Tobacco Research

The latest updates from the University of Bath's Tobacco Control Research Group

Tagged: smoke related illnesses

Impact of smoking ban on the most exposed children

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📥  Public policy

High levels of secondhand smoke exposure in children are known to have adverse consequences for arterial health. However, there is no information about the proportion of children in England that are exposed to these levels, whether it has changed over time and whether it has changed in response to the introduction of smoke-free legislation in 2007. 

Evidence suggests that legislation making enclosed public places and work-places smoke-free has reduced secondhand smoke exposure in non-smoking adults. There have however been concerns that smokers may smoke more at home if they cannot smoke in public places.  This displacement of smoking to the home could increase exposure among children.    In a paper published in Addiction, we report on trends in the proportion of children with high exposure, above a threshold level known to be detrimental to arterial health.  Understanding the impact of legislation is important because children who are not so heavily exposed may, by displacement of adult smoking to the home, be exposed to more secondhand smoke and are then pushed over this threshold. 

We analysed data from the Health Survey for England conducted between 1996 and 2008. These surveys measured cotinine, an indicator of tobacco smoke exposure, in the saliva collected from 16,000 children aged between 4 and 15.

We found that the proportion of children exposed to damaging levels of second-hand smoke has fallen over time. Amongst children in England, the percentage fell from 24% in 1996 to 13% in 2008. Despite the reduction over time, a large proportion of children continue to be highly exposed to second-hand smoke. In 2008, 49% of children living in homes allowing smoking inside and 34% of those with at least one parent who smokes had levels of exposure known to have adverse consequences for arterial health.

The research also reveals that legislation did not increase the proportion of children exposed to damaging levels of secondhand smoke. This strengthens evidence from England and other countries of the United Kingdom that legislation to prohibit smoking in public places and work-places does not displace adult smoking to the home.

 The study was funded by the Department of Health.

 The published paper can be accessed here:

Commentary on the paper can be accessed here:


Adults know that smoking harms others. Or do they really?

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📥  Public understanding


Children are still exposed to second-hand smoke in the home even though there is evidence that people know that it's harmful. However there’s little evidence to show that people know about the specific illnesses that second-hand smoke can cause.

We examined levels of and trends in knowledge of second-hand smoke related illnesses using the Omnibus Survey from 1996-2008 and we explored whether knowledge predicted smoke-free homes.

We found that when it comes to knowledge of specific illnesses caused by second-hand smoke, people do not know as much as we think they do. Amongst the general population in England, which includes both smokers and non-smokers, only 55 per cent knew that exposure to second-hand smoke can cause cot death in infants and only a third knew that it is causally linked with ear infections in children. Furthermore, a quarter were unaware that second-hand smoke exposure can cause heart attacks in non-smoking adults. Among smokers, these figures were even lower.

Smokers with good knowledge of the illnesses that can be caused by second-hand smoke were much more likely to make their homes smoke-free and were also more likely not to smoke when in the same room as a child.

We found that knowledge increased the most between 2003 and 2006; a period when mass media campaigns highlighting the toxicity of second-hand smoke were being aired on television.

In conclusion:

  • People’s knowledge of certain illnesses is poor.
  • People’s knowledge increased the most when targeted mass-media campaigns were aired.
  • Knowledge is positively associated with both smoke-free homes and refraining from smoking in a room with a child.

Our research suggests there is a valid case for reinstating mass-media campaigns as part of efforts to reduce children’s exposure to second-hand smoke.

The published paper can be accessed here: