Advertisement

International Journal of Public Health

, Volume 63, Issue 3, pp 367–375 | Cite as

Estimating lung cancer mortality attributable to second hand smoke exposure in Germany

  • Heiko Becher
  • Matthias Belau
  • Volker Winkler
  • Annette Aigner
Original Article

Abstract

Objectives

Public health measures such as nonsmoker protection laws affect smoking prevalence and consequently the number of lung cancer deaths attributable to second hand smoke (SHS). In Germany, a risk assessment of SHS has been performed in 1994 only, and therefore, a reassessment is of interest.

Methods

Based on current knowledge on the relative risk of lung cancer from SHS, SHS prevalence, lung cancer deaths in Germany, and two approaches to estimate the number of never smokers among lung cancer deaths, we estimated the current number of deaths attributable to SHS among never smokers in Germany.

Results

Based on a relative risk of 1.21 (95% CI 1.14–1.28), recent prevalence of SHS of 39.5% for men and 23.5% for women, the attributable risks are 7.66 and 4.70%, respectively. Out of about 47,000 lung cancer deaths per year, the estimated number of never smokers is about 6000, out of which we estimated 167 being attributable to SHS.

Conclusions

Despite an aging population, the number of deaths from lung cancer attributable to SHS decreased considerably. This positive trend should be strengthened by further public health measures.

Keywords

Lung cancer Second hand smoke Passive smoking Estimation Germany 

Supplementary material

38_2017_1022_MOESM1_ESM.docx (24 kb)
Supplementary material 1 (DOCX 25 kb)

