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Alonso Perez, TamaraAuthorAncochea Bermudez, JulioAuthorGarcia Castillo, ElenaAuthorSoriano JbAuthor

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March 18, 2021
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Burden of disease from exposure to secondhand smoke in children in Europe

Publicated to:PEDIATRIC RESEARCH. 90 (1): 216-222 - 2021-07-01 90(1), DOI: 10.1038/s41390-020-01223-6

Authors: Carreras, Giulia; Lachi, Alessio; Cortini, Barbara; Gallus, Silvano; Jose Lopez, Maria; Lopez-Nicolas, Angel; Lugo, Alessandra; Teresa Pastor, Maria; Soriano, Joan B; Fernandez, Esteve; Gorini, Giuseppe; Castellano, Yolanda; Fu, Marcela; Ballbe, Montse; Amalia, Beladenta; Tigova, Olena; Continente, Xavier; Arechavala, Teresa; Henderson, Elisabet; Liu, Xiaoqiu; Borroni, Elisa; Colombo, Paolo; Semple, Sean; O'Donnell, Rachel; Dobson, Ruaraidh; Clancy, Luke; Keogan, Sheila; Byrne, Hannah; Behrakis, Panagiotis; Tzortzi, Anna; Vardavas, Constantine; Vyzikidou, Vergina Konstantina; Bakelas, Gerasimos; Mattiampa, George; Boffi, Roberto; Ruprecht, Ario; De Marco, Cinzia; Borgini, Alessandro; Veronese, Chiara; Bertoldi, Martina; Tittarelli, Andrea; Verdi, Simona; Chellini, Elisabetta; Guerrero, Daniel Celdran; Radu-Loghin, Cornel; Nguyen, Dominick; Starchenko, Polina; Ancochea, Julio; Alonso, Tamara; Erro, Marta; Roca, Ana; Perez, Patricia; Garcia-Castillo, Elena

Affiliations

Agencia de Salut Publica de Barcelona - Author
Bellvitge Biomed Res Inst IDIBELL, Barcelona, Spain - Author
Catalan Inst Oncol ICO, Barcelona, Spain - Author
Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias - Author
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain - Author
CIBER Epidemiologia y Salud Publica - Author
Consortium Biomed Res Resp Dis, CIBERES, CIBER Enfermedades Resp, Madrid, Spain - Author
European Network for Smoking and Tobacco Prevention - Author
European Network Smoking & Tobacco Prevent ENSP, Brussels, Belgium - Author
Fdn IRCCS Ist Nazl Tumori INT, Milan, Italy - Author
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Author
Hellenic Canc Soc George D Behrakis Res Lab HCS, Athens, Greece - Author
Hellenic Cancer Society - George D. Behrakis Research Lab (HCS) - Author
Hosp Univ La Princesa IISP, Madrid, Spain - Author
Hospital Universitario de la Princesa - Author
IIB St Pau, Barcelona, Spain - Author
Institut d'investigació biomèdica de bellvitge - Author
Institut dInvestigacio Biomedica Sant Pau (IIB Sant Pau) - Author
Institute Catala Oncologia - Author
Ist DOXA, Worldwide Independent Network, Gallup Int Assoc, Milan, Italy - Author
Ist Ric Farmacol Mario Negri IRCCS IRFMN, Milan, Italy - Author
Istituto di Ricerche Farmacologiche Mario Negri - Author
Istituto per lo Studio, la Prevenzione e la Rete Oncologica - Author
Polytech Univ Cartagena UPCT, Cartagena, Spain - Author
Prevent & Res Inst ISPRO, Oncol Network, Florence, Italy - Author
Publ Hlth Agcy Barcelona ASPB, Barcelona, Spain - Author
TobaccoFree Res Inst Ireland TFRI, Dublin, Ireland - Author
TobaccoFree Research Institute Ireland - Author
Univ Barcelona, Barcelona, Spain - Author
Univ Stirling UNISTIR, Stirling, Scotland - Author
Universidad Politécnica de Cartagena - Author
Universitat de Barcelona - Author
University of Stirling - Author
Worldwide Independent Network/Gallup International Association (WIN/GIA) - Author
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Abstract

© 2020, International Pediatric Research Foundation, Inc. Background: Secondhand smoke (SHS) exposure at home and fetal SHS exposure during pregnancy are a major cause of disease among children. The aim of this study is quantifying the burden of disease due to SHS exposure in children and in pregnancy in 2006–2017 for the 28 European Union (EU) countries. Methods: Exposure to SHS was estimated using a multiple imputation procedure based on the Eurobarometer surveys, and SHS exposure burden was estimated with the comparative risk assessment method using meta-analytical relative risks. Data on deaths and disability-adjusted life years (DALYs) were collected from National statistics and from the Global Burden of Disease Study. Results: Exposure to SHS and its attributable burden stalled in 2006–2017; in pregnant women, SHS exposure was 19.8% in 2006, 19.1% in 2010, and 21.0% in 2017; in children it was 10.1% in 2006, 9.6% in 2010, and 12.1% in 2017. In 2017, 35,633 DALYs among children were attributable to SHS exposure in the EU, mainly due to low birth weight. Conclusions: Comprehensive smoking bans up to 2010 contributed to reduce SHS exposure and its burden in children immediately after their implementation; however, SHS exposure still occurs, and in 2017, its burden in children was still relevant. Impact: Exposure to secondhand smoke at home and in pregnancy is a major cause of disease among children.Smoking legislation produced the adoption of voluntary smoking bans in homes; however, secondhand smoke exposure at home still occurs and its burden is substantial.In 2017, the number of deaths and disability-adjusted life years in children attributable to exposure to secondhand smoke in the European Union countries were, respectively, 335 and 35,633.Low birth weight caused by secondhand smoke exposure in pregnancy showed the largest burden.Eastern European Union countries showed the highest burden.

Keywords

ChildDisability-adjusted life yearsEnvironmental exposureEuropeFemaleHumansInfant, low birth weightMalePregnancyTobacco smoke pollution

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal PEDIATRIC RESEARCH due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position 26/130, thus managing to position itself as a Q1 (Primer Cuartil), in the category Pediatrics.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 2.49. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 2.55 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 6.99 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-19, the following number of citations:

  • WoS: 12
  • Scopus: 13
  • Europe PMC: 8

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-19:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 65.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 70 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 9.8.
  • The number of mentions on the social network X (formerly Twitter): 9 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Belgium; Greece; Italy; United Kingdom.