Smoke-free Home Intervention in Scotland

When an individual smokes a cigarette (or roll-up, pipe or cigar), most of the smoke doesn't go into their lungs, it goes into the air around them where anyone nearby can breathe it in. This is known as second-hand smoke.

Infants and children are particularly vulnerable to the negative impact of smoke.

The WHO Framework on Tobacco Control Article 8 concerns the protection from exposure to tobacco smoke. Although there has been a great effort in many countries to make public places smoke free, children and young people are still regularly exposed to second-hand smoke in their homes.

This article, published in The Lancet Public Health, describes the public health media campaign Take it Right Outside (TiRO), which was launched in Scotland 2014.

In the study, the researchers wanted to understand whether the introduction of the TiRO campaign was associated with a decrease in the incidence of hospital admissions in children with respiratory conditions known to be associated with second-hand smoke exposure.

The researchers collected data from hospital records, particularly looking at the childs the age, sex, area deprivation, main diagnosis, and the month and year of admission were obtained.

The researchers found

  • During the 19 year period, 138 931 (18·8%) of hospital admissions were for respiratory conditions potentially related to second-hand smoke exposure.
  • After TiRO was introduced in 2014, there was a decrease in the relative to the underlying trend in the slope in admissions for asthma in younger children (age <5 years), but not in older children (age 5–15 years).
  • Monthly rates of asthma admissions did not significantly change over time among children living in the most deprived, intermediate deprived, and least deprived areas between 2000 and 2018
  • in all children, admissions for asthma and lower respiratory tract infection continued to decrease, relative to the underlying trend, 12 years after the 2006 legislation (banning smoking in public spaces) was implemented and independently of TiRO.

The researchers point out that these results only capture changes in severe respiratory problems and there may be additional promising results when minor respiratory are taken into account.

The results indicate these kinds of mass public health campaigns could help reduce the damage caused by second-hand smoking. The authors conclude by saying "Although causation cannot be inferred, these results further support policies that include legislation for smoke-free public spaces."

Turner, S., Mackay, D., Dick, S., Semple, S., & Pell, J. P. (2020). Associations between a smoke-free homes intervention and childhood admissions to hospital in Scotland: an interrupted time-series analysis of whole-population data. The Lancet Public Health, 5(9), e493-e500.