Smokefree Action: Child Health

Children are especially susceptible to harm from secondhand smoke. The risks associated with secondhand smoke exposure - from asthma to cot death - have been proven through robust international research.

According to the World Health Organisation children exposed to secondhand smoke are at risk of bronchitis, pneumonia, asthma attacks, middle ear infection and cot death.(1) It is estimated that about 40% of children in the UK live in a household where they are exposed to secondhand smoke. The most effective action parents can take to protect their children’s health is to give up smoking.(2)

How does prenatal smoking and secondhand smoke exposure harm an unborn baby?

Non-smoking women who are exposed to secondhand smoke during their pregnancy are more likely to have babies with lower birth weight and increase their likelihood of miscarriage. The BMA report, Breaking the cycle of children’s exposure to tobacco smoke maintains that no safe level of exposure to tobacco smoke during pregnancy has been identified.(2)

Maternal smoking is said to be the largest cause of preventable neonatal and infant ill health and death in the United Kingdom.(3) Further, maternal smoking creates a significant risk of Sudden Infant Death syndrome (SIDS) with the FSID, suggesting that 60% of cot deaths are due to either smoking during pregnancy or exposure to secondhand smoke.

Women who are exposed to secondhand smoke or smoke during pregnancy are at an increased risk of having low birth babies and on average weigh 200g lighter. Their babies are also at greater risk of respiratory disease such as asthma and bronchitis and foetal malfunctions including cleft lip and palate. Yet despite the risks associated with prenatal smoking, according to the Infant Feeding Survey 2005 a third of expectant mothers (33%) in the United Kingdom smoked in the 12 months before or during pregnancy.(4)

Childhood exposure to secondhand smoke has consistently been associated with serious illness during childhood and there is growing evidence of longer term health effects. With children’s immune systems and bodies still developing they face a greater risk of respiratory disease, asthma, cancer and sudden infant death syndrome.

The home is the most common environment where children are exposed to secondhand smoke. Measures such as smoking with a window open or smoking in another room where the child is not present are not sufficient to protect children from secondhand smoke and exposure to tobacco smoke is still greater than those found in children who live in homes which are smokefree.(3) The only way to ensure that children do not suffer the ill effects of secondhand smoke is to make homes smokefree.

As a result of secondhand smoke 17,000 children are admitted to hospital each year in the United Kingdom. Parents and other carers should be encouraged to stop smoking. Those who find it difficult to quit should be encouraged to use NRT whilst in the presence of children.

Smoking has a greater impact upon health inequalities for children from lower socioeconomic groups. There is a clear difference in smoking prevalence between socioeconomic groups with adults in routine occupations being twice as likely to smoke as those in professional occupations. It is estimated that 54% of children from lower income households are exposed to secondhand smoke compared with 18% of children from higher socioeconomic groups.(5)

Smoking is strongly associated with social deprivation. The average cost of smoking 20 cigarettes a day is £1800 per year, which brings an added economic burden to families who are already disadvantaged. Reducing smoking prevalence in the lowest socioeconomic groups is essential for reducing both the economic and health inequalities that children face.

A number of studies have found a strong association between parental smoking in the home and adolescent and child smoking prevalence. Studies have found that smoking restrictions in the home have a positive influence on adolescent smoking behaviour with lower odds of smoking with those living in homes without any smoking regulations.(6)

Smokers who begin to smoke at younger ages have higher rates of tobacco related mortality and morbidity and suffer tobacco related diseases earlier. Smoking during childhood and adolescence has a significant impact upon long term health including impaired lung growth and respiratory and heart problems.(7)

(1) World No Tobacco Day 2001, Second-hand smoke kills. Let’s clear the air

(2) Breaking the cycle of children’s exposure to tobacco smoke, British Medical Association, April 2007

(3) Royal College of Physicians (2007) Nictone Addiction in Britain.

(4) Infant feeding survey 2005, early results.

(5) Health Inequalities, Royal College of Physicians of London, Tobacco Advisory Group

(6) Szabo E, White V, Hayman N. Can smoking restrictions influence adolescent smoking behaviour if their parent and friends smoke? Add Beh 2006; 31: 2298-2303

(7) Smoking and child health: A review for paediatricians, BMA tobacco control resource centre 2006 [available from] http://www.doctorsandtobacco.org/files/123.ppt#1