The good news is that smoking among children in the UK is declining, but the bad news is that lots of children do still smoke, and this means they are at increased risks for lots of serious diseases. Childhood and adolescence is an important time for lots of reasons and one of those is that we know that this is when the majority of people take up smoking. Few studies have used national data to assess what are the factors associated with children and adolescents taking up smoking, which is important to know so that we can work to reduce this.

We used data from the Millennium Cohort Study, a study set up in the year 2000 which has been tracking over ten thousand children from birth until age 14. The study provides rich information on the family and social circumstances of these children as they enter adolescence and adulthood. We used data from when they were 14 years old to assess the number of ever and current use of tobacco in different areas of the UK, and what factors were related to being an ever or current smoker.

Percentages of children smoking vary across the UK. In Wales 15% of children aged 14 years have ever tried tobacco and 2.3% are current users. These percentages may seem small but they equate to more than 10,000 ever smokers and 1,500 current smokers among 14 year olds in Wales. Across the whole of the UK almost 230,000 14 year olds have ever tried tobacco and almost 40,000 are using it currently. Looking at what is associated with this smoking we found that caregiver and peer smoking are extremely important. If your caregiver smokes, then you are almost twice as likely to be a current smoker (26% vs. 11%) and if your peers smoke you are even more likely to be a current smoker (35% vs. 4). Finally, children whose mother smoked during pregnancy were also more likely to be smokers.

The findings highlight the links between peer and caregiver smoking and children taking up a deadly habit. Increased support is needed at a number of levels: caregivers should be further supported to quit, as should pregnant women. School based strategies have also been recommended which reduce uptake of smoking among children. We know what to do about smoking among children, but the challenge remains implementing these measures, which can be difficult and time consuming, in a time of public health budget cuts.

Anthony Laverty, Lecturer in Public Health – Imperial College London