APPENDIX 2
Memorandum by the National Asthma Campaign
(TB 2)
WELCOME
The National Asthma Campaign welcomes the opportunity
to submit written evidence to the Health Select Committee's Inquiry
into The Tobacco Industry and the Health Risks from Smoking.
INTRODUCTION
The National Asthma Campaign believes that all
of the UK's 3.4 millioni people with asthma should have the freedom
and independence to take
control of their health and control of their lives.
To enable this people with asthma should have
the right to breathe air that is clean and free of other people's
tobacco smoke.
The National Asthma Campaign is calling for the
Health Select Committee to consider, as part of its inquiry:
The immediate distress and long term disease
that other people's tobacco smoke causes for children and adults
with asthma in both public places and in their own homes;
The alarming relationship between parental,
particularly maternal smoking, and the adverse effects on the
baby's lungs of smoking during pregnancy.
National Asthma Campaign
The National Asthma Campaign is the independent
UK charity working to conquer asthma, in partnership with people
with asthma and all who share their concern, through a combination
of research, education and support.
The National Asthma Campaign estimates that
there are over 3.4 million people with asthma in the UK:
— Approximately one in seven children
(aged 2-15 years) has asthma symptoms currently requiring treatment—equivalent
to over 1.5 million children.
— At least one in 25 adults (aged 16
years and over) has asthma symptoms currently requiring treatment—equivalent
to over 1.9 million adults.
Since 1990, the National Asthma Campaign has
invested £16 million directly into funding research. We currently
commit total funds approaching £3 million annually to promoting
and funding research into asthma and related allergy, and to disseminating
the results. The charity also manages the NHS Research and Development
Programme on Asthma Management.
The Campaign spends about £1.5 million
each year on patient education, advice and support. Support at
local levels is provided through an active network of branches
and field based staff. We distribute approximately 250,000 information
booklets, videos and packs every year to people with asthma, parents,
health professionals, schools and students. We also offer telephone
advice and support via the Asthma Helpline where specialist asthma
nurse's answer over 18,000 calls each year. The Campaign's Professional
Subscription Scheme and programme of asthma education conferences
mean that it is in contact with a large number of health professionals
who care for people with asthma.
Asthma
Asthma is a long-term condition that affects
the airways—the tubes that carry air in and out of the lungs.
People with asthma have airways that are almost always red and
sensitive (inflamed). Asthma symptoms include coughing, wheezing,
a tight chest and getting short of breath. Not everyone will get
all these symptoms.
Freedom and Independence
The National Asthma Campaign believes that all
of the UK's 3.4 millionii people with asthma should have the freedom
and independence to take control of their health and so their
lives.
To enable this the National Asthma Campaign
believes that people with asthma should have the right to breathe
air that is clean and free of other people's tobacco smoke.
For all people smoking and passive smoking causes
avoidable distress and long term disease. But for people with
asthma; the impact of other people's tobacco smoke is immediate.
Cigarette smoke is a highly common trigger of
asthma attacks, causing difficulties for up to 80 per cent of
people with asthma.iii
Almost 50 children a day, over 17,000 a year,
are admitted to hospital because of the effects of other people's
cigarette smoke.iv
Of the 10,00 children who responded to the 1995
Blue Peter Asthma survey, 74 per cent said smoky places made their
asthma worse. Almost a third of those lived with somebody who
smoked.v
Actual smoking can cause an increased risk of
wheeze.
Research funded by the National Asthma Campaign
has shown that babies whose mothers continue to smoke during pregnancy
have almost a 50 per cent increased risk of being wheezy or having
breathing problems.vi
The impact of other people's tobacco smoke is
immediate.
Other people's tobacco smoke prevents people
with asthma enjoying full lives. People with asthma should not
have to restrict their working, recreational and social lives
because of other people's cigarette smoke.
