The Association Between Passive Smoke Exposure and the Incidence of Pneumonia in Children Under Five: A Systematic Review
Abstract
Introduction: Pneumonia remains the foremost infectious cause of mortality in children under five years of age globally, disproportionately affecting those in low- and middle-income countries. Concurrently, a substantial proportion of this vulnerable population is involuntarily exposed to passive tobacco smoke, a known and modifiable risk factor for respiratory illness. This systematic review aims to synthesize and critically evaluate the contemporary evidence on the association between passive smoke exposure and the incidence and severity of pneumonia in young children.
Methods: This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search of PubMed, Google Scholar, Semantic Scholar, Springer, Wiley Online Library was performed to identify observational studies (cohort, case-control, cross-sectional) that quantified the risk of pneumonia or lower respiratory tract infection (LRTI) associated with passive smoke exposure in children under five. Two independent reviewers performed study selection, data extraction, and quality appraisal using the Cochrane Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool.
Results: Seventeen primary observational studies and several supporting meta-analyses met the inclusion criteria. The synthesized evidence demonstrates a consistent and statistically significant association between passive smoke exposure and an increased risk…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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