Global disease burden analysis of Cardiometabolic disease attributable to second-hand smoke exposure from 1990 to 2040

Objective: Secondhand smoke (SHS) is a strong but comparatively controllable cardiometabolic risk factor. This study aims to assess the present and future burden of cardiometabolic diseases (CMDs) from SHS exposure. Methods: Using the Global Burden of Disease (GBD) framework, we examined mortality and disability-adjusted life year (DALY) from CMDs attributable to SHS, by age, sex, and year, including cardiovascular disease [CVD, ischemic heart disease (IHD) and/or stroke], and/or Type 2 Diabetes Mellitus (T2DM) from 1990 to 2019. The predicted death number and age-standardized mortality rate (ASMR) from 2020 to 2040 were estimated by the Bayesian age-period cohort (BAPC) model. Results: SHS exposure declined until 2016 but stabilized or increased thereafter. From 1990 to 2019, CMD-related deaths and DALYs due to SHS are continuously increasing, particularly in low-middle and middle Sociodemographic Index (SDI) regions. In 2019, a significant proportion of CMD-related deaths and DALYs among females under 65 were attributed to SHS exposure. In females aged 25-29, SHS contributed to 16.12 % and 13.30 % of IHD and T2DM deaths, respectively. Surprisingly, forecasts show that annual deaths from IHD, stroke, and T2DM related to SHS exposure are anticipated to rise over the next 20 years. Conclusions: SHS exposure has stopped declining in recent years. CMD-related deaths from controlled SHS have increased and are predicted to rise substantially over the next 20 years. Reducing SHS exposure could have major benefits for cardiometabolic health worldwide, especially for women under 65 years in less developed regions.