Long-Term Passive Smoking Doubles COPD Risk in Women, Study Finds
China: A new community-based study from Jinan, China, has revealed that women with long-term exposure to secondhand smoke face a significantly higher risk of developing chronic obstructive pulmonary disease (COPD), alongside more severe symptoms and greater lung function decline. The research, led by Dr. Jiling Lv from the Department of Respiratory Medicine at Shandong Second Provincial General Hospital, was published in the International Journal of Chronic Obstructive Pulmonary Disease.
COPD, a progressive lung condition often associated with smoking, is increasingly being recognized in non-smokers—particularly women exposed to secondhand smoke over extended periods. The study sought to explore the relationship between prolonged passive smoking and the onset of COPD in women, shedding light on a preventable but often overlooked risk factor.
Between October 2022 and April 2023, the research team examined 2,360 women aged 40 years and older. Participants underwent a battery of assessments, including detailed respiratory questionnaires, lung function measurements through spirometry, and blood tests to detect inflammation. Based on their history of secondhand smoke exposure, they were divided into two groups: long-term passive smokers (LPS, 610 participants) and non-passive smokers (NPS, 1,750 participants).
Key Findings:
- Women in the long-term passive smoking (LPS) group showed significantly poorer respiratory health compared to those without passive smoke exposure.
- The LPS group had a lower average forced expiratory volume in one second (FEV1: 2.97 vs 3.25 liters).
- Predicted FEV1 percentages were reduced in the LPS group.
- The LPS group had a lower FEV1/forced vital capacity ratio (83.3% vs 87.2%).
- Small airway function was more impaired in the LPS group, with reduced MEF75% (77.6 vs 86.1 L/s).
- MEF50% was lower in the LPS group (62.8 vs 89.4 L/s).
- Maximal mid-expiratory flow rate was also reduced in the LPS group (80.9 vs 87.5 L/s).
- Prevalence of preserved ratio impaired spirometry (PRISm) was almost twice as high in the LPS group (5.74% vs 2.91%).
- Women in the LPS group reported more frequent COPD exacerbations.
- The LPS group experienced more severe respiratory symptoms.
- Systemic inflammatory markers were higher in the LPS group.
The authors conclude that long-term passive smoking should be considered an independent risk factor for COPD in women, capable of accelerating disease progression and increasing both symptom burden and frequency of acute exacerbations. They argue that these findings strengthen the case for stricter public health measures aimed at minimizing secondhand smoke exposure, particularly in environments where women may be regularly exposed, such as homes or workplaces.
While the study provides compelling evidence, the researchers caution that certain limitations—such as potential selection bias and unmeasured lifestyle factors—could influence the results. They recommend that future large-scale, longitudinal studies be conducted to confirm these associations and further refine public health strategies.
"In the meantime, the message from this study is clear: for women, avoiding long-term exposure to secondhand smoke could play a crucial role in preventing the onset and progression of COPD," the authors concluded.
Reference:
Liu Z, Jiao M, Lv J, Han Q. Increased Incidence of Chronic Obstructive Pulmonary Disease in Women Due to Long-Term Passive Smoking. Int J Chron Obstruct Pulmon Dis. 2025;20:2745-2752. https://doi.org/10.2147/COPD.S534060
