A recent report published in The Lancet Public Health journal has revealed alarming data on the toll of passive smoking in India, showing that approximately 3,25,000 people died in 2023 alone from inhaling second-hand smoke — equivalent to nearly 900 deaths per day. The findings, drawn from the Global Burden of Disease (GBD) report, were highlighted at a national webinar organized by “Tobacco Free India” on Gandhi Jayanti, where leading health experts issued strong warnings about the scale of the problem.
According to figures presented by former NITI Aayog member Dr. V.K. Paul, the proportion of India’s population exposed to passive smoking declined from 43% in 1990 to 31% in 2023. However, due to population growth over the same period, the absolute number of people affected rose sharply, from 37.5 crore to 44.4 crore. Globally, passive smoking causes approximately 17 lakh deaths annually, of which 3.25 lakh occur in India alone, making the country the second-highest in the world for such deaths after China. Notably, passive smoking deaths in India have risen by 50% since 1990, indicating the problem has worsened rather than improved over three decades.
Experts noted that women and children bear the brunt of this exposure. Dr. Uma Kumar, Head of the Rheumatology Department at AIIMS Delhi, pointed out that women and children typically have the least control over their immediate environments. Of the 3.25 lakh deaths recorded in 2023, 1.57 lakh were women, with much of the exposure occurring within households where a family member smokes indoors. Medical experts noted that smoke released from the burning end of a cigarette often contains higher concentrations of carcinogens, carbon monoxide, and nicotine than the smoke inhaled directly by the smoker, contributing to rising cases of pneumonia, bronchitis, and asthma among children.
Former ICMR Director-General Dr. V.M. Katoch and cardiologist Dr. K.K. Talwar warned that even brief exposure to second-hand smoke carries significant health risks, including damage to the respiratory system’s protective lining, onset of Chronic Obstructive Pulmonary Disease (COPD), increased risk of heart attacks and strokes due to blood vessel constriction, and elevated risk of cancers including lung, blood, and bladder cancer. Dr. Katoch added that the effects of passive smoking extend beyond the lungs, impacting multiple organs over time. The health burden translates into an estimated loss of 9.28 million disability-adjusted life years annually in India.
Despite a law banning smoking in public places enacted on October 2, 2008, enforcement remains weak, with public smoking commonly observed near tea stalls, bus stops, restaurants, and office premises. While designated smoking zones exist in hotels and airports, health experts argue these do not fully prevent exposure. Dr. Uma Kumar has called for India to implement a complete “100% smoke-free public places” policy, noting that approximately 40% of countries worldwide already enforce strict smoke-free regulations without exceptions.
The economic impact of tobacco-related illness in India is also substantial, with WHO estimates placing the annual cost at approximately Rs. 1.77 lakh crore, nearly 1% of the country’s GDP. Beyond cigarettes and beedis, other tobacco products including khaini, gutka, zarda, and hookah contribute to an estimated 13.5 lakh direct deaths annually. Dr. V.K. Paul emphasized that reducing passive smoking exposure should not be the sole objective, calling for India to become a completely tobacco-free country, with tobacco use eliminated entirely from the vicinity of schools and colleges.