. New Zealand Health Survey: Annual update of key findings 2012/13. Wellington: Ministry of Health.

7. Craig E, Adams J, Oben G, Reddington A, Wicken A, Simpson J. 2013. The Health Status of Children and Young People in New Zealand. Dunedin: Dunedin School of Medicine, University of Otago. Available online: http://dnmeds.otago.ac.nz/departments/womens/paediatrics/research/nzcyes/nz_reports.html