Inter-provincial　trade　can　bring　“emission　leakage”,　and　consequently　influence　the　air　quality　and　public　health.　However,　there　has　been　a　lack　of　systematic　research　on　air　pollution　and　public　health　related　to　emission　leakage　embodied　in　inter-provincial　trade　of　China.　Here,　we　systematically　evaluated　for　the　first　time　the　influence　of　emission　leakage　on　national　air　pollution　and　related　premature　deaths　in　2012　of　China.　Unexpected　opposite　influences　of　emission　leakage　on　emission　and　air　quality/public　health　were　discovered.　Emission　leakage　embodied　in　inter-provincial　trade　in　2012　of　China　led　to　an　increase　of　1.4　%　to　4.8　%　in　national　air　pollutant　emissions,　but　a　decrease　of　1.5　%　(−0.8　μg·m−3)　in　population-weighted　concentration　of　PM2.5,　while　avoiding　1.1　%　(−1.4　×　104　people)　of　premature　deaths.　Therefore,　to　reveal　the　intrinsic　mechanism　of　this　opposite　influences,　we　proposed　two　coefficients,　the　Concentration　per　unit　primary　PM2.5　emission　(CPE,　unit:　μg·m−3/t)　and　the　Death　per　unit　primary　PM2.5　emission　(DPE,　unit:　people/t),　to　characterize　the　response　of　air　quality　and　health　to　emission　leakage　embodied　in　inter-provincial　trade.　Statistical　analysis　indicated　that　both　the　above　coefficients　showed　significant　negative　correlation　(P　＜　0.05)　with　provincial　PM2.5　emissions　changes.　The　findings　offer　a　means　of　adjustment　and　its　related　evaluation　parameters　for　the　emission　transfer　caused　by　inter-provincial　trade,　thereby　contributing　to　further　improvement　environmental　and　health　benefits　through　inter-provincial　trade.　©　2023　Elsevier　B.V.