GBD 2023 | 全球超27亿人暴露于二手烟，致近170万人死亡

Declaration of interests

S Afzal reports support for the present manuscript from the Institute of Public Health, Lahore (study materials, manuscripts, medical writing, and library resources); grants or contracts from the Dean’s Office, Institute of Public Health, Lahore (intellectual contributions and time protection); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the Dean, Institute of Public Health, Lahore; support for attending meetings or travel from the Dean, Institute of Public Health, Lahore; participation on a Data Safety Monitoring Board or Advisory Board as Member, Pakistan National Bioethics Committee; Member, Institutional Review Board of Fatima Jinnah Medical University; Member, Ethical Review Board and Data Monitoring Board, Institute of Public Health Lahore Pakistan; in charge, Clinical Research Organization, King Edward Medical University; and Member, Annals of King Edward Medical University Advisory Board; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as Member, Pakistan Higher Education Commission Research Committee; Member, Pakistan Medical and Dental Commission Research and Journals Committee; Member, Pakistan National Bioethics Committee; Member, Pakistan Society of Internal Medicine; Member, Pakistan Association of Medical Editors; Member, Medical Microbiology and Infectious Diseases Society; Fellow of Leads International; Fellow of Faculty of Public Health UK; and Fellow of College of Physicians and Surgeons Pakistan; receipt of equipment, materials, drugs, medical writing, gifts or other services from Bergen University, Norway (computer software and equipment for research writing); and other financial or non-financial interests as Dean, Public Health Institute of Public Health Birdwood Lahore; Member, National Bioethics Committee Pakistan; and Member, Prime Minister Taskforce on HCV, HIV and Infectious Diseases; outside the submitted work. M Alhaj Moustafa reports grants or contracts from Genmab (research grant); consulting fees from ADC Therapeutics and Abbvie (payment to self), and from Genetech (payment to institution); and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Florida Society of Clinical Oncology (presentation payment); outside the submitted work. M Aslam reports grants or contracts from the Xiamen University Malaysia Research Fund (XMUMRF) for three projects:grant number XMUMRF/2025-C15/ITCM/0006 (Therapeutic and Toxicity Evaluation of Selected Medicinal Herbs for Non-Alcoholic Fatty Liver Disease: Exploring the Inter-Organelle Contact Sites Modulation Theory; Co-Investigator; Jan 2025–Dec 2027, ongoing), grant number XMUMRF/2023-C11/ISEM/0041 (Children’s Rights Education in the Early Years of Divorce: An Exploration of Adolescents’ Perspectives; Co-Investigator; Jan 2023–Dec 2025, ongoing), and grant number XMUMRF/2026-C17/ITCM/0007 (Olfactory Stimulation and Autonomic Regulation in Menstrual Disorders; Co-Investigator; Jan 2026–Dec 2028, ongoing; all internal XMUMRF research grants administered by Xiamen University Malaysia; funds disbursed to institutional research account only; no salary, honoraria, or personal payments to author); outside the submitted work. M Bell reports grants or contracts from US National Institutes of Health (NIH), the Hutchinson Postdoctoral Fellowship, the Health Effects Institute, the Robert Wood Johnson Foundation, and the Wellcome Trust Foundation (all paid to institution); consulting fees from Clinique and ToxiMap (paid to M Bell for consulting fee); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Colorado School of Public Health, Duke University, University of Texas, Data4Justice, Korea University, Brown University, Konkuk University, and the Research and Management Center for Health Risk of Particulate Matter (honorarium for speaker), from IOP Publishing (honorarium for editorial duties), from NIH, European Science Foundation, University of Texas, Fonds National de la Recherche Scientifique, and the Health and Medical Research Fund (HMRF; honorarium for grant review), from Korea University (honorarium paid to M Bell for research), from Harvard University (honorarium for external advisory committee), and from SciQuest (honorarium for online survey and workshop); support for attending meetings or travel from Colorado School of Public Health, University of Texas, Duke University, Harvard University, American Journal of Public Health, Columbia University, Community Modeling and Analysis System Conference, Nature Conference, Boston University, Konkuk University, Massachusetts Institute of Technology, National Academy of Sciences, Wellcome Trust, and University of Pennsylvania (travel