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SmokeHaz: systematic reviews and meta-analyses of the effects of smoking on respiratory health

Jayes, Leah; Haslam, Patricia L.; Gratziou, Christina G.; Powell, Pippa; Britton, John; Vardavas, Constantine; Jimenez-Ruiz, Carlos; Leonardi-Bee, Jo


Leah Jayes

Patricia L. Haslam

Christina G. Gratziou

Pippa Powell

John Britton

Constantine Vardavas

Carlos Jimenez-Ruiz

Professor of Medical Statistics and Epidemiology


Background: Smoking tobacco increases the risk of respiratory disease in adults and children, but communicating the magnitude of these effects in a scientific manner that is accessible and usable by public and policymakers presents a challenge. We have therefore summarised scientific data on the impact of smoking on respiratory diseases to provide the content for a unique resource, SmokeHaz.

Methods: We conducted systematic reviews and meta-analyses of longitudinal studies (published to 2013) identified from electronic databases, grey literature, and experts. Random effect meta-analyses were used to pool the findings.

Results: We included 216 papers. Among adult smokers, we confirmed substantially increased risks of lung cancer (Risk Ratio (RR) 10.92, 95% CI 8.28-14.40; 34 studies), COPD (RR 4.01, 95% CI 3.18-5.05; 22 studies) and asthma (RR 1.61, 95% CI 1.07-2.42; 8 studies). Exposure to passive smoke significantly increased the risk of lung cancer in adult non-smokers; and increased the risks of asthma, wheeze, lower respiratory infections, and reduced lung function in children. Smoking significantly increased the risk of sleep apnoea, and asthma exacerbations in adult and pregnant populations; and active and passive smoking increased the risk of tuberculosis.

Conclusions: These findings have been translated into easily digestible content and published on the SmokeHaz website (


Jayes, L., Haslam, P. L., Gratziou, C. G., Powell, P., Britton, J., Vardavas, C., …Leonardi-Bee, J. (2016). SmokeHaz: systematic reviews and meta-analyses of the effects of smoking on respiratory health. Chest, 150(1),

Journal Article Type Article
Acceptance Date Mar 30, 2016
Online Publication Date Apr 19, 2016
Publication Date Jul 1, 2016
Deposit Date May 20, 2016
Publicly Available Date May 20, 2016
Journal Chest
Print ISSN 0012-3692
Electronic ISSN 1931-3543
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 150
Issue 1
Keywords Smoking, Passive Smoking, Systematic Review, Meta-Analysis, Respiratory Diseases, Lung Diseases, Health Risks, Policy Makers, Public Awareness
Public URL
Publisher URL


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