Experts call for second-hand smoke protection for children at home

An international team of public health experts, led by the University of Stirling’s ​​Institute for Social Marketing and Health, are calling for greater protection from second-hand smoke exposure for children within their homes.

Commentary published in the BMJ journal Tobacco Control highlights the urgent need for a fresh approach to the issue, including consideration of legislative measures to prevent smoking in homes where children are present.

It comes ahead of the 19th anniversary of Scotland's smoke-free public spaces legislation, which came into effect at 6am on March 26, 2006, and helped protect employees, customers and other visitors from the harms of second-hand smoke in most indoor settings.

While such existing smoke-free policies in public spaces and workplaces have successfully reduced adult exposure to harmful second-hand smoke, progress in lowering children’s exposure has been slower.

Evidence indicates that the concentration of second-hand smoke in homes is often significantly higher than in public spaces, due to smaller rooms and inadequate ventilation. Consequently, children exposed to second-hand smoke at home face an increased risk of health complications, including respiratory infections, asthma exacerbations, and impaired lung development.

Globally, second-hand smoke exposure causes over one million premature deaths annually, with 61% of the years of life lost borne by children. The exposure also disproportionately affects children from socio-economically disadvantaged backgrounds, exacerbating nationwide health inequalities.

National targets

As a result, academics are proposing a series of policy changes, including the introduction of national targets to reduce second-hand smoke exposure among children, coupled with tailored interventions among vulnerable populations.

The paper’s lead author, Professor Sean Semple, of the University of Stirling, said: “Despite 74 countries implementing comprehensive smoke-free policies in public spaces, this protection does not extend to homes – the primary environment where children are exposed. We have a significant gap in the protection of children’s health in the UK, with children unfairly bearing the brunt of lifelong health issues due to second-hand smoke exposure in private areas.

“The evidence suggests that legislative measures would help effect real change in the face of this large-scale health problem. A ban in the home could not only protect children’s health, but also shift social norms around smoking indoors, much like the effect of existing smoking bans in cars carrying children.

“With the UK Government's progressive Tobacco and Vapes Bill targeting a smoke-free generation, we would argue that measures to ensure smoke-free homes for children belong at the forefront of tobacco control strategies.

“We want to see a world where smoking in homes with children present is a thing of the past. This work is a vital step towards ensuring children globally have the right to grow up in clean and healthy living environments, free from the harmful effects of second-hand smoke.”

Professor Sean Semple

Experts also recommend the use of international data to track public support for home smoking bans at local, national, and global levels, and a review of current World Health Organisation Framework Convention on Tobacco Control guidelines to include private homes as a key environment for protection.

The paper highlighted that public support for such measures already exists, with a recent UK survey revealing that 68% of participants were in favour of banning smoking in homes where children are present.

Sheila Duffy, Chief Executive of health charity ASH Scotland (Action on Smoking and Health Scotland) said: “Tobacco smoke is toxic and is especially harmful to children whose lungs are growing and developing. ASH Scotland supports extending SAFE spaces (smoke-free and aerosol-free environments) especially to areas most used by children, to protect their health and discourage the uptake of tobacco and related products like e-cigarettes. How we achieve that protection should be consulted on and carefully considered.

“The new Tobacco and Vapes Bill brings an opportunity for real change; Scotland will be able to debate how best to protect children from breathing harmful tobacco smoke and the air pollution from recreational nicotine products like vapes and heated products. Everyone should have the right to breathe clean air.”

The paper, featuring contributions from international experts across the UK, Europe, and both South and North America, represents a global call to protect vulnerable populations through innovative and evidence-based policies.

Protecting children from second-hand tobacco smoke in the home: the need for a new approach is published in Tobacco Control.