Smoking in cars with children and health inequalities

There has been much discussion recently regarding banning smoking inside cars carrying children, in the lead up to MPs voting to legislate against it by 376 to 107 votes. The decision comes after recommendation of the move by the Royal College of Physicians and a letter in the British Medical Journal signed by 584 physicians calling for a ban.

The vote by MPs allows, but does not require, ministers to bring in the ban, and the shadow health minister has called on minsters not to delay in implementing the move. The move has predictably been opposed by organisations such as the tobacco industry funded Freedom Organisation for the Right to Enjoy Smoking Tobacco and the move is apparently opposed by the Deputy Prime Minister. However, in addition to the well-publicised health benefits, the move will also reduce health inequalities. Analysis of the Smoking, Drinking and Drug Use Survey of 11 to 15 year olds surveyed in 2012 found that overall 37.0% of these children had been exposed to smoke inside cars in the previous year. Exposure was considerably higher in children on Free School Meals than those not (48.6% vs. 34.8%) and analysis adjusting for age and sex found that these children were nearly twice as likely to be exposed (Adjusted Odds Ratio 1.83, 95% Confidence Interval 1.55 to 2.16). The survey asked children whether they were exposed to smoke inside the family, or another vehicle, and these results gave a similar picture.

So, in addition to the individual health benefits, banning smoking inside cars carrying children also presents an opportunity to protect poorer children and to narrow health inequalities.

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