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Passive smoking and associated causes of death in adults in Scotland

Executive Summary

Executive Summary

• Estimates of the numbers of deaths among adults in Scotland caused by exposure to environmental tobacco smoke (ETS) have been calculated using local data on the distribution of exposure categories where possible and international estimates of the level of risk posed.

• Four major disease categories have been considered as they are the causes of death most strongly related to smoking and unsurprisingly are the main causes of death in Scotland : lung cancer, ischaemic heart disease (IHD), stroke and respiratory disease.

• The objective of the report is to estimate how much past ETS exposure impacts on current levels of these four causes of death in Scotland.

• As most available data relate to the impact of ETS exposure on lifelong non-smokers, estimates have been made specifically for this sub-group of individuals.

• ETS exposure is associated with 865 deaths per year in Scotland among lifelong non-smokers from the four main causes listed.

• Individually, this divides into 395 IHD deaths, 335 stroke deaths, 91 respiratory death and 44 lung cancer deaths.

• Over 75% of the ETS-related deaths occur amongst women.

• Including other diseases known to be related to smoking, up to 1000 deaths per year might be attributed to ETS exposure among lifelong non-smokers.

• Whilst it is extremely difficult to quantify the risk of ETS exposure to ex-smokers as no reliable information exists, there would appear to be as many ex-smoking men and women exposed to ETS as there are lifelong non-smokers. It would not be unreasonable to assume that they are at similar risk after a suitable latent period and that the numbers of ETS related deaths would be similar to that seen for lifelong non-smokers.

• This would imply that some 1500 to 2000 deaths per year in Scotland are related to ETS exposure among non-smokers (lifelong or quitters).

• Passive smoking represents the greatest risk to public health when compared to other forms of 'involuntary' environmental exposure.

• A ban on smoking in the workplace might be considered to be capable of reducing the number of ETS-related deaths by however much it reduces the total ETS exposure in individuals (e.g. 50% reduction in total ETS exposure might lead to a 50% reduction in ETS related deaths).
  
• It should be recognised that there is a substantial benefit to be gained from such a ban in terms of the impact it would have on active smoking rates. A modest reduction in active smoking rates would have major benefits in terms of reducing numbers of deaths among the Scottish population generally.