Smoke-free homes:The final frontier

Over 1.2 billion tobacco users worldwide and almost 8 million tobacco-related deaths make tobacco control a public health high priority1. While the number of smokers has fallen in high-income countries (HICs) in recent years, the number of tobacco users in many low- and middle-income countries (LMICs) has steadily increased2. In addition to active smoking, inhalation of secondhand smoke (SHS) is a major cause of premature death and disease, especially among women and children3,4. More than one-third of women5 and half of the children6 are exposed to SHS worldwide. The exposure to SHS during pregnancy is also high in many countries; the prevalence ranging from 6% in Nigeria to 73% in Armenia7. The adverse health consequences of SHS exposure are well documented4,8-10. Exposure to SHS increases the risk of acquiring lower respiratory tract and middle-ear infections, invasive meningococcal disease, TB and incident cases, and recurrent episodes and increased severity of asthma among children10. Children living in smoking households are at risk of lower academic performance and a high rate of smoking uptake in later life11. SHS exposure during pregnancy can cause pregnancy complications, a modest reduction in birth weight, preterm delivery, stillbirths, and infant deaths10.