Stroke mortality and morbidity attributable to passive smoking in Germany.
BACKGROUND
Passive smoking is an established risk factor for coronary heart disease (CHD). Epidemiological studies suggest that passive smoking may also be associated with an increased risk of stroke. We estimate the burden of stroke due to passive smoking in Germany.


METHODS
Frequency of passive smoking was derived from the German national health survey. Nonsmokers who reported exposure to environmental tobacco smoke (ETS) at home were considered for analyses. The relative risk for stroke and passive smoking was derived by means of a meta-analysis from available cohort studies. We computed attributable risks for passive smoking and used data from official statistics to estimate stroke mortality due to ETS. Attributable stroke morbidity was calculated using the WHO-Global-Burden-of-Disease approach.


RESULTS
Passive smoking may account for 774 stroke-related deaths and 1837 incident first ever strokes in Germany every year. More strokes owing to passive smoking occur among women (1248) than among men (589). The majority of strokes attributable to ETS happen at the age of 65-84 years.


CONCLUSIONS
ETS is a common exposure and stroke is a frequent disease. Though the relative risk of passive smoking on stroke mortality and morbidity is small, the impact on population health is substantial.
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Peter U
PU
Heuschmann
Jan
J
Heidrich
Jürgen
J
Wellmann
Klaus
K
Kraywinkel
Ulrich
U
Keil
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D015996:Survival Rate / Q000639:trends; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data
D014028:Tobacco Smoke Pollution