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Passive smoking and children


In 2008, over 11,000 people in the UK are estimated to have died as a result of passive smoking. Although regarded for many years as little more than a nuisance, exposure to ambient tobacco smoke released directly by burning tobacco and indirectly by exhalation of smoke by smokers (also variously referred to as environmental tobacco smoke, second-hand smoke, or tobacco smoke pollution) is now a recognised cause of significant short- and long-term harm to others. Many of those adverse health effects were summarised, particularly in relation to adult exposure, in an earlier Royal College of Physicians report

Increasing awareness of these health risks has led the UK and several other countries to introduce legislation restricting or prohibiting smoking in enclosed public places. This legislation has typically been justified by the legal and moral obligation to ensure safe working environments and, in the UK, to prevent the 600 or so deaths previously estimated to be caused each year by passive smoking at work. However, these are the minority of deaths caused by passive smoking, the bulk of which (an estimated 10,700 deaths in adults in 2003)* arise from exposure to tobacco smoke in the home.

Passive smoking in the home is also a major hazard to the health of the millions of children in the UK who live with smokers, and the extent of this health problem has not, to date, been accurately quantified. Therefore use established literature and additional analysis to estimate the prevalence, determinants and trends in passive smoking exposure, present new systematic reviews and meta-analyses of the magnitude of the effects of passive smoking on the main recognised health consequences in children, and estimate the numbers of cases of illness and death arising from these effects. We also quantify the effect of exposure to smoking behaviour on the risk of children starting to smoke, and estimate the number of children who do take up smoking as a consequence. We then consider the financial cost of the disease burden for the NHS and wider society arising from all of these exposures. We must also explores ethical issues relating to passive smoking and children, and public opinion on measures to prevent passive smoking, concluding with policy options that would reduce exposure of children to this significant health hazard and negative behavioural model.

The costs of passive smoking in children
* Passive smoking in children costs at least £9.7 million each year in UK primary care visits and asthma treatment costs, and £13.6 million in UK hospital admissions.
* The cost of providing asthma drugs for children who develop asthma each year as a result of passive smoking up until the age 16 in the UK is approximately £4 million.
* The future treatment costs of smokers who take up smoking as a consequence of exposure to smoking by parents could be as high as £5.7 million each year, or £48 million over 60 years.
* These smokers may also impose an annual cost of £5.6 million in lost productivity due to smoking-related absence and smoking breaks in the workplace, which translates to an estimated £72 million over their working careers.
* These significant economic costs are all avoidable.
* Interventions to reduce passive smoking thus have potential to make cost savings to the NHS and in the workplace, as well as improving the health of children.

Governments, and societies, have a duty to ensure that children grow up in a safe environment, and are protected from explicit or implicit encouragement to take up hazardous behaviours such as smoking. This report provides some of the background and policy measures necessary to ensure that that duty is discharged.

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