Evaluating the Causal Link Between Secondhand Smoke Exposure and Lung Cancer. An Application of Bradford Hill's Criteria (eBook, PDF)
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Scientific Study from the year 2025 in the subject Biology - Diseases, Health, Nutrition, , language: English, abstract: Secondhand smoke (SHS), also known as environmental tobacco smoke, has been widely studied for its detrimental health effects, particularly its association with lung cancer in non-smokers. Despite growing public health awareness and legislative measures to reduce SHS exposure, global prevalence remains significant, especially in low- and middle-income countries. This paper critically examines the relationship between secondhand smoke and lung cancer through the lens of Bradf...
Scientific Study from the year 2025 in the subject Biology - Diseases, Health, Nutrition, , language: English, abstract: Secondhand smoke (SHS), also known as environmental tobacco smoke, has been widely studied for its detrimental health effects, particularly its association with lung cancer in non-smokers. Despite growing public health awareness and legislative measures to reduce SHS exposure, global prevalence remains significant, especially in low- and middle-income countries. This paper critically examines the relationship between secondhand smoke and lung cancer through the lens of Bradford Hill's nine criteria for establishing causality: strength, consistency, specificity, temporality, biological gradient, plausibility, coherence, experiment, and analogy. Findings from major epidemiological studies and meta-analyses show that exposure to SHS significantly increases lung cancer risk among non-smokers. The biological mechanisms-such as the presence of carcinogens like benzene and formaldehyde in SHS-offer strong plausibility. Moreover, temporal relationships are evident in cohort studies, while experimental and interventional data from smoke-free laws reveal reductions in SHS exposure and related disease burdens. Although challenges exist in measuring long-term exposure levels, the cumulative evidence supports a strong causal relationship. The application of Hill's criteria thus reinforces the need for stricter enforcement of public smoking bans and targeted education campaigns to protect vulnerable populations.
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