{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:12:04Z","timestamp":1762866724046},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T00:00:00Z","timestamp":1444780800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T00:00:00Z","timestamp":1444780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We investigated the association between introduction of smoke-free legislation in the UK (March 2006 for Scotland, April 2007 for Wales and Northern Ireland and July 2007 for England) and the incidence of respiratory diseases among children. We extracted monthly counts of new diagnoses of wheezing\/asthma and RTIs among children aged 0\u201312 years from all general practices in the Clinical Practice Research Datalink during 1997\u20132012. Interrupted time series analyses were performed using generalised additive mixed models, adjusting for underlying incidence trends, population size changes, seasonal factors and pandemic influenza, as appropriate. 366,642 new wheezing\/asthma diagnoses and 4,324,789 RTIs were observed over 9,536,003 patient-years. There was no statistically significant change in the incidence of wheezing\/asthma after introduction of smoke-free legislation in England (incidence rate ratio (IRR) 0.94, 95% CI 0.81\u20131.09) or any other UK country (Scotland: IRR 0.99, 95% CI 0.83\u20131.19; Wales: IRR 1.09, 95% CI 0.89\u20131.35; Northern Ireland: IRR 0.96, 95% CI 0.76\u20131.22). Similarly no statistically significant changes in RTI incidence were demonstrated (England: IRR 0.95, 95% CI 0.86\u20131.06; Scotland: IRR 0.96, 95% CI 0.83\u20131.11; Wales: IRR 0.97, 95% CI 0.86\u20131.09; Northern Ireland: IRR 0.90, 95% CI 0.79\u20131.03). There were no demonstrable reductions in the incidence of paediatric wheezing\/asthma or RTIs following introduction of smoke-free legislation in the UK.<\/jats:p>","DOI":"10.1038\/srep15246","type":"journal-article","created":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T09:24:15Z","timestamp":1444814655000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Smoke-free legislation and the incidence of paediatric respiratory infections and wheezing\/asthma: interrupted time series analyses in the four UK nations"],"prefix":"10.1038","volume":"5","author":[{"given":"Jasper V.","family":"Been","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Szatkowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tjeerd-Pieter","family":"van Staa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert G.","family":"Leufkens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onno C.","family":"van Schayck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aziz","family":"Sheikh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Souverein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2015,10,14]]},"reference":[{"key":"BFsrep15246_CR1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/S0140-6736(10)61388-8","volume":"377","author":"M Oberg","year":"2011","unstructured":"Oberg, M., Jaakkola, M. S., Woodward, A., Peruga, A. & Pruss-Ustun, A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 377, 139\u2013146 (2011).","journal-title":"Lancet"},{"key":"BFsrep15246_CR2","doi-asserted-by":"crossref","unstructured":"Callinan, J. E., Clarke, A., Doherty, K. & Kelleher, C. Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst. Rev. CD005992 (2010).","DOI":"10.1002\/14651858.CD005992.pub2"},{"key":"BFsrep15246_CR3","doi-asserted-by":"publisher","first-page":"2177","DOI":"10.1161\/CIRCULATIONAHA.112.121301","volume":"126","author":"CE Tan","year":"2012","unstructured":"Tan, C. E. & Glantz, S.A. Association between smoke-free legislation and hospitalizations for cardiac, cerebrovascular and respiratory diseases: a meta-analysis. Circulation 126, 2177\u20132183 (2012).","journal-title":"Circulation"},{"key":"BFsrep15246_CR4","unstructured":"World Health Organization, WHO report on the global tobacco epidemic, 2015. Raising taxes on tobacco. (2015). Available at: http:\/\/www.who.int\/tobacco\/global_report\/2015\/en. (Accessed 19th August 2015)."