Quick facts and figures

• According to the WHO Global Status Report on NCDs 2010, smoking is estimated to cause about 71% of all lung cancer deaths and 42% of chronic respiratory disease worldwide. Of the six WHO regions, the highest overall prevalence for smoking in 2008 was estimated to be the in the European Region, at nearly 29%.
• Survey data from 2002–2007 indicate that over half of all children aged 13–15 years in many countries in the European Region are exposed to second-hand tobacco smoke at home. This exposure exceeds 90% in the Balkans and the Caucasus. Second-hand smoke causes severe respiratory health problems in children, such as asthma and reduced lung function; and asthma is now the most common chronic disease among children throughout the Region. 
• According to the latest available data for 1997–2006, over 12% of infant deaths in the Region are due to respiratory diseases. In general, rates are considerably higher in eastern than in western Europe
• Indoor air pollution from biological agents related to damp and mould increases the risk of respiratory disease in children and adults. Children are particularly susceptible to the health effects of damp, which include respiratory disorders such as irritation of the respiratory tract, allergies and exacerbation of asthma. Damp is often associated with poor housing and social conditions, poor indoor air quality and inadequate housing hygiene, which includes factors such as overcrowding, low air exchange rate, low indoor temperature and poor insulation.
• Children subject to higher exposure to poor air quality indoors are at greater risk of being affected by outdoor pollutants.
• Increasing evidence suggests that allergic sensitization, which is the most common precursor to the development of asthma, can already occur antenatally. Emphasis on the health, nutrition and environment of the pregnant woman and the unborn child are therefore essential.
• Long-term average exposure to particulate matters determines both the risks of chronic effects of pollution on children’s health and the frequency of acute effects, such as the aggravation of asthma or incidence of respiratory symptoms.
• Ozone pollution causes breathing difficulties, triggers asthma symptoms, causes lung and heart diseases, and is associated with about 21 000 premature deaths per year in 25 countries in the WHO European Region.
• Most countries in the European Region have introduced a wide range of comprehensive policies to reduce and eliminate tobacco smoke. For example, the advertising of cigarettes and the sale of tobacco products to minors have been banned in more than 80% of the countries in the Region. Smoking in restaurants and bars continues to be regulated less strictly, however. Ireland, Turkey and the United Kingdom are the first countries to make public places 100% smoke free.

Selected country profiles

Kyrgyzstan

Mountainous geography contributes to Kyrgyzstan’s high mortality rate for chronic lung diseases. One in 10 adults, or approximately 200 000 people, require a metered-dose inhaler for chronic obstructive pulmonary disease (COPD) and bronchial asthma. Risk factors include high rates of heavy smoking and widespread use of biomass fuels for indoor heating and cooking.

The Netherlands

Even though it is a relatively small country, the Netherlands has over one million lung patients, and approximately 23 000 die of related causes every year, making lung disease the fourth most common cause of death. 28% of the Dutch adult population smokes. In the Netherlands, the incidence of CRD is increasing, while health-care spending is being reduced.

Poland

Asthma is worsening in Poland, along with an increased prevalence of rhinitis, wheezing and eczema. In total, 13 million Poles suffer from allergies.