Second-Hand Smoke: Rising Health Burden in India

  • September 08, 2026
  • Current Affairs

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Context:

A recent study published in The Lancet Public Health highlights the growing health burden of second-hand smoke (SHS) in India. Despite a decline in the prevalence of exposure, the absolute number of people exposed and deaths attributable to SHS have increased significantly since 1990.

Key Findings

  • India had the second-highest number of people exposed to second-hand smoke globally in 2023, after China.
  • Around 444 million Indians were exposed to SHS in 2023, up from 375 million in 1990 — an increase of about 18.4%.
  • The age-standardised exposure prevalence declined from 43.2% in 1990 to 30.6% in 2023, indicating that population growth has offset the decline in exposure rates.
  • Deaths attributable to SHS increased from around 2.18 lakh in 1990 to 3.26 lakh in 2023.

  • SHS was responsible for approximately 9.28 million DALYs in India in 2023, representing years of healthy life lost due to premature death, illness or disability.
  • Women and children remain particularly vulnerable because of prolonged household exposure and the susceptibility of developing lungs.

About the Tobacco

  • Species: Over 60 species, with N. tabacum and N. rustica (Aztec tobacco) commonly cultivated. It belongs to the nightshade family and indigenous to South America. 
  • Climate: Requires frost-free period of 90-120 days from transplanting to final harvest. 
  • Temperature: Mean daily temperature of 20-30°C with dry harvesting period. 
  • Soil: Prefers sandy or sandy loam but varies as per variety but sensitive to waterlogging; requires well-aerated, well-drained soils.
  • Rainfall: Minimum 500 mm; not suitable above 1200 mm.
  • Production: India is the world's 2nd largest producer (after China) and 2nd largest exporter of unmanufactured tobacco by quantity (after Brazil). 

o   Major states: Gujarat, AP, UP, Karnataka, West Bengal, Telangana, and Bihar. 

§  Gujarat accounts for 45% of production with highest productivity, followed by AP.

§  The Tobacco Board of India (Guntur, AP) ensures the smooth functioning of the farming system and to ensure fair and remunerative prices for tobacco farmers and the promotion of exports.

 

 

 

Major Challenges and India's Context

  • Regional Concentration: Nearly 50% of global SHS-related deaths occur in just two countries: China and India, largely due to high population density and varying levels of enforcement of smoke-free laws.
  • Industry Interference: The tobacco industry continues to challenge smoke-free legislation, especially in the hospitality sector (hotels, bars, and restaurants).
  • The "Unfiltered" Risk: Sidestream smoke—the smoke from the burning end—is often more toxic than the smoke inhaled by the smoker, as it is unfiltered and contains higher concentrations of carcinogens.

Global Policy Response: The MPOWER Framework

To combat this, the World Health Organization (WHO) promotes the MPOWER measures. As of 2025, four countries—Brazil, Mauritius, the Netherlands, and Türkiye—have fully implemented all these measures:

  1. Monitor tobacco use and prevention policies.
  2. Protect people from tobacco smoke (Smoke-free air laws).
  3. Offer help to quit tobacco use.
  4. Warn about the dangers of tobacco (Graphic health warnings).
  5. Enforce bans on tobacco advertising and sponsorship.
  6. Raise taxes on tobacco.

Way Forward

  • Strengthen implementation of tobacco-control measures and smoke-free public spaces.
  • Promote smoke-free homes, particularly to protect children and women.
  • Increase public awareness about the health risks of passive smoking.
  • Encourage smokers to smoke only in outdoor areas away from children and non-smokers.
  • Integrate SHS screening and counselling into primary healthcare.
  • Strengthen surveillance of tobacco exposure and its health outcomes.

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