},{"key":"BFsrep15246_CR5","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1016\/S0140-6736(14)60082-9","volume":"383","author":"JV Been","year":"2014","unstructured":"Been, J. V. et al. Effect of smoke-free legislation on perinatal and child health: systematic review and meta-analysis. Lancet 383, 1549\u20131560 (2014).","journal-title":"Lancet"},{"key":"BFsrep15246_CR6","doi-asserted-by":"crossref","unstructured":"Been, J. V., Millett, C., Lee, J. T., van Schayck, C. P. & Sheikh A. Smoke-free legislation and childhood hospitalisations for respiratory tract infections. Eur. Respir. J., 10.1183\/09031936.00014615 (2015).","DOI":"10.1183\/09031936.00014615"},{"key":"BFsrep15246_CR7","doi-asserted-by":"publisher","first-page":"1475","DOI":"10.1093\/ntr\/ntt033","volume":"15","author":"O Tinuoye","year":"2013","unstructured":"Tinuoye, O., Pell, J. P. & Mackay, D. F. Meta-analysis of the association between secondhand smoke exposure and physician-diagnosed childhood asthma. Nicotine Tob. Res. 15, 1475\u20131483 (2013).","journal-title":"Nicotine Tob. Res."},{"key":"BFsrep15246_CR8","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/1465-9921-12-5","volume":"12","author":"LL Jones","year":"2011","unstructured":"Jones, L. L. et al. Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis. Respir. Res. 12, 5 (2011).","journal-title":"Respir. Res."},{"key":"BFsrep15246_CR9","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1001\/archpediatrics.2011.158","volume":"166","author":"LL Jones","year":"2012","unstructured":"Jones, L. L., Hassanien, A., Cook, D. G., Britton, J. & Leonardi-Bee, J. Parental smoking and the risk of middle ear disease in children: a systematic review and meta-analysis. Arch. Pediatr. Adolesc. Med. 166, 18\u201327 (2012).","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"BFsrep15246_CR10","doi-asserted-by":"publisher","first-page":"e1001611","DOI":"10.1371\/journal.pmed.1001611","volume":"11","author":"J Saulyte","year":"2014","unstructured":"Saulyte, J., Regueira, C., Montes-Martinez, A., Khudyakov, P. & Takkouche, B. Active or passive exposure to tobacco smoking and allergic rhinitis, allergic dermatitis and food allergy in adults and children: a systematic review and meta-analysis. PLoS Med. 11, e1001611 (2014).","journal-title":"PLoS Med."},{"key":"BFsrep15246_CR11","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1183\/09031936.00061911","volume":"39","author":"J Garmendia","year":"2012","unstructured":"Garmendia, J., Morey, P. & Bengoechea, J. A. Impact of cigarette smoke exposure on host-bacterial pathogen interactions. Eur. Respir. J. 39, 467\u2013477 (2012).","journal-title":"Eur. Respir. J."},{"key":"BFsrep15246_CR12","unstructured":"US Department of Health and Human Services, The health consequences of smoking-50 years of progress. A report of the Surgeon General. (2014) Available at: http:\/\/www.surgeongeneral.gov\/library\/reports\/50-years-of-progress. (Accessed 22nd May 2015)"},{"key":"BFsrep15246_CR13","unstructured":"The Scottish Government, Clearing the air. Available at: http:\/\/www.clearingtheairscotland.com. (Accessed 30th Nov 2014)."},{"key":"BFsrep15246_CR14","unstructured":"Welsh Government, Ban on smoking in public places. Available at: http:\/\/gov.wales\/topics\/health\/improvement\/smoking\/legislation\/ban\/?lang=en. (Accessed 9th June 2015)."},{"key":"BFsrep15246_CR15","unstructured":"NIdirect Government Services, Smoking regulations in Northern Ireland. Available at: http:\/\/www.nidirect.gov.uk\/smoking-regulations-in-northern-ireland. (Accessed 9th June 2015)."},{"key":"BFsrep15246_CR16","unstructured":"Health Direct, Smokefree England. Available at: http:\/\/www.smokefreeengland.co.uk. (Accessed 9th June 2015)."