The risks of smoking in the home are well-established and affects of second-hand smoke on young children are particularly acute. All health practitioners, as well as other members of the early years workforce, have a role in raising awareness of the dangers of second-hand smoke with parents and carers of young children, and to support parents and carers to stop smoking and ensure a smoke-free home for their family.
Smoking in the home and inequalities in the early years
Smoking in the home has direct negative effects on the health of infants and children.
Smoking rates are higher among families living in deprivation and are major source of health inequalities across society.
Outcomes for children of smokers can be improved if they can make their homes smoke-free, ideally by quitting smoking.
Quick links:
- What are health inequalities?
- How do inequalities relate to smoking in the home?
- What are the risks to children from smoking in the home?
- Identifying those at risk
- Providing information and support to parents
What are health inequalities?
The WHO defines health inequalities as "differences in health status or in the distribution of health determinants between different population groups."
For a fuller discussion, please see Inequalities in the early years.
How do inequalities relate to smoking in the home?
Adults in the 15 per cent most deprived areas of Scotland are considerably more likely than those in the rest of Scotland to say that they are current smokers (40 per cent and 21 per cent respectively) (The Scottish Government 2010/2011: Scottish Household Survey(external link)).
Non-smokers’ cotinine levels (a measure of exposure to tobacco smoke) in the most deprived groups in Scotland are three times those living in the least deprived group (Scottish Health Survey, 2011 (external link)).
What are the risks to children from smoking in the home?
Among children across the UK each year, second-hand smoke is estimated to result in:
- over 165,000 new episodes of disease (lower respiratory infection, middle-ear disease, wheeze, asthma, meningitis)
- 300,000 GP consultations (mainly for middle-ear disease)
- 9,500 hospital admissions
- at least 200 cases of bacterial meningitis
- about 40 sudden infant deaths each year.
Most of this additional burden of disease occurs among the more disadvantaged children in our society.
Smoking in the home increases the risk of children experiencing:
- ear (including glue ear, middle ear disease), nose and throat problems
- reduced lung function, asthma symptoms (onset and worsening of existing symptoms - e.g. through increased severity of attacks and frequency of episodes) and respiratory infections (e.g. coughing, breathlessness, wheezing, bronchitis and pneumonia)
- sudden infant death syndrome.
Children who grow up in a home with smokers are also around twice as likely to become smokers themselves. (Royal College of Physicians, 2010: Passive Smoking and Children, (external link) and British Medical Association Board of Science, 2007, Breaking the cycle of children’s exposure to tobacco smoke (PDF download 361Kb)).
Smokers’ materials are also the most common factor in fatal fires in Scotland (Fire Statistics Scotland, 2011-12 (external link).
Identifying those at risk
Any child being cared for in an environment where people smoke indoors (or in vehicles used by the child) is at risk from the effects of second-hand smoke.
Those who work with parents and carers should ask directly about smoking in the home and offer advice to help them maintain a smoke-free home.
For specific advice for various workforce groups, please see the advice given below in how can I help address inequalities and promote smoke-free homes?
A Pathway of Care for Vulnerable Families (0-3) (external link) sets out key contact points and interactions for those working with vulnerable families.
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Providing information and support to parents
The 2012 Health Scotland paper: Exploration of the information support needs of parents(external link), was the result of in-depth work with 132 parents from across Scotland.
It found that parents preferred 'personal, empathetic support from individuals in dealing with their specific needs for information and support on child health and parenting'.
Three overarching themes emerged:
- Parent information/support is undermined when parents feel marginalised
- ‘Trust’ shapes how information is sought, received and used
- Parents respond most positively to personalised information and support.
