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



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.


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.


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.


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.


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)


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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

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