Admissions fell by 12.3 per cent in first year of legislation, finds Imperial study

The introduction of smoke-free legislation in England was immediately followed by a fall in the number of children admitted to hospital with asthma symptoms, a new study has found.

NHS statistics analysed by researchers at Imperial College London show a 12.3 per cent fall in admissions for childhood asthma in the first year after the law on smoking in enclosed public places and workplaces came into effect in July 2007. The researchers found that asthma admissions continued to fall in subsequent years, suggesting that the benefits of the legislation were sustained over time.

The effect was equivalent to 6,802 fewer hospital admissions in the first three years of the legislation, according to the analysis published today in the journal Pediatrics.

Asthma affects one in every 11 children in the UK. Before the law was implemented, hospital admissions for children suffering a severe asthma attack were increasing by 2.2 per cent per year, peaking at 26,969 admissions in 2006/2007. The trend reversed immediately after the law came into effect, with lower admission rates among boys and girls of all ages. There were similar reductions among children in wealthy and poor neighbourhoods, both in cities and in rural areas.

Previous studies have shown that hospital admissions for childhood asthma fell after smoke-free legislation was introduced in Scotland and North America. The law in England was also found to have reduced the rate of heart attacks.

Dr Christopher Millett, from the School of Public Health at Imperial College London, who led the study, said: "There is already evidence that eliminating smoking from public places has resulted in substantial population health benefits in England, and this study shows that those benefits extend to reducing hospital admissions for childhood asthma.

"Previous studies have also suggested that the smoke-free law changed people's attitudes about exposing others to second-hand smoke and led more people to abstain from smoking voluntarily at home and in cars. We think that exposing children to less second-hand smoke in these settings probably played in important role in reducing asthma attacks.

"The findings are good news for England, and they should encourage countries where public smoking is permitted to consider introducing similar legislation."

Reference

C. Millett et al. 'Hospital Admissions for Childhood Asthma After Smoke-free Legislation in England' Pediatrics 2013;131:1–7 doi: 10.1542/peds.2012-0001