reimbursement); and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as a member of the Fifth National Climate Assessment, The Lancet Countdown, the Johns Hopkins Department of Environmental Health and Engineering Advisory Board, the Harvard external advisory committee for training grant, and the WHO Global Air Pollution and Health Technical Advisory Group (no payment for all), and the US Environmental Protection Agency Clean Air Scientific Advisory Committee (CASAC; honorarium paid to M Bell); outside the submitted work. L Belo reports other financial or non-financial interests: L Belo acknowledges the support from Fundação para a Ciência e a Tecnologia in the scope of the project UID/04378/2025 and UID/PRR/04378/2025 of the Research Unit on Applied Molecular Biosciences—Applied Biomolecular Sciences Unit and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy—i4HB; outside the submitted work. S Bhaskar reports grants or contracts from the Japan Society for the Promotion of Science (JSPS) and the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT; Grant-in-Aid for Scientific Research [KAKENHI], grant number 23KF0126), and from JSPS and the Australian Academy of Science (JSPS International Fellowship, grant number P23712); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the Japan Stroke Society, Japan (honoraria for invited keynote presentation at the 50th Annual Meeting of the Japan Stroke Society, Osaka), and from Semey Medical University, Kazakhstan (honorarium for invited professorship and teaching course in neurocardiovascular therapy); support for attending meetings or travel from the Japan Stroke Society, Japan (travel award for invited keynote presentation at the 50th Annual Meeting of the Japan Stroke Society, Osaka), and from Asialink, The University of Melbourne (travel support for opening invited keynote at the 31st Asialink Leaders Foundation Week Program 2026, Melbourne); and leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as District Chair, Diversity, Equity, Inclusion & Belonging, Rotary District 9675, Sydney, Australia; Chair, Founding Member and Manager, Global Health & Migration Hub Community, Global Health Hub Germany, Berlin, Germany; Editorial Board Member, PLOS One, BMC Neurology, Frontiers in Neurology, Frontiers in Stroke, Frontiers in Public Health, Journal of Aging Research, Neurology International, Diagnostics, TouchNeurology, and BMC Medical Research Methodology; Member, College of Reviewers, Canadian Institutes of Health Research (CIHR), Government of Canada; Director of Research, World Headache Society, Bengaluru, India; Expert Adviser or Reviewer, Cariplo Foundation, Milan, Italy; Visiting Director, National Cerebral and Cardiovascular Center, Department of Neurology, Division of Cerebrovascular Medicine and Neurology, Suita, Osaka, Japan; Member, Scientific Review Committee, Cardiff University Biobank, Cardiff, UK; Chair, Rotary Reconciliation Action Plan; and Healthcare and Medical Adviser, Japan Connect, Osaka, Japan; outside the submitted work. M Carvalho reports other financial or non-financial interests from LAQV/REQUIMTE, University of Porto, Porto, Portugal (M Carvalho acknowledges the support from Fundação para a Ciência e a Tecnologia and Ministério da Ciência, Tecnologia e Ensino Superior under the scope of the project UID/50006/2025, DOI 10.54499/UID/50006/2025); outside the submitted work. R Dandona reports grants or contracts from the Mariwala Health Initiative, Mumbai, India, and the Indian Council of Medical Research, India; and participation on a Data Safety Monitoring Board or Advisory Board as Chair, Independent Programme Oversight Committee for COPE-BP (National Institute for Health and Care Research [NIHR] 206976); Member, Funding Committee, Global NIHR Global Health Research Groups Call 5, NIHR, UK; and Member, Health Metrics Sciences MS Admissions Committee, University of Washington, USA; outside the submitted work. I El Bayoumy reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as Editor in Chief for the journal Recent Trends in Infectious Diseases, and Editorial Member, Texila American Journal; outside the submitted work. C Farinha reports consulting fees from European Commission (Expert on assessing calls in health and wellbeing thematics), from Atheneum Partners (Expert/Avaliator), from Centre for Environmental and Sustainability Research – NOVA FCT, NOVA University of Lisbon (Research Collaborator), from TOP HEALTH association, Lisbon, Portugal (Board of com), and from Scientific Committee Conferences since 2019 (member of the Scientific Committee of RCS—Portugal); payment for expert testimony from European Commission and from Atheneum Partners; support