Keywords
Tobacco smoke pollution
Respiratory diseases
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To investigate the association between exposure to passive smoking and COPD. Methods: A systematic review conducted according to PRISMA guidelines and registered in the PROSPERO platform. The guiding question, formulated using the PECo strategy, evaluated whether exposure to passive smoking at any stage of life is associated with COPD. Studies published in the last five years, in Portuguese, English, or Spanish, with full-text availability, including observational and clinical trial designs, were included from PubMed, SciELO, Scopus, and Web of Science databases. Study selection was performed independently by two reviewers, and methodological quality was assessed using standardized tools. Results: Ten studies were included, demonstrating an association between prolonged exposure to passive smoking and higher risk of COPD, decline in lung function, increased inflammatory markers, and higher mortality. A dose–response relationship was observed, with worse spirometric parameters in more intense exposures, particularly among women and workers in enclosed environments. Final considerations: Passive smoking constitutes an independent risk factor for the development and progression of COPD, emphasizing the importance of smoke-free environments and longitudinal studies to evaluate its cumulative impact.
References
AGUSTI A e VOGELMEIER C. GOLD 2024: uma breve visão geral das principais mudanças. Jornal Brasileiro de Pneumologia, 2023; 49(6).
BRASIL. MINISTÉRIO DA SAÚDE. Diretrizes para o diagnóstico e manejo da DPOC. Brasília: Ministério da Saúde, 2018. Disponível em: https ://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_diagnostico_manejo_dp oc.pdf. Acessado em: 7 de novembro de 2025.
BRASIL. MINISTÉRIO DA SAÚDE. Política Nacional de Controle do Tabaco: avanços e desafios. Brasília: INCA, 2019. Disponível em: https ://bvsms.saude.gov.br/bvs/publicacoes/inca/Programa_naci onaL_de_control e_do_tabagismo.pdf. Acessado em: 7 de novembro de 2025.
BRASIL. MINISTÉRIO DA SAÚDE. ROBIS: ferramenta para avaliar risco de viés em revisões sistemáticas. Brasília: Ministério da Saúde, 2017; 9. Disponível em: https ://rebrats.saude.gov.br/d iretrizes-metodologicas?download=128:robis-risk-of-bias-in-systematic-reviews-ferramenta-para-avaliar-o-risco-de-vies-em-revisoes-sistematicas-orientacoes-de-uso. Acessado em: 7 de novembro de 2025.
BRASIL. MINISTÉRIO DA SAÚDE. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes metodológicas: elaboração de revisão sistemática e metanálise de estudos observacionais comparativos sobre fatores de risco e prognóstico. Brasília: Ministério da Saúde, 2014; 132. Disponível em: https ://www.saude.gov.br/bvs. Acessado em: 20 de outubro de 2025.
CHEN P, et al. Secondary smoke exposure and the risk of chronic obstructive pulmonary disease: a systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 2023; 18: 1067–1076.
CHENN L, et al. The role of active and passive smoking in chronic obstructive pulmonary disease and systemic inflammation: a 12-year prospective study in China. Journal of Epidemiology and Global Health, 2024; 14(3): 1332–1340.
CLARIVATE ANALYTICS. End Note Web, 2024. Disponível em: https ://access.clarivate.com/login?ap p=endnote. Acessado em: 17 de março de 2025.
CLARIVATE ANALYTICS. End Note Web, 2024. Disponível em: https ://access.clarivate.com/login? app=endnote. Acessado em: 17 de março de 2025.
DÍAZ DEL VALLE F, et al. Long-term respiratory health outcomes after secondhand smoke exposure in flight attendants. Chest, 2022; 162(3): 556-568.
DIVER WR, et al. Secondhand smoke exposure in childhood and adulthood in relation to adult mortality among never smokers. American journal of preventive medicine, 2018; 55(3): 345-352.
EISNER RMD, et al. Directly measured secondhand smoke exposure and COPD health outcomes. BMC pulmonary medicine, 2006; 6: 1-11.
FLOR LS, et al. Health effects associated with exposure to secondhand smoke: a Burden of Proof study. Nature medicine, 2024; 30(1): 149-167.
FU Z, et al. Objective exposure to secondhand smoke and COPD outcomes in non-smoking patients: NHANES 2007–2012. Annals of Translational Medicine, 2020; 8(7): 445.
GULDAVAL F, et al. What are the Differences Between Smoker and Non-smoker COPD Cases? Is it a Different Phenotype? Turkish Thoracic Journal, 2021; 22(4): 284–288.
