More than 22,000 children seek medical help for asthma and wheezing as a result of passive smoking every year, according to the first UK assessment of the impact of second-hand smoke. The 200-page report on the health impacts of passive smoking on children, and the costs to the NHS, concludes that it is responsible for thousands of avoidable hospital and GP visits, as well as for one in five sudden infant deaths.
Doctors said that it provided the most compelling case yet for an extension of the smoking ban, which is due for review later this year, to enclosed public places, including cars, and open spaces frequented by children such as parks and playgrounds.
The report’s authors added that stronger action was needed to prevent the promotion of smoking in films watched by the young, with “gratuitous smoking” requiring an 18 certificate.
The report, from the Royal College of Physicians (RCP), calculates that more than 20,000 chest infections, 120,000 bouts of middle ear disease and 200 cases of meningitis in the young are linked to the effects of second-hand smoke.
Passive smoking results in more than 300,000 GP consultations for children and about 9,500 hospital admissions. Of the £23.3 million spent by the NHS every year treating the effects of passive smoking on the young, £9.7 million is due to doctors’ visits and asthma treatments, £13.6 million is spent in hospital admissions and £4 million on asthma drugs for the under 16s.
Presenting the report yesterday, John Britton, the chairman of the RCP’s tobacco advisory group, said that it should inform a series of strong policy decisions. He said that legislation to ban smoking in the home would be unenforceable so, instead, views of what was acceptable had to be changed to protect the millions of children who live with smokers.
Professor Britton added, however, that a total ban on smoking in cars and vans would be easier to enforce than the current situation where officers are expected to differentiate between business and private vehicles.
A Populus survey last year found that about three quarters of children whose parents smoked in their car wanted them to stop and were worried about the effect on their own health. Professor Britton said that even drivers who never had child passengers should get out of their cars before lighting up for reasons of road safety.
Richard Ashcroft, a professor of bioethics at Queen Mary, University of London, who contributed to the report, said that the review also gave opportunities to clamp down on smoking in public places frequented by children such as play areas and outdoor swimming pools.
Professor Britton said that this could include banning parents from smoking around the school gates but added that it would be difficult to legislate for situations like family barbecues in private gardens. “Adults need to think about who’s seeing them smoke,” he said.
More than three quarters of 13,000 adults told a YouGov poll last year that they would support a ban on smoking in children’s outdoor play areas.
Today’s report, funded by Cancer Research UK and carried out by the UK Centre for Tobacco Control Studies, partly based at Nottingham University, found that children whose parents both smoked were almost nine times as likely to be exposed to second-hand smoke as those in non-smoking families. If the father smoked then exposure was around three times higher. It was more than six times higher if the mother smoked. “Many parents believe that smoking in only one room or when the children have gone to bed will somehow protect the children from exposure,” Professor Britton said. “It doesn’t.” He added that there was a misconception that opening a window would reduce risk.
The RCP called for increases in the real price of tobacco, measures to tackle tobacco smuggling and illegal trading and investment in media campaigns targeted at young people. Cigarettes should also be taken off display in shops, while packaging should be generic and standardised, doctors said.
Other measures in the report include cutting down exposure to images of people smoking in the media — with films and television programmes that show gratuitous smoking classified as adult viewing — and stiff penalties for those who sell cigarettes to under-age children.
Sir Liam Donaldson, the Chief Medical Officer, welcomed the report. “This is a serious public health concern,” he said. The report’s recommendations aligned well with the Government’s 10-year vision for tobacco control set out in its strategy for England, A Smokefree Future.
“Among the many commitments in that report are plans to do more to reduce smoking in homes and cars in which children are present,” Sir Liam added.
The report was “very valuable” and would be considered as part of the Department of Health’s review of the legislation in England later this year.
The Department of Health said that children were being exposed to far less second-hand smoke as a result of smokefree legislation. “The Government is looking at ways to go further to reduce the 9,500 children admitted to hospital every year as a direct result of exposure to second-hand tobacco smoke,” said a spokesman.
“Parents have a responsibility to protect their children by stopping smoking around them in enclosed spaces like their cars and in their homes.”
Simon Clark, director of the smokers’ lobby group Forest, said that banning smoking in cars was “unacceptable and unenforceable”.
“If you ban smoking in cars, which is a private space, it’s a small step to banning smoking in the home,” he said. “Smoking in outdoor areas poses little or no threat to anyone’s health. Banning smoking in parks and other areas where children congregate would be a gross overreaction. We wouldn’t encourage people to smoke around children but adults should be allowed to use their common sense.”
By Sam Lister, The Times
March 24, 2010