for attending meetings or travel from Top Health association; patents planned, issued or pending with Top Health association and with RCS–Scientific Committee; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with Top Health association and with RCS–Scientific Committee, outside the submitted work. A Gogali reports consulting fees from Boehringer Ingelheim, Chiesi, and Menarini; payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing, or educational events from AstraZeneca, Boehringer Ingelheim, Chiesi, ELPEN, GSK, and Menarini; and support for attending meetings or travel from AstraZeneca, Boehringer Ingelheim, Chiesi, and Menarini; outside the submitted work. I Ilic reports support for the present manuscript from the Ministry of Science, Technological Development and Innovation of the Republic of Serbia (number 451–03–137/2025–03/200110); outside the submitted work. H Jiang reports grants or contracts from the Australian Research Council (DP200101781; LP240100314; DP260103244; payments made to La Trobe University to fund studies on alcohol, tobacco, and gambling harms and harm prevention); outside the submitted work. M Kashyap reports grants or contracts from the Indian Council of Medical Research (ICMR), New Delhi (grant number 5/13/55/2020/NCD-III); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Institute of Liver and Biliary Sciences, New Delhi, India, and Kuvempu University, Shimoga, Karnataka, India; and patents planned, issued or pending: 2023–1100–3940 (Indian Patent-Pending) and 2023–1105–8515 (Indian Patent-Pending); outside the submitted work. C Kieling reports grants or contracts from the Wellcome Trust, the UK Academy of Medical Sciences, and the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (Brazil; all research grants); consulting fees from the Wellcome Trust and the Child Mind Institute; and other financial or non-financial interests as Cofounder, Wida (digital mental health platform); outside the submitted work. K Kostikas reports grants or contracts from AstraZeneca, Boehringer Ingelheim, Chiesi, ELPEN, GSK, and Menarini; consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi, ELPEN, GSK, Guidotti, Menarini, Pfizer, and Sanofi; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Boehringer Ingelheim, Chiesi, ELPEN, GSK, Guidotti, Menarini, Pfizer, and Sanofi; support for attending meetings or travel from AstraZeneca, Boehringer Ingelheim, Chiesi, Menarini, Pfizer, and Sanofi; participation on a Data Safety Monitoring Board or Advisory Board from Chiesi; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as Member of GOLD Assembly; and other financial or non-financial interests from AstraZeneca (employee from Sept 2, to Nov 29, 2024); outside the submitted work. K Krishan reports other financial or non-financial interests: Kewal Krishan acknowledges non-financial support from the UGC Centre of Advanced Study, CAS II, awarded to the Department of Anthropology, and RUSA 2.0 grant awarded by Ministry of Education to Panjab University, Chandigarh, India. G La Rosa reports grants or contracts: GRM La Rosa was awarded a 2026 Scholarship from the Knowledge Action-Change Tobacco Harm Reduction Programme, an independent public health organisation based in the UK and funded by Global Action to End Smoking, a US-based independent non-profit 501(c)(3) grant making organisation, for a project focused on oral health. G La Rosa previously received funding through the same programme in 2024–25 for an additional oral health-related project. GRMLR received research support from ECLAT srl, a spin-off of the University of Catania. ECLAT has received funding from Global Action to End Smoking (which was known at the time as the Foundation for a Smoke-Free World); outside the submitted work. G Liu reports support for the present manuscript from the Al & Val Rosenstrauss Fellowship from the Rebecca L. Cooper Medical Research Foundation (the fellowship supports G Liu’s salary); outside the submitted work. J Liu reports support for the present manuscript: J Liu declared the grants from Beijing Natural Science Foundation (Z240004) and National Natural Science Foundation (72474005). J Lopez-Campos reports grants or contracts from Menarini and Grifols; consulting fees from GSK, Menarini, Zambon, Gebro, and Sanofi; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Grifols, Sanofi, AstraZeneca, CSL Behring, Bial, Faes Pharma, Menarini, GSK, Gebro, and Chiesi; and support for attending meetings or travel from Grifols, Chiesi, and Gebro; outside the submitted work. W Marz reports consulting fees from AMGEN, Sanofi, Amryt Pharmaceuticals, Abbott Diagnostics, Akzea Therapeutics, Novartis Pharma GmbH, and SOBI (all personal); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AMGEN, Sanofi, Amryt Pharmaceuticals, Abbott Diagnostics, Akzea Therapeutics, Novartis Pharma GmbH, and SOBI (all personal); leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as Board Member, DACH Society Prevention of Cardiovascular Disease; and other financial or non-financial interests from SYNLAB Holding Deutschland GmbH (employment); outside the submitted work. S Masi reports grants or contracts from Servier (personal contracts for consulting activities, lectures, presentations, manuscript writing, and educational events); consulting fees from Servier (personal consulting fees, 2022 to present); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Servier (personal honoraria for lectures, presentations, manuscript writing, and educational events, 2018 to present); support for attending meetings or travel from Servier (personal support for attending national and international meetings, 2018 to present); and participation on a Data Safety Monitoring Board or Advisory Board from Servier (participation on advisory board for the launch of new drugs, 2024 to present); outside the submitted work. G Mensah reports leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as Chair, World Heart Federation Science Committee; Member, World Heart Federation Executive Committee; and Member, GBD Scientific Council; and stock or stock options from NVIDIA, CrowdStrike, iShares U.S. Technology, and Palantir Technologies; outside the submitted work. S Meo reports grants or contracts: S Meo acknowledges support from the Ongoing Research Funding Program (ORF-2026–47), King Saud University, Riyadh, Saudi Arabia; outside the submitted work. G Milani reports consulting fees from Angelini Pharma (payments made to G Milani for scientific consultancy about the topic of fever of unknown origin and fever management); outside the submitted work. L Monasta reports support for the present manuscript: L Monasta acknowledges support from the Italian Ministry of Health (Ricerca Corrente 34/2017), payments made to the Institute for Maternal and Child Health IRCCS Burlo Garofolo. R Moreira reports grants or contracts from the CNPq Research Productivity Scholarship (R Moreira is a research productivity fellow of CNPq, National Council for Scientific and Technological Development; scholarship registration number 308986/2025–3; R Moreira requested that the acknowledgment of this grant and its number be included, as it is related to research using the GBD); outside the submitted work. S Nomura reports support for the present manuscript from the Ministry of Education, Culture, Sports, Science and Technology of Japan (24H00663); outside the submitted work. B Oancea reports support for the present manuscript from Unitatea Executivă pentru Finanțarea Învățământului Superior, a Cercetării, Dezvoltării și Inovării (project PN-IV-P6–6·1-CoEx-2024–0196, contract number 17/2.03.2026) and MRID (project PNRR/2022/C9/ MCID/I8, project code: 842027778, CF 68, project 760096); outside the submitted work. R Palma-Alvarez reports payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing, or educational events from Angelini Pharma, Casen Recordati, Lundbeck, Neuraxpharm, Rubio, Servier, and Takeda; and support for attending meetings or travel from Angelini Pharma, Italfarmaco, Advanz Pharma, Takeda, Lundbeck, and Camurus; outside the submitted work. R Passera reports participation on a Data Safety Monitoring Board or Advisory Board as Member of the Data Safety Monitoring Board for the clinical trial “Consolidation with ADCT-402 (loncastuximab tesirine) after immunochemotherapy: a phase II study in BTKi-treated/ineligible Relapse/Refractory Mantle Cell Lymphoma (MCL) patients”— Fondazione Italiana Linfomi, Alessandria, Italy (no payment received); and leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as Member of the European Society for Blood and Marrow Transplantation Statistical Committee, Paris, France (no payment received), Member of the Fondazione Italiana Linfomi Statistical Committee, Alessandria, Italy (no payment received), and Past Member (2020–23, biostatistician) of the Institutional Review Board/ Independent Ethics Committee Comitato Etico Antonio e Biagio Alessandria, Italy (no payment received); outside the submitted work. E Pirera reports support for attending meetings or travel from Chiesi Farmaceutici, Menarini, Sanofi, and Regeneron; and participation on a Data Safety Monitoring Board or Advisory Board: E Pirera has served as external expert for GSK; outside the submitted work. L Ronfani reports support for the present manuscript from the Italian Ministry of Health (Ricerca Corrente 