Royal college calls for smoking ban in cars

BMJ 2010; 340 doi: (Published 24 March 2010) Cite this as: BMJ 2010;340:c1689
  1. Jacqui Wise
  1. 1London

    The Royal College of Physicians of London has called for a ban on smoking in all vehicles, parks, and other public places frequented by children, as part of a raft of initiatives designed to protect children from passive smoking.

    A major report from the college’s tobacco advisory group concludes that passive smoking is a serious hazard to the health of millions of children. New figures in the report show that every year passive smoking causes more than 20 000 cases of lower respiratory tract infection, 120 000 cases of middle ear disease, 22 000 new cases of wheeze and asthma, 200 cases of bacterial meningitis, and about 40 sudden infant deaths. Most of this additional burden of disease falls on the more disadvantaged children.

    Launching the report, John Britton, chairman of the tobacco advisory group and director of the UK Centre for Tobacco Control Studies, said, “2010 is when the existing smoke free legislation comes up for review. It has proved highly effective in reducing exposure to smoke and resulted in marked improvements in health.

    “We now have the opportunity to close the small number of gaps in the legislation. We have made massive progress, but there are still two million children living in a home where somebody smokes.”

    The report contains new research carried out by the UK Centre for Tobacco Control Studies in Nottingham and funded by Cancer Research UK. Jo Leonardi-Bee, lecturer in medical statistics at the University of Nottingham and one of the report’s authors, said, “Passive smoking produces a threefold increase in sudden infant death syndrome and a 54% increase in lower respiratory infection, mainly bronchiolitis. It also results in a 35% increase in risk of middle ear infection.”

    The report states that the most important factor governing children’s exposure to smoke is whether their parents or carers smoke and whether smoking is allowed in the home. Professor Britton said, “We would like to promote smoke free homes and get away from the belief that smoking in only one room or only after the children go to bed is sufficient.”

    The report calls for mass media campaigns and health warnings on smoking in homes. It also calls for the real cost of cigarettes to increase and further action to reduce illicit supply. Professor Britton said he believed that smoking should be banned in all vehicles, not just those carrying children, as this would be easier to enforce. He added: “We are looking for a change in public perception in what is acceptable behaviour.”

    The report states that children growing up with parents or siblings who smoke are around 90% more likely to become smokers themselves. Liam Donaldson, chief medical officer for England, says in a foreword to the report: “One of the biggest impacts of smoking around children is that adult smokers can be seen as role models, increasing the likelihood that the child will, in due course, also become a regular smoker.”

    Richard Hubbard, professor of respiratory epidemiology at the University of Nottingham, said, “Passive smoking results in 303 000 excess consultations and about 9500 excess hospital admissions in the UK. The additional costs to the NHS are £9.7m [€10.8m; $14.6] a year in primary care costs and £13.6m in hospital costs.”

    Martin Dockrell, director of research and policy at Action on Smoking and Health, said, “There has been a shift in public opinion towards supporting smoke free legislation.” He said that support was growing for a ban on smoking in children’s play areas and in cars.


    Cite this as: BMJ 2010;340:c1689


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