The Prevalence of Secondhand Smoke Exposure and Its Association With Chronic Diseases and Metabolic Abnormalities: Findings From the Steps Survey 2021 Publisher



Zarepour P ; Salehi S ; Khojaste M ; Azizpour Y ; Khosravi S ; Yunesian M
Source: Journal of Diabetes and Metabolic Disorders Published:2025

Abstract

Purpose: This study investigates the association between secondhand smoke (SHS) exposure and chronic diseases and metabolic abnormalities. Method: This study utilized data from the 2021 STEPwise approach to chronic disease risk factor surveillance (STEPS) survey in Iran. The final analytical sample consisted of 14,448 participants, who were non-smoking adults aged ≥ 25 years and completed all three phases of the STEPS survey. Self-reported exposure to tobacco smoke at home or work was used to categorize participants, while demographic, lifestyle, and clinical data were collected through standardized questionnaires, physical measurements, and laboratory tests. Associations with Cardiovascular diseases (CVDs), Chronic kidney disease (CKD), stroke, heart attack, metabolic syndrome, diabetes, hypertension, hypercholesterolemia, cancer, and multiple chronic conditions were examined using multivariable and multinomial logistic regression analyses, adjusting for age and sex. Result: The study, involving 14,448 participants (mean age 48.59 years, SD = 0.18, 63.37% female), found that SHS exposure is significantly linked to various health risks. Exposure in either home or workplace settings raised the odds for high blood pressure (13%), metabolic syndrome (12%), hypercholesterolemia (18%), diabetes (16%), and hypertension (17%), at least one chronic disease (17%), and multiple chronic diseases (43%) compared to those who were not exposed. Combined exposure (exposed in both home and workplace environments simultaneously) heightened the odds for metabolic syndrome (36%), abdominal obesity (28%), diabetes (22%), increase in high blood pressure (26%), hypertension (33%), a single chronic disease (26%), and multiple chronic conditions (51%). Conclusion: This study underscores the significant health exposure of SHS, linking it to chronic conditions such as CVDs, hypertension, metabolic syndrome, and diabetes. It stresses the urgent need for enhanced public health efforts, such as tougher smoke-free laws and educational campaigns, to lower SHS exposure. © 2025 Elsevier B.V., All rights reserved.