Kualitas bukti 4.25/5
Skor tinjauan delapan dimensi terhadap rubrik kualitas . Setiap dimensi dinilai 1–5.
- D1 Dasar sumber
- 4/5
- D2 Otoritas sumber
- 5/5
- D3 Aritmetika
- 4/5
- D4 Ketidakpastian
- 4/5
- D5 Cakupan
- 5/5
- D6 Prosa
- 4/5
- D7 Kejujuran persepsi
- 3/5
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- 5/5
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Dipersepsikan
Kebanyakan orang dewasa di negara bebas rokok dengan tepat menggolongkan asap rokok pasif (SHS) sebagai tidak sehat, namun beban mortalitas kuantitatifnya jarang tercatat. Model mentalnya samar — «ini buruk bagimu» alih-alih «ini membunuh puluhan ribu bukan perokok di AS setiap tahun». Risiko seumur hidup bagi bukan perokok pada tingkat paparan rata-rata saat ini berada dalam kisaran yang oleh kebanyakan orang akan ditebak sepersepuluh dari nilai sebenarnya. Dimensi anak-anak adalah bagian yang paling kurang dihargai: paparan SHS masa kanak-kanak menyebabkan penurunan permanen dalam perkembangan paru-paru dan peningkatan risiko asma yang bertahan puluhan tahun setelah paparan berakhir, namun rantai kausalnya tidak terlihat dibandingkan gejala akut yang memang mendorong tindakan orang tua (infeksi telinga, mengi). Masalah keterlihatan ini diperparah oleh cara bahaya tembakau dikomunikasikan — hampir semua pesan kesehatan masyarakat menyasar perokok, meninggalkan bukan perokok dengan rasa yang kuat tetapi terkalibrasi buruk bahwa bahaya terutama menimpa orang yang menyalakan rokok.
Perkiraan kasar: Kebanyakan orang dewasa sangat meremehkan berapa banyak bukan perokok yang meninggal akibat SHS setiap tahun, dan sebagian besar tidak menyadari kerusakan paru-paru permanen yang ditimbulkannya pada anak-anak
Sumber: intuisi redaksi, bukan hasil survei
Aktual
~41.000 orang dewasa AS bukan perokok meninggal akibat asap rokok pasif setiap tahun
orang dewasa AS bukan perokok, tingkat paparan SHS rata-rata saat ini
Tampilkan perhitungan
CDC mengatribusikan >41.000 kematian bukan perokok per tahun ke asap rokok pasif di AS: ~7.300 dari kanker paru-paru dan ~33.950 dari penyakit jantung iskemik, ditambah ~400 kematian bayi. Populasi orang dewasa AS bukan perokok kira-kira 225 juta (kira-kira 87 % dari ~260 juta orang dewasa AS, mengingat prevalensi perokok aktif ~12,5 %). Laju mortalitas teratribusi tahunan: 41.000 / 225.000.000 ≈ 1,82 × 10⁻⁴ per orang dewasa per tahun. Dimajemukkan selama 60 tahun kehidupan dewasa: 1 − (1 − 1,82e-4)^60 ≈ 0,011, atau kira-kira 1 dari 91. Angka ini mencerminkan paparan SHS tingkat-populasi rata-rata di bawah rezim larangan merokok dalam ruangan saat ini dan bukan risiko bagi subkelompok yang terpapar berat seperti seseorang yang tinggal dengan pasangan perokok selama puluhan tahun dan bekerja di tempat yang mengizinkan merokok. Paparan telah turun secara substansial sejak tahun 1980-an setelah adopsi luas undang-undang bebas rokok; angka 1-dari-91 mencerminkan kondisi pasca-larangan. Rentang ketidakpastian 0,006–0,017 menangkap ketidakpastian dalam metodologi fraksi-teratribusi (model SAMMEC yang menggunakan fraksi teratribusi populasi alih-alih observasi langsung) dan dalam distribusi intensitas paparan SHS aktual di seluruh populasi bukan perokok.