34/2017): L Ronfani acknowledges support from the Italian Ministry of Health through the contribution given to the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy (Ricerca Corrente 34/2017). A Shaban-Nejad reports grants or contracts from the National Cancer Institute, the Tennessee Department of Health, and the National Institute on Minority Health and Health Disparities (all research grants; unrelated to this manuscript); consulting fees from Haleon (consulting fees for digital technologies; unrelated to this manuscript); payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing, or educational events from the National Comprehensive Cancer Network (honoraria for panel participation; unrelated to this manuscript); and support for attending meetings or travel from Haleon and the National Comprehensive Cancer Network (travel support to attend a meeting; unrelated to this manuscript, for both); outside the submitted work. V Shivarov reports payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing, or educational events from Johnson & Johnson, MSD, and Novartis (paid lectures, not related to this work); support for attending meetings or travel from AstraZeneca (travel grant, not related to this work); and patents planned, issued, or pending: one patent on COVID-19, not related to this work (Bulgarian Patent Office—BG113116A); outside the submitted work. J A Singh reports consulting fees from ROMTech, Atheneum, Clearview Healthcare Partners, Yale University, Hulio, Horizon Pharmaceuticals–DINORA, ANI–Exeltis USA, SOBI Pharmaceuticals, Frictionless Solutions, Schipher, Crealta–Horizon, Medisys, Fidia, PK Med, Two Labs, Adept Field Solutions, Clinical Care Options, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM, Trio Health, Medscape, WebMD, and Practice Point Communications, NIH, and the American College of Rheumatology (consultant fees paid to J A Singh for each entity); payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing, or educational events: J A Singh is on the speakers bureau of Simply Speaking (JAS previously served as a consultant and consultant fees were paid to J A Singh); support for attending meetings or travel: past Steering Committee Member of OMERACT (J A Singh previously received support from the organisation to attend their meeting every 2 years); participation on a Data Safety Monitoring Board or Advisory Board from the US Food and Drug Administration Arthritis Advisory Committee (J A Singh served previously as a member; no financial support); leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid: past Steering Committee Member of the OMERACT, an international organisation that develops measures for clinical trials and receives arm’s-length funding from 12 pharmaceutical companies (J A Singh previously received support from the organisation to attend their meeting every 2 years); and stock or stock options from Atyr Pharmaceuticals, Atai Life Sciences, Kintara Therapeutics, Intelligent Biosolutions, Acumen Pharmaceutical, TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, Aebona Pharmaceuticals, and Charlotte’s Web Holdings(J A Singh owns stock options), and previously from Amarin, Viking, and Moderna (J A Singh previously owned stock options in these companies); outside the submitted work. J Soriano reports support for the present manuscript: J Soriano has received pharmaceutical company grants from 2022 to 2026 from Chiesi, GSK, Linde, and Novartis via Hospital Universitario de La Princesa. Participated in speaking activities, advisory committees, and consultancies from 2022 to 2026 sponsored by Air Liquide, Almirall, AstraZeneca, Boehringer Ingelheim, American College of Chest Physicians, Chiesi, Comité Nacional de Prevención del Tabaquismo, European Respiratory Society, Fundación Teófilo Hernando, Gebro, Grifols, GSK, The Institute for Health Metrics and Evaluation, Laminar Pharma, Linde, Lipopharma, Menarini, Mundipharma, Novartis, WHO, Pfizer, ResApp, Research in Real Life, Laboratorios Farmaceuticos ROVI, Sociedad Española de Neumología y Cirugía Torácica, Sapio Group, Seqirus, WHO Europe, Takeda, and Zambon. J Soriano declares never having received, directly or indirectly, any funding from tobacco manufacturers or their affiliates. S Straube reports leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as Editorial Board Member, SN Comprehensive Clinical Medicine, and Board Member, M.S.I. Foundation (payments to S Straube); outside the submitted work. E Zainal Abidin reports grants or contracts from the UK Research and Innovation Medical Research Council (project grant MR/ W027801/1); outside the submitted work. All other authors declare no competing interests.