— Asthma attacks;
— Increased sensitivity and reduced lung
function in people with asthma;
— Irritation of the eye, nose and throat;
— Reduced lung function in adults with
chronic chest problems.
Approximately 85 per cent of the smoke from
a lit cigarette goes unfiltered straight into the air where it
is inhaled by others. This is actually more harmful than the smoke
drawn direct from a cigarette by the smoker.vii
"There is evidence that exposure to other
people's tobacco smoke can lead to an increased need for emergency
hospital treatment for people with asthma".viii
One study showed how exposure to cigarette smoke
for just one hour caused a 20 per cent deterioration in the short-term
lung function of adults with asthma.ix
Children and tobacco smoke
Children are too often subjected to other people's
cigarette smoke, even in their own homes. Cigarette smoke is the
most common indoor environment pollutant to which children are
exposed. All children and in particular those with asthma should
have the choice to breathe air that is free of pollutants. Those
that live with smokers are too often denied that choice.
The 1995 Blue Peter Asthma survey, one of the
biggest contemporary surveys of children with asthma, showed that
the majority are suffering unnecessarily because of other people's
tobacco smoke.
Over 10,000 children responded to the survey
which revealed that for 74 per cent of them other people's tobacco
smoke made their asthma worse. Alarmingly, almost a third of those
children had to live with somebody who smoked in their own home.x
There is overwhelming scientific evidence to
verify the fact that other people's tobacco smoke not only increases
asthma symptoms and attacks, it impedes a child's recovery from
illness and it can actually cause new cases of asthma in healthy
children.
"Parental smoking is hazardous to all children,
especially those who have asthma. Passive smoke exposure can cause
an increase in asthma symptoms, emergency department visits and
hospital admissions".xi
"The increased risk associated with smoking
by other household members suggests that exposure to environmental
tobacco smoke after birth is a cause of acute chest illness in
young children".xii
Research has shown that when children that have
been hospitalised for acute asthma return to a home where there
is a smoker their recovery is impaired. 82 per cent of children
that went home to non-smoking households had less than one symptomatic
day per week compared with only 27 per cent of the children who
went home to households with smokers.xiii
A report on environmental tobacco smoke published
in September 1997 by the California Environmental Protection Agency
affirmed the findings of the US Environmental Protection Agency
on the link between other people's tobacco smoke and lung cancer
and respiratory diseases. It revealed for the first time that
passive smoking could be a causal factor in as many as 2,600 new
cases of asthma in the US annually.xiv
The 1996 Health Education Authority Survey found
that school pupils were three times more likely to be smokers
if both their parents smoked.xv
Actual smoking can increase the risk of wheeze
like symptoms in an unborn child
It is established that other people's tobacco
smoke, in both the home and public places, causes avoidable distress
and disease to children and adults with asthma.
However, the impact of tobacco smoke extends
even further, to unborn children. Children are being introduced
to the world with a greater chance that they will have breathing
problems, including wheezing and asthma, because their parents
have smoked during the pregnancy. There are already 1.5 million
children with asthma in the United Kingdom.
The medical research is conclusive:
"Children whose mothers smoke 15 or more
cigarettes a day have a 33 per cent higher risk of developing
a wheeze".xvi
"Smoking isn't just harmful early on in
a pregnancy, it is harmful at any stage and the risks to the baby
of wheezing and breathlessness are greater the longer a woman
smokes".xviii
Without effective government action the young
women smokers of today are likely to become the mothers of children
with asthma tomorrow.
Tobacco Advertising, Sponsorship and Promotion
The National Asthma Campaign welcomes the government
commitment to tackling tobacco advertising, sponsorship and promotion.
A Department of Health survey published in 1997 found that 15
per cent of girls and 11 per cent of boys aged 11-15 were regular
smokers.xx The tobacco companies are obviously still managing
to recruit young smokers through advertising and sponsorship.
What the National Asthma Campaign wants:
The National Asthma Campaign believes that firm
government measures are required to tackle the distress and long
term disease that smoking and other people's smoking causes for
people with asthma.
