title: Mortality Attributable to Secondhand Smoke Exposure in Spain (2011).
abstract: BACKGROUND
  The objective of this study was to assess the mortality attributable to secondhand smoke (SHS) exposure among never-smokers in Spain in 2011, after the implementation of the Spanish smoking law.
  
  
  METHODS
  Data on SHS exposure were obtained from a computer-assisted telephone survey carried out in a representative sample of the adult Spanish population. We included the two main diseases widely associated with SHS exposure: lung cancer and ischaemic heart disease. The relative risks for these diseases were selected from previously published meta-analyses. The number of deaths attributable to SHS was calculated by applying the population attributable fraction to mortality not attributable to active smoking in 2011. The analyses were stratified by sex, age and setting of exposure (home, workplace, and both combined). In addition, a sensitivity analysis was performed for distinct scenarios.
  
  
  RESULTS
  In 2011, a total of 586 deaths in men and 442 deaths in women would be attributable to SHS exposure. The total number of deaths from lung cancer attributable to SHS exposure would be 124, while the total number of deaths from ischaemic heart disease would be 904. The inclusion of ex-smokers or SHS exposure in leisure time in the study would considerably increase the total number of attributable deaths (by 20% and 130%, respectively).
  
  
  CONCLUSIONS
  The total number of deaths attributable to SHS exposure at home and at work in Spain would be 1028 in 2011. Efforts are still needed to reduce the current prevalence of exposure-mainly due to exposure in nonregulated settings such as homes or cars and some outdoor spaces-and the associated morbidity and mortality.
authors.affiliation: Evaluation and Intervention Methods Service, Agència de Salut Pública de Barcelona, Barcelona, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain; mjlopez@aspb.cat.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: López
authors.affiliation: Epidemiology Unit, Galician Directorate for Public Health, Galician Health Authority, Xunta de Galicia, Santiago de Compostela, Galicia, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Santiago de Compostela, A Coruña, Spain;
authors.forename: Mónica
authors.initials: M
authors.lastname: Pérez-Ríos
authors.affiliation: Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat (Barcelona), Barcelona, Spain;
authors.forename: Anna
authors.initials: A
authors.lastname: Schiaffino
authors.affiliation: Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat (Barcelona), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, L'Hospitalet del Llobregat (Barcelona), Barcelona, Spain.
authors.forename: Esteve
authors.initials: E
authors.lastname: Fernández
mesh_terms: D000328:Adult; D000368:Aged; D001336:Automobiles; D002423:Cause of Death; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000401:mortality*; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D017132:Workplace
chemical_list: D014028:Tobacco Smoke Pollution