Catatan: Entri ini mencakup risiko mortalitas bagi bukan perokok dari paparan SHS pasif, …
Entri ini mencakup risiko mortalitas bagi bukan perokok dari paparan SHS pasif, bukan beban morbiditas yang lebih luas (penyakit pernapasan non-fatal, infeksi telinga masa kanak-kanak, eksaserbasi asma, efek perkembangan kognitif). Angka utama (~1 dari 91 seumur hidup) adalah rata-rata populasi di seluruh tingkat paparan AS saat ini dan mengaburkan variasi yang lebar: seseorang yang telah tinggal dengan perokok dalam ruangan selama puluhan tahun menghadapi risiko yang jauh lebih tinggi daripada seseorang di lingkungan yang sepenuhnya bebas rokok. Angka 41.000 kematian SHS AS per tahun diturunkan dari model fraksi-teratribusi SAMMEC dan tidak diamati langsung dari akta kematian, yang tidak mencatat status paparan SHS; metodologinya membawa ketidakpastian substansial dan perkiraan yang masuk akal berkisar dari ~25.000 hingga ~60.000 tergantung pilihan metodologis. Dimensi kerusakan paru-paru permanen pada anak-anak tidak tertangkap dalam estimasi titik — ini meningkatkan kerentanan dewasa secara multiplikatif alih-alih menambahkan peningkatan mortalitas diskret. Paparan SHS telah turun secara substansial di AS sejak tahun 1980-an setelah larangan merokok dalam ruangan; angka 41.000 saat ini mencerminkan kondisi pasca-larangan dan akan lebih tinggi pada dekade-dekade sebelumnya. Entri ini tidak secara terpisah membahas mortalitas anak-anak akibat SIDS yang terkait SHS (dibahas dalam entri SIDS) atau infeksi saluran pernapasan bawah akut, yang lebih terkonsentrasi di negara berpenghasilan rendah menurut Öberg et al.
Bagaimana risiko bervariasi
Angka utama merata-ratakan situasi yang sangat berbeda. Berikut bagaimana probabilitas bervariasi berdasarkan skenario atau konteks:
1 dari 91 · 1,1%
Headline. 41,000 annual attributable deaths / ~225M non-smoking adults, compounded 60 years.
1 dari 33 · 3,0%
Home is the dominant SHS exposure route; a smoking spouse or housemate multiplies cotinine levels 2-3x vs population average, consistent with the ~20-30% lung cancer relative risk elevation for non-smoking spouses documented in Surgeon General 2006 and the Hackshaw meta-analysis
1 dari 500
Residual risk from incidental outdoor and transitional exposure; reflects the post-ban floor, not zero
1 dari 63 · 1,6%
Childhood SHS adds a permanent lung-function deficit that raises adult susceptibility; this row reflects the upward shift for someone with a childhood SHS history, in addition to any current adult exposure
Panjang dan gradasi warna batang memeringkat skenario ini satu sama lain, bukan terhadap risiko lain. Peluang pastinya ditampilkan di samping masing-masing.
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Risiko lain dengan tema serupa — untuk menjelajahi ketakutan terkait.
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Pilih penantang
The CDC attributes more than 41,000 non-smoker deaths per year in the United States to secondhand smoke — roughly 7,300 from lung cancer and 33,950 from heart disease, plus around 400 infant deaths. Spread across approximately 225 million non-smoking US adults and compounded over a 60-year adult lifespan, the lifetime attributable mortality for a non-smoker at average current exposure levels works out to roughly 1 in 91. The WHO’s current global estimate anchors the same order of magnitude from an independent direction: approximately 1.6 million non-smokers die from secondhand smoke worldwide each year. An earlier peer-reviewed analysis of 2004-era global data (Öberg et al., 2011, in The Lancet, covering 192 countries) put SHS deaths nearer 600,000 a year, about 1% of worldwide mortality at the time. Both estimates land in the same order of magnitude, well above the intuitive estimate most people carry. The mental model asymmetry runs in a consistent direction: people correctly file secondhand smoke as dangerous, but the quantitative weight they assign is typically a fraction of the actual figure — closer to “occasional nuisance” than “kills more than 41,000 non-smoking Americans a year.”
