Impact of smoke-free vehicle legislation on childhood hospitalisations for asthma: an interrupted time-series analysis of Scottish data over 19 years

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUNDIn Scotland, childhood asthma hospitalisations fell in March 2006 following legislation to prohibit smoking in public places. In December 2016, new Scottish legislation banned smoking in vehicles containing a child. This study aimed to determine if this produced additional benefit.METHODSData were obtained on all asthma emergency hospitalisations in Scotland between 2000 and 2018 for individuals aged <16 years. Interrupted time series analyses studied changes in monthly incidence following the introduction of smoke-free vehicle legislation, taking account of previous smoke-free interventions. Sub-group analyses were undertaken by age and area-deprivation, and the analyses repeated for a control condition, gastroenteritis, and other respiratory conditions.RESULTSOf the 32,342 asthma hospitalisations, 13,954 related to children <5 years old. After the smoke-free vehicle legislation, the slope in asthma hospitalisations fell by 1.49% per month [95% CI 0.27 to 2.69]) relative to the underlying trend among children <5 years (equivalent to 6 fewer hospitalisations per annum), but not older children. Hospitalisations fell significantly among children living in the most affluent areas (2.27% per month [95% CI 0.07 to 4.41]) but not those living in the most deprived areas. There was no change in hospitalisations for gastroenteritis or other respiratory conditions following the legislation.CONCLUSIONSLegislation banning smoking in vehicles was associated with reduction in severe asthma attacks requiring hospitalisations among pre-school children, over and above the underlying trend and previous interventions designed to reduce exposure to second-hand smoke. Similar legislation should be adopted in other countries.
Original languageEnglish
JournalThe Lancet Public Health
Publication statusAccepted/In press - 24 May 2021

Keywords

  • asthma
  • child
  • environmental tobacco smoke pollution
  • legislation
  • second-hand smoke

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