GÜLDAVAL FF, et al. Chronic effects of passive smoking on pulmonary function. Respiration, 2012; 84(6): 502–510.
GUNASEKERA KD, et al. Chronic obstructive pulmonary disease (COPD) in non-smoking Sri Lankan adults; a cross-sectional study. BMC Research Notes, 2025; 18(1).
HIGGINS JPT, et al. Revised Cochrane risk of bias tool for randomized trials (RoB 2): additional considerations for crossover trials. [S. l.]: Cochrane, 2021; 16. Disponível em: https ://www.riskofb ias.info. Acessado em: 20 de outubro de 2025.
HIKICHI M, et al. Pathogenesis of chronic obstructive pulmonary disease (COPD) induced by cigarette smoke. Journal of Thoracic Disease, 2019; 11(17): 2129–2140.
HUANG SL, et al. The impact of environmental tobacco smoke on children’s respiratory health. Pediatrics, 2007; 119(4): 535–541.
INCA. INSTITUTO NACIONAL DE CÂNCER JOSÉ ALENCAR GOMES DA SILVA. Tabaco e saúde pulmonar: Dia Mundial sem Tabaco 2019. Rio de Janeiro: INCA, 2019. Disponível em: https ://www.in ca.gov.br/sites/ufu .sti.inca.local/files/media/document/manual-dia-mundial-sem-tabaco-2019.pdf. Acess ado em: 7 de novembro de 2025.
JADAD AR, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996; 17(1): 1-12.
LAURSEN LC, et al. Long-term exposure to secondhand smoke and lung function decline: a cohort study. International Journal of Epidemiology, 2020; 49(3): 789-798.
LI XL, et al. The impact of secondhand smoke on COPD development and mortality: a nationwide cohort study. International Journal of Epidemiology, 2020; 49(6): 1350-1362.
LIU Z, et al. Chronic passive smoking exposure as an independent risk factor for COPD in women: a cross-sectional study. International Journal of Chronic Obstructive Pulmonary Disease, 2025; 20: 2745-2752.
LOIVOS LP. DPOC – definições e conceitos – as bases clínicas. Revista Atualização Temática SOPTERJ, 2009; 1(1): 34-37.
MALTA DC, et al. Tobacco use, cessation, secondhand smoke and exposure to media about tobacco in Brazil: results of the National Health Survey 2013 and 2019. Revista Brasileira de Epidemiologia, 2021; 24(2): 210006.
MATTOS VGW, et al. Associação entre tabagismo passivo e hipertensão: um estudo de painel com 621.506 adultos do Brasil. Arquivos Brasileiros de Cardiologia, 2025; 122(6): 20250024.
MESQUITA DNC, et al. Associação entre doenças respiratórias e fumo passivo domiciliar em crianças de 6 a 10 anos atendidas pela atenção primária em Araguaína/TO. Revista Brasileira de Medicina de Família e Comunidade, 2023; 18(45): 3482.
MOHER D, et al. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. PLoS Medicine, 2009; 6(7): 1000097.
PAGE MJ, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. The BMJ, 2021; 372: 160.
RAKIC M, et al. Association between environmental tobacco smoke exposure and COPD: results from a multicenter study. European Respiratory Journal, 2022; 59(4): 2101456.
RITCHIE A e WEDZICHA J. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clinics in Chest Medicine, 2020; 41: 421-438.
RODRIGUES SO, et al. Mechanisms, pathophysiology and currently proposed treatments of chronic obstructive pulmonary disease. Pharmaceuticals, 2021; 14(10): 979.
SALES MPU, et al. Atualização na abordagem do tabagismo em pacientes com doenças respiratórias. Jornal Brasileiro de Pneumologia, 2019; 45(1): 20180314.
SILVA EPF, et al. Doença pulmonar obstrutiva crônica- uma revisão abrangente sobre a fisiopatologia, diagnóstico e avaliação, tratamento e prevenção. Brazilian Journal of Health Review, 2024; 7(1): 7152-7162.
SU WC, et al. Secondhand smoke increases the risk of developing chronic obstructive pulmonar disease. Scientific Reports, 2024; 14(1): 7481.
WANG Z, et al. Prevalence, risk factors, and mortality of COPD in young people in the USA: results from a population-based retrospective cohort. BMJ Open Respiratory Research, 2023; 10(1): 1550.
YIN P, et al. Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study. The Lancet, 2007; 370(9589): 751-757.
ZHAO L e ZHAO Q. Knowledge, attitudes, and practices regarding COPD prevention among high-risk populations: a cross-sectional study. International Journal of Nursing Sciences, 2023; 10: 238-244.