Smoke-free legislation and childhood hospitalisations for respiratory tract infections

Second-hand smoke exposure is a major risk factor for respiratory tract infections (RTIs). Although evidence suggests important early-life health benefits of smoke-free public environments, the impact on childhood RTIs is unclear. We investigated the association between England's smoke-free legislation and childhood RTI hospitalisations.

We used the Hospital Episode Statistics database to obtain nationwide data on hospital admissions for acute RTIs among children (

We analysed 1 651 675 hospital admissions. Introduction of smoke-free legislation was followed by an immediate reduction in RTI admissions (-3.5%, 95% CI -4.7--2.3%), this mainly being attributable to a decrease in lower RTI admissions (-13.8%, 95% CI -15.6--12.0%). The reductions in admissions for upper RTI were more incremental.

The introduction of national smoke-free legislation in England was associated with similar to 11 000 fewer hospital admissions per year for RTIs in children.