Associations between a smoke-free homes intervention and childhood admissions to hospital: an interrupted time series analysis of whole population data

Steve Turner* (Corresponding Author), Danny Mackay, Smita Dick, Sean Semple, Jill P. Pell

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background. Many children remain exposed to secondhand smoke (SHS) in the home and are at increased risk asthma and other respiratory conditions. Our objective was to determine whether a national mass media smoke-free homes initiative (Take it Right Outside, TiRO) was followed by a fall in admissions for childhood asthma and other SHS-related respiratory conditions across Scotland.
Methods. Data were obtained on all emergency hospital admissions in Scotland between 2000 and 2018 for <16 year olds. Interrupted time series analysis studied changes in the monthly incidence of admissions for SHS-related conditions/1,000 children following TiRO (introduced in 2014) whilst
considering legislation banning smoking in public places (introduced in 2006). The primary SHSrelated condition was asthma. Gastroenteritis was included as a control condition. The analysis considered subgroups stratified by age and quintile of Scottish Index of Multiple Deprivations.
Findings. There were 740,055 eligible admissions, including 518,341 for under five-year-olds. After TiRO there was a fall relative to the underlying trend in the slope of admissions for asthma (0∙5%/month [95% CI 0∙1, 0.9]) for under five-year-olds, but not in older children. Following the 2006 legislation, the slopes for asthma admissions reduced among children aged under five years (0∙4%/month [0∙05, 0∙7]) and older (0∙7%/month [0∙4, 1∙1]) and for the most, but not the least, deprived areas (0.5%/month [0.1, 0.9]).
Interpretation. Policy implications of our findings are that (i) smoke-free homes interventions may lead to reduced asthma admissions in young children and (ii) smoke-free public spaces legislation may improve child health for many years, especially in the most deprived communities.
Original languageEnglish
JournalThe Lancet Public Health
Publication statusAccepted/In press - 23 Jul 2020

Keywords

  • asthma
  • children
  • respiratory
  • second-hand smoke

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