Modifying parental smoking habits – how things have changed since 2010?

Abstract

Smoking legislation is associated with reduced children’s SHS exposure and asthma exacerbations. Bans on smoking in public enclosed space were introduced in the UK, first in Scotland in 2006 and then England and Wales in 2007. At the time of implementation there was concern that these legislations might paradoxically increase children’s SHS exposure by shifting smoking into private enclosed spaces, i.e. the child’s home. However, the bans have been associated with reductions in SHS exposure, e.g. in England the proportion of children with detectable SHS exposure has fallen from 66% to 51% between 2006 and 2008. Perhaps more importantly, the smoking bans have coincided with a reduction in the number of children admitted to hospital with asthma in the UK. Smoke free homes can be implemented, are appreciated by parents and are associated with reduced SHS exposure in children. Establishing a Smoke Free Home (SFH) is one method of creating a “smoke free bubble” around the children whilst parents continue to smoke. Despite some reservations that SFH offered smokers an opportunity to carry on smoking and not quit, SFH are now widely accepted as an effective means to safeguard children from SHS. Additional evidence supporting the role of SFH is that the chance of a smoker in a SFH quitting is 8% per annum compared to 2% for all smokers. One important limitation to SFH is that they do not safeguard the unborn child. A series of recent articles have demonstrated the feasibility and potential effect of SFH. In Leeds, approximately one third of smoking households are currently smoke free and simple interventions can double this proportion. A study in Aberdeen demonstrated that SFH was associated with lower SHS exposure in preschool children. Work from the South West of England demonstrated maternal smoking continued to determine SHS exposure at ages 7 and 15 years. In 2010 I wrote “There is a rather thin evidence base to guide clinicians through the