A third of children hospitalised with asthma "exposed to cigarette smoke"

One in three children who ends up in hospital with an asthma attack has been exposed to cigarette smoke, prompting renewed concern about parents smoking at home around their offspring.

A major review of how hospitals treat children with asthma found that 32% of those treated for breathing difficulties encountered “environmental tobacco smoke” just beforehand.

Given that both the number of people and also the number of mothers who smoke is declining, “the fact that one third of children admitted in this audit were recorded as being exposed to cigarette smoking is worrying”, according to the British Thoracic Society’s national paediatric asthma audit.

It examined the records of 5,443 children treated as inpatients for asthma in 153 hospitals during November 2015.

“This study highlights the importance of making homes smoke-free since that is where children are most likely to be exposed to tobacco smoke, which can trigger asthma attacks,” said Deborah Arnott, chief executive of the anti-tobacco group Action on Smoking and Health.

“Health professionals need to do more to inform parents of the health risks of second-hand smoke, particularly to their children, and also to support parents who smoke to quit.”

Dr Russell Viner, officer for health promotion at the Royal College of Paediatrics and Child Health, said: “It is concerning that one third of children are exposed to environmental tobacco smoke. The effects of second-hand smoke on children are well known, yet it seems our children are still often feeling the brunt of it.”

Children’s doctors want the government to reverse its £200m-a-year cut to the public health budget in England in order to boost stop-smoking services, he added. “If adults and parents are properly supported to overcome this addiction, then this can have a real positive knock-on effect to asthma sufferers.”

A legal ban on adults smoking in cars containing under-18s came into force in England and Wales in October 2015. However, freedom of information requests in March showed that 39 out of 44 police forces who responded to the BBC’s request had issued none of the £50 fines or court summons and only six warnings to adults found smoking in a vehicle containing a child. Police officers say the law is almost unenforceable as they cannot issue a physical ticket for the offence.

The audit found that “medical care of children with acute wheeze/asthma continues to be highly efficient and effective”. Few children need to be ventilated or spend time in intensive care and most spend only a short time in hospital.

But too many children who present with asthma receive an X-ray or antibiotics or both and 44% still do not receive a written personal asthma plan when they are being discharged, making it more likely that they will have to be readmitted, the audit points out. In addition, 58% were not shown how to use their inhaler properly and 47% received explanatory leaflets about asthma and how to avoid a flare-up.

A third of children hospitalised with asthma "exposed to cigarette smoke"