References

  1. Augustin R, Metz K, Heppenkausen K, Kraus L (2005) Tobacco use, dependency and readiness to change. Results of the 2003 Epidemiological Survey of Substance Abuse. Sucht 51:40–48CrossRefGoogle Scholar
  2. Baumeister SE, Kraus L, Stonner TK, Metz K (2008) Tobacco use, nicotine dependence and trends. Results of the 2006 Epidemiological Survey of Substance Abuse. Sucht 54:26–35CrossRefGoogle Scholar
  3. Becher H, Wahrendorf J (1994) Passivrauchen und Lungenkrebsrisiko. Dtsch Arztebl 91:A-3352–A-3358Google Scholar
  4. Becher H, Jahn I, Jöckel K (1987) Passivrauchen als Gesundheitsrisiko. Der Minister für Arbeit, Gesundheit und Soziales des Landes Nordrhein-Westfalen, HerfordGoogle Scholar
  5. Boffetta P (2002) Involuntary smoking and lung cancer. Scand J Work Environ Health 28(Suppl 2):30–40PubMedGoogle Scholar
  6. European Commission (2017) Press release. Tobacco in the EU: Exposure to second hand smoke reduced, but still too high, says Commission report. http://europa.eu/rapid/press-release_IP-13-147_en.htm. Accessed 26 Jun 2017
  7. European Commission’s Directorate for public health and risk assessment (2017) Tobacco. Smoke-free environments. https://ec.europa.eu/health/tobacco/smoke-free_environments_en. Accessed 26 Jun 2017
  8. Florescu A, Ferrence R, Einarson T, Selby P, Soldin O, Koren G (2009) Methods for quantification of exposure to cigarette smoking and environmental tobacco smoke: focus on developmental toxicology. Ther Drug Monit 31:14–30CrossRefPubMedPubMedCentralGoogle Scholar
  9. Gandini S, Botteri E, Iodice S, Boniol M, Lowenfels AB, Maisonneuve P, Boyle P (2008) Tobacco smoking and cancer: a meta-analysis. Int J Cancer 122:155–164CrossRefPubMedGoogle Scholar
  10. German Cancer Research Center (DKFZ) (2016) Atlas of cancer mortality. Lung cancer—secular trend of mortality and age-specific mortality rates. http://www.dkfz.de. Accessed 09 Aug 2016
  11. Gosswald A, Lange M, Dolle R, Holling H (2013) The first wave of the German Health Interview and Examination Survey for Adults (DEGS1): participant recruitment, fieldwork, and quality management Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 56:611–619Google Scholar
  12. Hackshaw AK, Law MR, Wald NJ (1997) The accumulated evidence on lung cancer and environmental tobacco smoke. BMJ 315:980–988CrossRefPubMedPubMedCentralGoogle Scholar
  13. International Agency for Research on Cancer (2004) Tobacco smoke and involuntary smoking. IARC Monographs on the evaluation of the carcinogenic risks to humans, vol 83. LyonGoogle Scholar
  14. Jöckel KH (1991) Passivrauchen—Bewertung der epidemiologischen Befunde VDI Verlag 888:517–535Google Scholar
  15. Kamtsiuris P, Lange M, Hoffmann R, Schaffrath Rosario A, Dahm S, Kuhnert R, Kurth BM (2013) The first wave of the German Health Interview and Examination Survey for Adults (DEGS1): sample design, response, weighting and representativeness Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 56:620–630Google Scholar
  16. Kim CH et al (2014) Exposure to secondhand tobacco smoke and lung cancer by histological type: a pooled analysis of the International Lung Cancer Consortium (ILCCO). Int J Cancer 135:1918–1930CrossRefPubMedPubMedCentralGoogle Scholar
  17. Kraus L, Augustin R (2005) Design and methodology of the 2003 epidemiological survey of substance abuse. Sucht 51:6–18CrossRefGoogle Scholar
  18. Kraus L, Baumeister SE (2008) Study design and methodology of the 2006 epidemiological survey on substance abuse. Sucht 54:6–15CrossRefGoogle Scholar
  19. Kreuzer M, Jöckel KH, Wichmann HE, Straif K (2006) Active smoking, passive smoking and cancer. Curr Stud Germany Contrib New IARC Monogr Onkol 11:1094–1105Google Scholar
  20. Kuntz B, Lampert T (2016) Smoking and passive smoke exposure among adolescents in Germany—prevalence, trends over time, and differences between social groups. Dtsch Arztebl Int 113:23–30PubMedPubMedCentralGoogle Scholar
  21. Lee PN, Forey BA (2013) Indirectly estimated absolute lung cancer mortality rates by smoking status and histological type based on a systematic review. BMC Cancer 13:189CrossRefPubMedPubMedCentralGoogle Scholar
  22. Riboli E et al (1990) Exposure of nonsmoking women to environmental tobacco smoke: a 10-country collaborative study. Cancer Causes Control 1:243–252CrossRefPubMedGoogle Scholar
  23. Robert Koch-Institute, Association of Population-based Cancer Registries in Germany (GEKID) (2013) Cancer in Germany 2009/2010, 9 edn, BerlinGoogle Scholar
  24. Robert Koch-Institute, Department of Epidemiology and Health Monitoring (2015) German Health Interview and Examination Survey for Adults (DEGS1). Public Use File first Version. doi: 10.7797/16-200812-1-1-1
  25. Rowell TR, Tarran R (2015) Will chronic e-cigarette use cause lung disease? Am J Physiol Lung Cell Mol Physiol 309:L1398–L1409CrossRefPubMedPubMedCentralGoogle Scholar
  26. Saracci R, Riboli E (1989) Passive smoking and lung cancer: current evidence and ongoing studies at the International Agency for Research on Cancer. Mutat Res 222:117–127CrossRefPubMedGoogle Scholar
  27. Schulze A, Lampert T (eds) (2006) Bundesgesundheits-Survey: Soziale Unterschiede im Rauchverhalten und in der Passivrauchbelastung in Deutschland. Beiträge zur Gesundheitsberichterstattung des Bundes. Robert Koch-Institut, BerlinGoogle Scholar
  28. Statistisches Bundesamt (1993–2014) Statistische Jahrbücher 1993–2014 für die Bundesrepublik Deutschland. WiesbadenGoogle Scholar
  29. Statistisches Bundesamt (2015) Statistisches Jahrbuch 2015 Deutschland und Internationales. WiesbadenGoogle Scholar
  30. Trichopoulos D, Kalandidi A, Sparros L, MacMahon B (1981) Lung cancer and passive smoking. Int J Cancer 27:1–4CrossRefPubMedGoogle Scholar
  31. US Department of Health and Human Services (2006) The Health Consequences of Involuntary Exposure to Tobacco Smoke. A Report of the Surgeon General. US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, AtlantaGoogle Scholar
  32. Wald NJ, Nanchahal K, Thompson SG, Cuckle HS (1986) Does breathing other people’s tobacco smoke cause lung cancer? Br Med J 293:1217–1222CrossRefGoogle Scholar
  33. Winkler V, Ng N, Tesfaye F, Becher H (2011) Predicting lung cancer deaths from smoking prevalence data. Lung Cancer 74:170–177CrossRefPubMedGoogle Scholar
  34. Zhong L, Goldberg MS, Parent ME, Hanley JA (2000) Exposure to environmental tobacco smoke and the risk of lung cancer: a meta-analysis. Lung Cancer 27:3–18CrossRefPubMedGoogle Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2017

Authors and Affiliations

  • Heiko Becher
    • 1
  • Matthias Belau
    • 2
  • Volker Winkler
    • 3
  • Annette Aigner
    • 1
  1. 1.Institute of Medical Biometry and EpidemiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Faculty of Health ScienceUniversity of BielefeldBielefeldGermany
  3. 3.Institute of Public HealthUniversity Hospital HeidelbergHeidelbergGermany

Personalised recommendations