Intended for healthcare professionals

Rapid response to:


Peers vote to legislate against smoking in cars with children

BMJ 2014; 348 doi: (Published 31 January 2014) Cite this as: BMJ 2014;348:g1284

Rapid Response:

Re: Peers vote to legislate against smoking in cars with children

Second hand exposure to tobacco smoke is a major cause of ill-health in children[1 2]. Smoke inhalation damages the developing lung and The Royal College of Physicians estimate that each year in the UK it is responsible for 300,000 primary care contacts, 9,500 hospital admissions, at least 200 cases of bacterial meningitis, and about 40 sudden infant deaths[1]. Most of this additional burden of disease falls on the more disadvantaged children in society[3] and all of it is avoidable. There is a strong consensus that children need to be protected from unnecessary hazards, that exposing children to tobacco smoke is unacceptable and that removing this exposure is effective[2].

Children in cars where a person is smoking are forced to inhale high levels of tobacco smoke[4]. As health professionals working to improve respiratory health we therefore welcome the amendment to the Children and Families Bill which allows the Government to introduce legislation to ban smoking in cars where children are present.[5]

Objections that this legislation impinges on freedom assume that there is a right to force children to breathe tobacco smoke and seem to value this more highly than children’s right to breathe clean air. There are precedents for legislation to determine behaviour while driving, most obviously laws requiring the wearing of seatbelts and the use of child car-seats[6], as well as the ban on mobile phone use while driving. Smoking in cars where children are present has been banned in other countries.

We urge Members of Parliament to support this important public health measure which will protect the wellbeing of children now and in the future.

Dr Nicholas S Hopkinson Chair, British Thoracic Society Specialist Advisory Group on Chronic Obstructive Pulmonary Disease
Professor Azeem Majeed, Professor of Primary Care, London
Professor John Britton, Professor of Epidemiology, Nottingham
Professor Andy Bush, Professor of Paediatric Respiratory Medicine, London
Professor Jon Ayres, Professor of Environmental & Respiratory Medicine, Birmingham
Professor Martin McKee CBE, Professor of European Public Health, London
Professor Trish Greenhalgh, Professor of Primary Health Care, London
and 584 others.

1. Royal College of Physicians. Passive smoking and children. A report of the Tobacco Advisory Group of the Royal College of Physicians. 2010
2. Mackay D, Haw S, Ayres JG, et al. Smoke-free Legislation and Hospitalizations for Childhood Asthma. New England Journal of Medicine 2010;363(12):1139-45 doi: doi:10.1056/NEJMoa1002861[published Online First: Epub Date]|.
3. Gartner CE, Hall WD. Is the socioeconomic gap in childhood exposure to secondhand smoke widening or narrowing? Tobacco Control 2013;22(5):344-48 doi: 10.1136/tobaccocontrol-2011-050297[published Online First: Epub Date]|.
4. Sendzik T, Fong GT, Travers MJ, et al. An experimental investigation of tobacco smoke pollution in cars. Nicotine & Tobacco Research 2009;11(6):627-34 doi: 10.1093/ntr/ntp019[published Online First: Epub Date]|.
5. Kmietowicz Z. Peers vote to legislate against smoking in cars with children. BMJ 2014;348 doi: 10.1136/bmj.g1284[published Online First: Epub Date]|.
6. World Health Organisation/ FIA Foundation. Seat-belts and child restraints. A road safety manual for decision-makers and practitioners. 2009

Competing interests: No competing interests

07 February 2014
Nicholas S Hopkinson
Senior Lecturer Respiratory Medicine
Professor Azeem Majeed, Professor John Britton, Professor Andy Bush, Professor Jon Ayres, Professor Martin McKee, Professor Trish Greenhalgh on behalf of 584 other health professionals
NIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Trust and Imperial College London
Royal Brompton Hospital, Fulham Rd, London SW3 6NP