The children’s dimension is the part of the SHS literature that most consistently goes unregistered. Secondhand smoke exposure during childhood causes persistent deficits in lung function: Gilliland et al. (2001, Am J Respir Crit Care Med), studying school-aged children in the Children’s Health Study, found that both in-utero exposure to maternal smoking and childhood environmental tobacco smoke exposure were associated with persistent reductions in lung function. These are not transient irritation effects — the airway geometry is set during development, and what the smoke compresses during the years of lung growth is not fully recovered in adulthood. The downstream consequences are an elevated lifetime asthma prevalence (roughly 20–35% higher in children with SHS-exposed childhoods), higher susceptibility to respiratory infections across the lifespan, and an increased baseline for the SHS-attributable cancer and cardiovascular risk captured in this entry’s point estimate. The infant SIDS risk associated with prenatal and postnatal SHS exposure (2–4x baseline in households with smoking) is the acute end of the same mechanism: impaired lung development increases vulnerability to hypoxic events in the first year of life. Globally, Öberg et al. estimated 165,000 child deaths under age 5 per year from lower respiratory infections attributable to SHS — a figure concentrated in low- and middle-income countries where indoor cooking fire co-exposure amplifies the burden, but the biological mechanism operates regardless of geography.
The policy context matters for interpreting the headline number. The 41,000 US figure reflects the post-ban era: indoor smoke-free laws adopted across US workplaces, restaurants, and bars since the 1980s have substantially reduced non-smoker exposure from the levels that prevailed before the bans. The home remains the dominant residual exposure route — cotinine measurements in non-smoking adults consistently show that living with an indoor smoker is associated with SHS exposure levels comparable to pre-ban workplaces. For the many US non-smokers who share a home with a current smoker, the relevant risk sits meaningfully above the population-average headline. The entry is tagged underrated not because the hazard is unrecognized at a qualitative level — most people know SHS is bad — but because the numeric gap between “I know it’s bad” and “the lifetime risk is 1 in 91 even today, and significantly higher if you or your children were regularly exposed at home” is large enough to warrant explicit calibration.
Fakta terkait
Bagi orang dewasa bukan perokok di AS, peluang meninggal akibat asap rokok pasif seumur hidup sekitar ~1 in 91, pada kisaran 41,000 kematian per tahun. Kebanyakan orang memperkirakannya jauh lebih rendah, sehingga risiko ini lebih diremehkan daripada dilebih-lebihkan.
Buku besar klaim
Setiap angka di bawah ini adalah apa yang dilaporkan masing-masing sumber, dengan kutipan kata demi kata yang kami andalkan dan bagaimana kami sampai pada angka kami. Klik tautan mana saja untuk memverifikasi langsung.
2/3 sumber diverifikasi secara independen kata demi kata terhadap sumber terkutip
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[1] US Centers for Disease Control and Prevention — About Smoking and Tobacco Use Terverifikasi
About Smoking and Tobacco UseSee all 2 Likelier entries citing this source →
- Statistik
SHS contributes to >41,000 non-smoker adult deaths and ~400 infant deaths per year in the US; >480,000 total smoking-related deaths including SHS- Kutipan
“"Smoking and secondhand smoke exposure cause more than 480,000 deaths each year in the United States. This is nearly one in five deaths. [...] Secondhand smoke exposure contributes to over 40,000 deaths among nonsmoking adults and 400 deaths in infants each year." ”
- Data sumber dari
- 2024-05-15
- Diakses
- 2026-04-11 · salinan arsip
- Verifikasi
- Kutipan diambil ulang secara independen dan dikonfirmasi kata demi kata terhadap sumber terkutip selama audit pendasaran kami.
- Perhitungan
- 41,000 non-smoker adult deaths per year is the primary domestic headline figure and the numerator for the normalized calculation. US non-smoking adult population denominator: ~225 million (87% of ~260M US adults). Annual attributable rate: 41,000 / 225M = 1.82e-4. Compounded over 60 adult years: 1 − (1 − 1.82e-4)^60 ≈ 0.011. The CDC does not directly report the lung cancer / heart disease breakdown on this page; the ~7,300 lung cancer and ~33,950 heart disease sub-totals appear in the CDC's dedicated SHS resource pages and the 2006 Surgeon General Report on involuntary tobacco smoke exposure.
