Scotland’s Smoking, Health and Social Care Act banned smoking in all public places and workplaces as of March 26, 2006. Previous studies have shown that adoption of the comprehensive smoke-free law has been associated with reduced respiratory symptoms among workers in bars.  A recent study published in the New England Journal of Medicine examines the impact of the legislation on children by looking at trends in childhood asthma hospitalization admissions before and after the law went into effect.  The study used hospital admissions records between January 2000 and October 2009 to determine asthma hospitalization rates for children under the age of 15 years.

Key findings:

• Admissions for asthma before the implementation of the smoke-free legislation increased at an average rate of 4.4% per year.  After implementation, there was an average reduction in admission rates of 15.1% per year.
• The reduction in childhood asthma hospitalization admissions occurred for both preschool and school-age children.

Before implementation of the Scottish legislation, there was concern that it might increase smoking activity to homes, leading to an increase in exposure to environmental tobacco smoke among children. Studies of exposure among both adults and children have shown no evidence of displacement of smoking to the home.  Instead, the legislation has been followed by an increase in voluntary restrictions in the home. Household smoking restrictions reduce the exposure of children to environmental tobacco smoke, and the overall exposure of children to environmental tobacco smoke has fallen since the implementation of the Scottish legislation.

Key messages:

• The exposure of children to environmental tobacco smoke has fallen since the implementation of the Scottish legislation, resulting in fewer hospital admissions for asthma.
• In addition to workers, children also benefit from comprehensive smoke-free legislation through reduced exposure to environmental tobacco smoke.

A link to the abstract [English only] can be found at: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1002861

Additional Resources:

• To access FCTC Article 8 Guidelines on protection from exposure to secondhand smoke [English]: http://www.who.int/fctc/cop/art%208%20guidelines_english.pdf
• To access fact sheets on smoke-free policies [English] including a fact sheet on health effects of secondhand smoke, go to: http://tobaccofreecenter.org/resources/smoke_free_laws/fact_sheets

Full Citation: Mackay D, Haw S, Ayres J, Fischbacher C, Pell J. Smoke-free Legislation and Hospitalizations for Childhood Asthma. New England Journal of Medicine Vol. 363:1139-45, 2010.

The New England Journal of Medicine is the oldest continuously published medical periodical.  Established in 1811, it employs a rigorous peer-review and editing process to evaluate manuscripts for scientific accuracy, novelty, and importance.

If you have any questions about the materials or how you may use them in your advocacy efforts, please e-mail research@tobaccofreecenter.org

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