Global Burden of Otitis Media Attributable to Secondhand Smoke in 204 Countries and Territories from 1990 to 2019: The Analysis of the Global Burden of Disease Study

Ear Nose Throat J. 2025 Jan 7:1455613241310582. doi: 10.1177/01455613241310582. Online ahead of print.

Abstract

Objective: Secondhand smoke (SHS) is a major public health concern. In this study, we evaluated the global burden of otitis media (OM) due to SHS exposure during 1990-2019 and explored the impact of socioeconomic factors on it.

Methods: With reference to the 2019 Global Burden of Disease (GBD) data, we assessed the OM burden linked to SHS during 1990-2019, stratified by gender, GBD region, and country. Join-point regression models analyzed trends in OM burden by calculating the average annual percent change (AAPC). Spearman's correlation examined the relationship between the Socio-demographic Index (SDI), Healthcare Access and Quality (HAQ) index, and SHS-related OM burden.

Results: During 1990-2019, age-standardized disability-adjusted life years (ASDRs) and age-standardized mortality rates (ASMRs) for OM due to SHS declined globally, with AAPCs of -1.45 for ASDR and -7.97 for ASMR. Significant declines in ASMR were noted in low-to-middle SDI regions. Regionally, Eastern Sub-Saharan Africa had the highest OM-related deaths, while South Asia had the highest disability-adjusted life years. OM burden decreased with higher SDI and HAQ.

Conclusion: Despite global declines, significant regional and national disparities remained, which emphasizes the need for targeted interventions.

Keywords: Global Burden of Disease; otitis media; risk factor; secondhand smoke.