Second-hand tobacco smoke exposure in Israel: A systematic review and meta-analysis of prevalence data, 2012-2024

Abstract

Objectives Exposure to second-hand tobacco smoke (SHS) remains a significant global public health concern. Although previous studies have estimated the prevalence of SHS exposure in Israel, a systematic synthesis has not been performed. This study aims to identify and describe the different studies performed in Israel to ascertain the prevalence of exposure to SHS. Study design Systematic review and meta-analysis. Methods A systematic literature review was conducted using Ovid Medline, Embase, and Web of Science, covering publications between 2012 and 2024. All studies reporting data on the prevalence of exposure to SHS in Israel were included. Data were extracted, summarised in tables, and differentiated by type of population (adults vs. children). A qualitative and quantitative synthesis of the results was performed. For the quantitative synthesis, a random effects model was used. Quality assessment was performed using a modified version of the Newcastle-Ottawa Scale. Results Eighteen studies met the inclusion criteria. The prevalence of exposure to SHS ranged from 20.5% to 94.9% among adults, and the respective range among children was 29.0% to 85.6%. Among adults, the pooled prevalence of SHS exposure was 56.0% (95% CI: 54.0% to 57.0%) by self-report and 51.0% (95% CI: 47.0% to 55.0%) by biomarker assessment. The corresponding estimates among children were 74.0% (95% CI: 73.0% to 75.0%) and 55.0% (95% CI: 50.0% to 60.0%). Heterogeneity was high in all analyses (I2 >90%). Conclusions The prevalence of exposure to SHS in Israel varies significantly due to differences in population type, definition of exposure, and assessment methods.