Passive smoking: Double standards

It is ironic that the Government is condoning passive smoking by children, says Maggie Jones

At the same time that childminders are to be officially allowed to smoke in front of babies and young children with their parents' consent, the Department of Health is backing a proposal to protect adults from tobacco smoke in the workplace. Odd logic? Not, it seems, to the Government.

The Health and Safety Commission, a Government quango, has recommended an Approved Code of Practice for passive smoking at work under the Health and Safety At Work Act 1974. Failing to follow the Code would not be an offence in itself, but an employer would need to demonstrate that equally effective methods had been adopted to signal compliance with the law. Ways to control tobacco smoke could include a complete or partial ban on smoking; segregating non-smokers; providing adequate ventilation or implementing a system of work that reduces the time an employee is exposed to tobacco smoke. Ministers are considering the proposal.

Support for smoking restrictions has also been increasing among the general public since 1996, according to a report, Smoking-Related Behaviour and Attitudes, carried out for the Department of Health and published by National Statistics at the end of last year. Eighty-five per cent of those questioned in the survey were in favour of smoking restrictions at work, 88 per cent wanted them in restaurants and 54 per cent in pubs.

But it is children, rather than adults, who are most vulnerable to the effects of passive smoking. Every year 17,000 children under the age of five are admitted to hospital because of the effects of inhaling cigarette smoke, according to Smoking and the Young, a Royal College of Physicians report published in 1992.

Risk business Tobacco smoke contains more than 4,000 chemicals in the form of particles and gases, including tar, nicotine, benzene, carbon monoxide, ammonia, formaldehyde and hydrogen cyanide. Some 60 of these chemicals are known or suspected to be carcinogenic (causing cancer). The known health risks of passive smoking include:

• Cot death: The UK's largest-ever study into cot death found that babies who died were at least twice as likely to have been exposed to tobacco smoke. Postnatally, the more hours babies were exposed to cigarette smoke, the greater the risk of cot death. Babies exposed to more than eight hours of smoke a day were four times more likely to die than babies exposed to one hour.
  
  
• Immediate adverse effects: These can include eye irritation, headache, cough, sore throat, dizziness and nausea. Inhaling cigarette smoke can worsen asthma and actually cause it in children - the children of smokers have twice the risk of being asthmatic.

Passive smoking also increases the risk of lower respiratory tract infections such as bronchiolitis, bronchitis and pneumonia. And children exposed to passive smoking are 30 per cent more likely to suffer from glue ear, the commonest form of childhood deafness.

• Long-term risks: These include an increased chance of getting smoking-related diseases such as lung cancer and heart disease. According to one recent medical study, the risk for children is as high as 72 per cent in households where both parents smoke. The World Health Organisation report on Environmental Tobacco Smoke and Child Health showed that passive smoking has also been linked to cardiovascular and neurological impairment in children.

Informed choice How much do parents know about the health risks of smoking in front of children? Last year's health department survey showed that there has actually been a decrease in the numbers of parents who know about the risk of cot death from smoking, although about 53 per cent of parents in the survey did know there was some risk. Between 80 and 89 per cent knew about the higher risk of chest infections, lung cancer, bronchitis and asthma. There was evidence that adults modified their smoking behaviour in front of children, with 60 per cent saying they did not smoke at all in front of them, and 30 per cent saying they smoked fewer cigarettes.

We can hope parents will choose childminders who don't smoke. But regulation would be better for everyone. What if, in years to come, childminders were to be held liable for a smoking-related disease contracted by a child in their care, even if the parents consented at the time?

The Government is ignoring its own Scientific Committee on Tobacco and Health, which said that 'smoking in the presence of infants is a cause of serious respiratory illness and asthmatic attacks' and pointed out the link with cot death, as well as the Education Select Committee's recent report on the early years that came out against childminders smoking.