Protecting children from second-hand tobacco smoke: evidence of major progress but a final push is needed in the UK

Abstract

First paragraph: We welcome the findings of Tattan-Birch and Jarvis1 in demonstrating a 90% reduction in objective measures of exposure to second-hand tobacco smoke [SHS] among children in England between 1998 and 2018. Their important study uses Health Survey of England [HSE] data on salivary cotinine, as a marker of nicotine intake and SHS exposure, to show that geometric mean values of cotinine reduced from 0.50 to 0.05 ng/ml. Their results additionally show that by 2018 over 93% of children in England were classified as living in a smoke-free home environment. Policymakers in Scotland have achieved similar improvements with a 2014 world-leading target to reduce the proportion of children exposed to SHS at home to under 6% by 2020.2 The change in social norms relating to smoking around children has been significant and well documented3 over the past two decades and, coupled to reductions in adult smoking prevalence, now mean that the majority of children in England have no detectable cotinine in their saliva.