Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study

P Yin MSc a, Prof CQ Jiang MD b c, Prof KK Cheng PhD email address a Corresponding Author Information, Prof TH Lam MD d, KH Lam MPhil a, MR Miller MD e, WS Zhang PhD b, GN Thomas PhD d and P Adab MD a
a. Department of Public Health and Epidemiology, University of Birmingham, UK b. Guangzhou Number 12 People's Hospital, Guangzhou, China c. Guangzhou Medical College, Guangzhou, China d. School of Public Health, Department of Community Medicine, University of Hong Kong, Hong Kong, SAR China e. University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
The Lancet 2007; 370:751-757


Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in China, where the population is also exposed to high levels of passive smoking, yet little information exists on the effects of such exposure on COPD. We examined the relation between passive smoking and COPD and respiratory symptoms in an adult Chinese population.


We used baseline data from the Guangzhou Biobank Cohort Study. Of 20.430 men and women over the age of 50 recruited in 2003–06, 15.379 never smokers (6497 with valid spirometry) were included in this cross-sectional analysis. We measured passive smoking exposure at home and work by two self-reported measures (density and duration of exposure). Diagnosis of COPD was based on spirometry and defined according to the GOLD guidelines.


There was an association between risk of COPD and self-reported exposure to passive smoking at home and work (adjusted odds ratio 1.48, 95% CI 1.18–1.85 for high level exposure; equivalent to 40 h a week for more than 5 years). There were significant associations between reported respiratory symptoms and increasing passive smoking exposure (1.16, 1.07–1.25 for any symptom). Interpretation

Exposure to passive smoking is associated with an increased prevalence of COPD and respiratory symptoms. If this association is causal, we estimate that 1.9 million excess deaths from COPD among never smokers could be attributable to passive smoking in the current population in China. Our findings provide strong evidence for urgent measures against passive smoking in China.




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