SmokeHaz: Systematic Reviews and Meta-analyses of the Effects of Smoking on Respiratory Health.
BACKGROUND
Smoking tobacco increases the risk of respiratory disease in adults and children, but communicating the magnitude of these effects in a scientific manner that is accessible and usable by the public and policymakers presents a challenge. We have therefore summarized scientific data on the impact of smoking on respiratory diseases to provide the content for a unique resource, SmokeHaz.


METHODS
We conducted systematic reviews and meta-analyses of longitudinal studies (published to 2013) identified from electronic databases, gray literature, and experts. Random effect meta-analyses were used to pool the findings.


RESULTS
We included 216 articles. Among adult smokers, we confirmed substantially increased risks of lung cancer (risk ratio (RR), 10.92; 95% CI, 8.28-14.40; 34 studies), COPD (RR, 4.01; 95% CI, 3.18-5.05; 22 studies), and asthma (RR, 1.61; 95% CI, 1.07-2.42; eight studies). Exposure to passive smoke significantly increased the risk of lung cancer in adult nonsmokers and increased the risks of asthma, wheeze, lower respiratory infections, and reduced lung function in children. Smoking significantly increased the risk of sleep apnea and asthma exacerbations in adult and pregnant populations, and active and passive smoking increased the risk of tuberculosis.


CONCLUSIONS
These findings have been translated into easily digestible content and published on the SmokeHaz website.
UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, England.
Leah
L
Jayes
European Respiratory Society (ERS) Tobacco Control Committee, ERS European Union Affairs Department, Brussels, Belgium; National Heart & Lung Institute, Imperial College, London, England; Royal Brompton Hospital, London, England.
Patricia L
PL
Haslam
European Respiratory Society (ERS) Tobacco Control Committee, ERS European Union Affairs Department, Brussels, Belgium; Smoking Cessation Clinic, Asthma & Allergy Centre, Pulmonary & Intensive Care Department, Athens University, Evgenidio Hospital, Athens, Greece.
Christina G
CG
Gratziou
European Lung Foundation, Sheffield, England.
Pippa
P
Powell
UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, England.
John
J
Britton
European Respiratory Society (ERS) Tobacco Control Committee, ERS European Union Affairs Department, Brussels, Belgium; Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA.
Constantine
C
Vardavas
European Respiratory Society (ERS) Tobacco Control Committee, ERS European Union Affairs Department, Brussels, Belgium; Smoking Cessation Service, Community of Madrid, Madrid, Spain.
Carlos
C
Jimenez-Ruiz
UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, England. Electronic address: jo.leonardi-bee@nottingham.ac.uk.
Jo
J
Leonardi-Bee
D006801:Humans; D011634:Public Health; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology
health risks; lung diseases; meta-analysis; passive smoking; policymakers; public awareness; respiratory diseases; smoking; systematic review