Secondhand Smoke Exposure and the Risk of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Abstract

Background

Many studies have shown that active smoking leads to an increasing incidence of chronic obstructive pulmonary disease (COPD). However, studies interested in the effects of secondhand smoke exposure (SHS exposure) on COPD were less or underappreciated.

Methods

A systematic review and meta-analysis was conducted to investigate the association between SHS exposure and the risk of COPD. Three databases (PubMed, Embase and Web of Science) were searched to obtain data. After assessing the study quality, stratified analyses were performed according to the region, gender, and duration of exposure. Cochran’s Q and I² were utilized for heterogeneity assessment. To assess publication bias, we used a funnel plot and Egger’s test.

Results

A total of 15 studies (6 cross-sectional studies, 6 case-control studies, and 3 cohort studies) with 25,592 participants were involved in this meta-analysis. This study showed that SHS exposure was associated with an increased risk of COPD (odds ratio (OR): 2.25, 95% CI: 1.40–3.62, I² = 98%, p < 0.01 for heterogeneity based on a random-effects analysis model), especially in those with a longer time exposure of more than 5 years was 4.38 (95% CI: 1.28–15.00, I² = 89%, p < 0.01 for heterogeneity based on a random-effects analysis model). In addition, SHS exposure also increases the risk of COPD in women (odds ratio (OR): 2.02, 95% CI: 1.52–2.67, I² = 0%, p = 0.89 for heterogeneity based on a random-effects analysis model).

Conclusion

The findings suggest that SHS exposure is associated with the risk of COPD, especially for individuals with a long time exposed.

Trial Registry

Prospero CRD42022329421.

Keywords:

• COPD
• secondhand smoke exposure
• systemic review
• meta-analysis

Abbreviations

COPD, chronic obstructive pulmonary disease; SHS, Secondhand smoke.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors declare no competing interests in this work.

Additional information

Funding

Zhejiang Province and Province jointly established key disciplines of medicine (2022-S01).