The National Asthma Campaign believes that a
ban on smoking in public places would allow people with asthma
the freedom and choice in their working, recreational and social
lives to take control of their health and take control of their
lives.
The opinion of people with asthma
Alongside the medical evidence of the distress
and long term disease that other people's tobacco smoke causes
for people with asthma, there is clear indication from the public,
and in particular those people with asthma, that they want to
use public places that are free of other people's tobacco smoke.
The 1997 National Asthma Campaign Members' Survey
found that almost 90 per cent of those who responded wanted smoking
banned in public places, with over 70 per cent of the 16 to 19
year age group agreeing.xxi
The opinion of health professionals is as equally
resolute.
"The tobacco industry must now stop its
pathetic attempts to evade the evidence and accept that cigarettes
not only harm and kill those who smoke them, they harm and kill
non-smokers too." Dr Bill O'Neill, Science and Research Adviser
for the BMA.
The charity has been calling for:
— A ban on all tobacco advertising,
sponsorship, and brand promotion;
— A ban on smoking in public places;
— Tobacco taxation to be introduced
at the maximum level allowed by European Union Law;
— A government awareness campaign to
highlight the proven fact that smoking during pregnancy increases
the risk of the unborn child developing wheeze like symptoms;
— Ongoing resourcing of support and
cessation advice for smokers who want to give up;
— Ongoing and targeted health education
campaigns aimed at discouraging young people to start smoking
in the first place.
July 1999
i National Asthma Campaign Audit 1997.
ii National Asthma Campaign Audit 1997.
iii The impact of Asthma Survey, 1996. The National
Asthma Campaign and Allen and Hanburys Ltd.
iv Royal College of Physicians. Smoking and
the Young: a report of a working party of the Royal College of
Physicians. London: Royal College of Physicians, 1992.
v The Blue Peter Asthma Survey was carried out
in association with the National Asthma Campaign in October 1995.
vi Professor Jean Golding, The Institute of
Child Health, Bristol University, 1996.
vii Royal College of Physicians. Smoking and
the Young: a report of a working party of the Royal College of
Physicians. London: Royal College of Physicians, 1992
viii Evans D et al. American Review of
Respiratory Disease 1987; 567-72.
ix Dahms TE, Bohlin JF and Slavin RG. Passive
smoking effects on bronchial asthma. Chest 1981; 80.
x The Blue Peter Asthma Survey was carried out
in association with the National Asthma Campaign in October 1995.
xi Beeber SJ. Parental smoking and childhood
asthma. Journal of Paediatric Health Care 1996;58-62.
xii Strachan D P, Cook D G. Parental Smoking
and lower respiratory illness in infancy and early childhood.
Thorax 1997;52:905-914.
xiii Abulhosn RS et al. Passive smoke exposure
impairs recovery after hospitalisation for acute asthma Archives
of Paediatrics and Adolescent Medicine, 1997;135-9.
xiv California Environmental Protection Agency,
Office of Environmental Health Hazard Assessment. Health effects
of exposure to environmental tobacco smoke. Sacramento: California
Environmental Protection Agency 1997.
xv Jarvis, L Smoking among secondary school
children in 1996: England, 1997. London SO.
xvi Lewis S et al. Prospective study
of risk factors for early and persistent wheezing in childhood.
European Respiratory Journal 1995; 8:349-356.
xvii Dr John Henderson, The Institute of Child
Health, London, 1996.
xviii Jarvis, L Smoking among secondary school
children in 1996: England, 1997. London SO.
xix The National Asthma Campaign's 1997 Members'
survey, Healthcare Professionals' Survey (Nurses) and Healthcare
Professionals' Survey (General Practitioners) were conducted by
PMSI UK Ltd on behalf of the National Asthma Campaign, with the
support of an educational grant from 3M Health Care.
| 
