Objectives To investigate parental smoking behaviours between England and Scotland after the smoke-free legislation in Scotland came into effect in 2006 and examine inequalities in maternal smoking behaviours between countries.
Methods 5954 white mothers and 3757 fathers resident in England and 1522 white mothers and 904 fathers resident in Scotland who participated in the Millennium Cohort Study (a prospective nationally representative cohort study) when the cohort child was age 9 months (before legislation) and 5 years (after legislation in Scotland but not in England). The main outcome measures were smoking at 9 months and 5 years, quitting smoking by 5 years, starting smoking by 5 years.
Results In England and Scotland approximately 30% of parents reported smoking at 9 months with only a slight decrease in smoking at 5 years. There were no differences between countries in parental smoking after the smoke-free legislation in Scotland came into effect, taking into account prior smoking levels. Light smokers (1–9 cigarettes/day) from Scotland were less likely to quit by 5 years than those from England, but there were no differences between countries among heavy smokers (10+ cigarettes/day). Non-smoking mothers from Scotland (6.2%) were less likely to start smoking by 5 years than mothers from England (7.3%). Mothers from more disadvantaged circumstances in both countries were more likely to report that they smoked or started smoking. In England quitting was also socially patterned, but in Scotland, after the legislation was introduced, the gradients in quitting smoking were flatter across social groups.
Conclusions Smoking behaviours among parents with young children remained relatively stable, highlighting the need for additional tobacco control efforts to support smoking cessation. However, the smoke-free legislation does not appear to widen health inequalities and may even help reduce them by encouraging quitting across socioeconomic groups.
- preschool children
- public policy
- environmental tobacco smoke
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Funding The Millennium Cohort Study is funded by grants to Professor Heather Joshi, director of the study, from the ESRC and a consortium of government funders. Summer Sherburne Hawkins is a Robert Wood Johnson Foundation Health & Society Scholar at the Harvard University site in Boston, Massachusetts. TJC is funded through an MRC programme grant (G0700961). Research at the Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust benefits from R&D funding received from the NHS Executive. The study design, collection, analysis and interpretation of data, writing of the report and the decision to submit the article for publication was conducted independent of the funding sources.
Competing interests None.
Ethics approval The MCS received ethical approval from the South West and London Multi-Centre Research Ethics Committees; however, no additional ethics approval was required for this study.
Provenance and peer review Not commissioned; externally peer reviewed.
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