21 January 2013 Last updated at 05:00 GMT
Childhood asthma 'admissions down' after smoking ban
By Adam Brimelow
Health Correspondent, BBC News
There was a sharp fall in the number of children admitted to hospital with severe asthma after smoke-free legislation was introduced in England, say researchers.
A study showed a 12% drop in the first year after the law to stop smoking in enclosed public places came into force.
The authors say there is growing evidence that many people are opting for smoke-free homes as well.
Asthma UK says the findings are "encouraging".
Researchers at Imperial College in London looked at NHS figures going back to April 2002.
Presenting their findings in the journal Pediatrics, they said the number of children admitted to hospital with severe asthma attacks was rising by more than 2% a year before the restrictions were introduced in July 2007.
Taking that into account, they calculated the fall in admissions in the next 12 months was 12%, and a further 3% in each of the following two years. They say over the three-year period, this was equivalent of about 6,800 admissions.
The fall was seen among boys and girls of all ages, across wealthy and deprived neighbourhoods, in cities and in rural areas.
Prior to the smoke-free law much of the debate on the legislation centred on protection of bar workers from passive smoke.
At the time many critics said smokers would respond by lighting up more at home - harming the health of their families. But the authors of this study say there is growing evidence that more people are insisting on smoke-free homes.
The lead researcher, Prof Christopher Millett, said the legislation has prompted unexpected, but very welcome, changes in behaviour.
"We increasingly think it's because people are adopting smoke-free homes when these smoke-free laws are introduced and this is because they see the benefits of smoke-free laws in public places such as restaurants and they increasingly want to adopt them in their home.
"This benefits children because they're less likely to be exposed to second hand smoke."
These findings reinforce evidence on the impact of smoke-free legislation from studies in North America and Scotland, which also showed a fall in hospital admissions for children with severe asthma attacks. The law in England has also resulted in fewer admissions for heart attack.
Emily Humphreys from the health charity, Asthma UK, welcomed the findings: "This is something we campaigned for, so it is particularly encouraging that there has been a fall in children's hospital admissions for asthma since its introduction.
"We have long known that smoking and second hand smoke are harmful - they not only trigger asthma attacks which put children in hospital but can even cause them to develop the condition."
She said the need now was to do more to prevent children and young people from taking up smoking, and she repeated the charity's call for the introduction of plain packaging for tobacco.
Hospital Admissions for Childhood Asthma After Smoke-Free Legislation in England
Christopher Millett, PhDa, John Tayu Lee, PhDa, Anthony A. Laverty, MSca, Stanton A. Glantz, PhDb,c, and Azeem Majeed, MDa
Pediatrics peds.2012-2592; Published online January 21, 2013 (10.1542/peds.2012-2592)
aDepartment of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom;
bDivision of Cardiology, Department of Medicine, and
cCenter for Tobacco Control Research and Education, University of California, San Francisco, California
OBJECTIVE: To assess whether the implementation of English smoke-free legislation in July 2007 was associated with a reduction in hospital admissions for childhood asthma.
METHODS: Interrupted time series study using Hospital Episodes Statistics data from April 2002 to November 2010. Sample consisted of all children (aged ?14 years) having an emergency hospital admission with a principle diagnosis of asthma.
RESULTS: Before the implementation of the legislation, the admission rate for childhood asthma was increasing by 2.2% per year (adjusted rate ratio 1.02; 95% confidence interval [CI]: 1.02?1.03). After implementation of the legislation, there was a significant immediate change in the admission rate of ?8.9% (adjusted rate ratio 0.91; 95% CI: 0.89?0.93) and change in time trend of ?3.4% per year (adjusted rate ratio 0.97; 95% CI: 0.96?0.98). This change was equivalent to 6802 fewer hospital admissions in the first 3 years after implementation. There were similar reductions in asthma admission rates among children from different age, gender, and socioeconomic status groups and among those residing in urban and rural locations.
CONCLUSIONS: These findings confirm those from a small number of previous studies suggesting that the well-documented population health benefits of comprehensive smoke-free legislation appear to extend to reducing hospital admissions for childhood asthma.
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