Why are smoke-free homes important and how can we increase the number of smoke-free homes? Professor Amanda Amos

Second-Smoke Exposure- a global public health issue Over 600,00 deaths a year Also a major cause of morbidity and health care costs An important cause of inequalities in health- adults and children Children are especially vulnerable- small airways, shallow breathing 40% of the world’s children exposed to SHS, particularly in many Asian countries eg Indonesia 79%, China 67%

‘Studies of respiratory illnesses in children whose parents smoke, and research into whether ETS exposure exacerbates symptoms for people with conditions such as asthma, suggest that ETS can increase risks of respiratory illnesses in children and can affect people with pre-existing conditions such as asthma’.

‘Studies of respiratory illnesses in children whose parents smoke, and research into whether ETS exposure exacerbates symptoms for people with conditions such as asthma, suggest that ETS can increase risks of respiratory illnesses in children and can affect people with pre-existing conditions such as asthma’.

Why is SHS exposure in the home an issue? The home is a major source of children’s exposure 600 million children live in homes where people smoke regularly 54% of 10-11 year olds in Malaysia exposed to SHS in the home Gender issue fathers are the main source of exposure in the home where male smoking rates much higher than females (Asia) - Malaysia 43% men smoke, 1% women smoke opposite in UK where rates similar, men 18% and women 14%, but mothers still provide most childcare Female adult non-smokers also exposed to men’s smoke at home- 33% in Malaysia (GATS 2011) An inequalities issue- exposure levels higher in low SES homes- UK and Malaysia Malaysia- also varies by race/ethnicity and religion (GATS 2011)

Why are smoke-free homes important? In UK as a result of SHS exposure related ill-health : 800 children per day see a doctor 25 children per day admitted to hospital A smoke-free home makes successful quitting x5 more likely for smokers Reduced risk of child becoming an adult smoker- Children of non-smoking parents 70% less likely to become smokers than children of smoking parents Current estimates are that 50,000 children in Scotland are still exposed to SHS at home * UK figures – from RCP March 2010 report

Children’s exposure to SHS in their homes in Scotland (Scottish Health Survey)

Children ever exposed to SHS in the home by age, Scotland (SHeS 2015)

Source: SALSUS 2016

15 year olds who say at least one parent smokes daily by deprivation, Scotland 2015 (SALSUS)

Smoking in children’s (<16) homes by deprivation, Scotland, 2016 (SHeS)

How can we increase the number of smoke-free homes? Reduce adult smoking prevalence Reduce levels of smoking in the home Capability- knowledge, awareness of risks Motivation- considerate smoker, caring parent Opportunity- to change smoking behaviour eg smoking outside