- Independensi
- CDC SAMMEC (Smoking-Attributable Mortality, Morbidity, and Economic Costs) model draws on Cancer Prevention Study II hazard ratios and NHANES SHS exposure data — methodologically overlapping with the 2006 Surgeon General Report, which uses the same underlying cohort hazard ratios. Treat as institutional confirmation of the same underlying estimate rather than a fully independent line of evidence.
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[2] World Health Organization — Tobacco — fact sheet Terverifikasi
Tobacco — fact sheetSee all 2 Likelier entries citing this source →
- Statistik
SHS kills ~1.6 million non-smokers globally per year; no safe level of SHS exposure exists- Kutipan
“"Tobacco kills more than 7 million people each year, including an estimated 1.6 million non-smokers who are exposed to second-hand smoke." ”
- Data sumber dari
- 2025-07-31
- Diakses
- 2026-04-11 · salinan arsip
- Verifikasi
- Kutipan diambil ulang secara independen dan dikonfirmasi kata demi kata terhadap sumber terkutip selama audit pendasaran kami.
- Perhitungan
- The WHO 1.6 million non-smoker SHS deaths globally provides the international anchor and cross-check. Scaling naively to the US by population share (~4.2M of 57M global deaths) would imply ~118,000 US SHS deaths, higher than the CDC's 41,000. The gap primarily reflects: (a) the WHO/IHME figure includes lower-income regions where indoor solid-fuel cooking fire co-exposure substantially inflates the SHS burden; (b) CDC's SAMMEC model uses a more conservative attributable-fraction method. The US CDC figure is used for the normalized headline as more relevant to a US adult in a post-ban environment.
- Independensi
- WHO draws on IHME Global Burden of Disease estimates using a different exposure-prevalence and relative-risk framework than CDC SAMMEC. The two-to-three-fold difference in implied US figures is a genuine methodological disagreement, not a simple error; it is reflected in the wide uncertainty band.
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[3] The Lancet (Öberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A) — Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries
Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries- Statistik
~600,000 global deaths/year from SHS (2004 data); 165,000 children under 5 from lower respiratory infections; SHS accounts for ~1% of worldwide mortality- Kutipan
“[Paraphrase from abstract — full text paywalled] In 2004, SHS caused approximately 379,000 deaths from ischaemic heart disease, 165,000 from lower respiratory infections (mainly in children under 5), 36,900 from asthma, and 21,400 from lung cancer. SHS accounted for about 1% of worldwide mortality. The greatest child burden was 165,000 deaths from lower respiratory infections, concentrated in low-income countries. ”
- Data sumber dari
- 2011-01-08
- Diakses
- 2026-05-18 · salinan arsip
- Perhitungan
- Öberg et al. 2011 is the most comprehensive independent global burden estimate and provides the strongest peer-reviewed anchor for both the adult and child mortality dimensions. The 165,000 child deaths from lower respiratory infections (concentrated in low- and middle-income countries with high indoor SHS from cooking and heating) is the key quantitative evidence base for the children's mortality dimension, distinct from the US-centric CDC estimate. The global ischaemic heart disease figure (379,000 / ~600,000 total ≈ 63% cardiovascular) is broadly consistent with the CDC's US breakdown (~83% heart disease), validating the mechanism framing. The 21,400 lung cancer figure as a fraction of total deaths (~3.6%) is lower than the US proportion (~18%), reflecting differential tobacco exposure histories and cancer screening rates across the 192 countries.
- Independensi
- Öberg et al. use WHO global SHS exposure prevalence data combined with meta-analytic relative risks from the epidemiological literature; the analytic framework is independent of the CDC SAMMEC model and the WHO fact-sheet figure (which draws on the same IHME GBD pipeline as Öberg). The child lower-respiratory-infection mortality component is the most methodologically distinct from the US adult estimates and is not derived from the CPS-II cohort.