},{"key":"BFsrep15246_CR17","unstructured":"Department of Health, Smokefree England - one year on. London: Department of Health. Available at: http:\/\/www.smokefreeengland.co.uk\/files\/dhs01_01-one-year-on-report-final.pdf. (Accessed 9th June 2015)."},{"key":"BFsrep15246_CR18","unstructured":"Department of Health Social Services and Public Safety, Smoke-free legislation in Northern Ireland - A one year review. (2009) Available at: http:\/\/www.dhsspsni.gov.uk\/smoke-free.pdf. (Accessed 9th June 2015)."},{"key":"BFsrep15246_CR19","doi-asserted-by":"publisher","first-page":"S36","DOI":"10.2500\/aap.2012.33.3543","volume":"33","author":"RG Robison","year":"2012","unstructured":"Robison, R. G. & Singh, A. M. Chapter 11: the infant and toddler with wheezing. Allergy Asthma Proc. 33 Suppl 1, S36\u2013S38 (2012).","journal-title":"Allergy Asthma Proc."},{"key":"BFsrep15246_CR20","doi-asserted-by":"publisher","first-page":"f7027","DOI":"10.1136\/bmj.f7027","volume":"347","author":"M Thompson","year":"2013","unstructured":"Thompson, M. et al. Duration of symptoms of respiratory tract infections in children: systematic review. BMJ 347, f7027 (2013).","journal-title":"BMJ"},{"key":"BFsrep15246_CR21","unstructured":"Independent Scientific Advisory Committee, Independent Scientific Advisory Committee for Medicines and Healthcare products Regulatory Agency (MHRA) database research (ISAC). Annual report Jan 2012-Dec 2012. Available at: http:\/\/www.mhra.gov.uk\/home\/groups\/pl-a\/documents\/committeedocument\/con297550.pdf. (Accessed 30th November 2014)."},{"key":"BFsrep15246_CR22","doi-asserted-by":"publisher","first-page":"e128","DOI":"10.3399\/bjgp10X483562","volume":"60","author":"NF Khan","year":"2010","unstructured":"Khan, N. F., Harrison, S. E. & Rose, P. W. Validity of diagnostic coding within the General Practice Research Database: a systematic review. Br. J. Gen. Pract. 60, e128\u2013e136 (2010).","journal-title":"Br. J. Gen. Pract."},{"key":"BFsrep15246_CR23","doi-asserted-by":"publisher","first-page":"871","DOI":"10.2165\/00002018-200427120-00004","volume":"27","author":"L Wood","year":"2004","unstructured":"Wood, L. & Martinez, C. The general practice research database: role in pharmacovigilance. Drug Saf. 27, 871\u2013881 (2004).","journal-title":"Drug Saf."},{"key":"BFsrep15246_CR24","doi-asserted-by":"crossref","unstructured":"Wood, S. N. Generalized additive models: an introduction with R. (Boca Raton: Chapmann and Hall, 2006).","DOI":"10.1201\/9781420010404"},{"key":"BFsrep15246_CR25","unstructured":"Met Office, UK climate \u2013 Historic station data. Available at: http:\/\/www.metoffice.gov.uk\/climate\/uk\/stationdata. (Accessed 15th November 2013)."},{"key":"BFsrep15246_CR26","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1136\/thorax.55.8.662","volume":"55","author":"DM Fleming","year":"2000","unstructured":"Fleming, D. M., Cross, K. W., Sunderland, R. & Ross, A. M. Comparison of the seasonal patterns of asthma identified in general practitioner episodes, hospital admissions and deaths. Thorax 55, 662\u2013625 (2000).","journal-title":"Thorax"},{"key":"BFsrep15246_CR27","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1016\/S0140-6736(10)61380-3","volume":"376","author":"WW Busse","year":"2010","unstructured":"Busse, W. W., Lemanske, R. F. Jr. & Gern, J. E. Role of viral respiratory infections in asthma and asthma exacerbations. Lancet 376, 826\u2013834 (2010).","journal-title":"Lancet"},{"key":"BFsrep15246_CR28","unstructured":"Health Protection Agency, Epidemiological report of pandemic (H1N1) 2009 in the UK; April 2009-May 2010. (2010) Available at: http:\/\/webarchive.nationalarchives.gov.uk\/20140714084352\/http:\/www.hpa.org.uk\/webc\/HPAwebFile\/HPAweb_C\/1284475321350. (Accessed 9th June 2015)."},{"key":"BFsrep15246_CR29","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1023\/A:1010024016308","volume":"1","author":"A Biglan","year":"2000","unstructured":"Biglan, A., Ary, D. & Wagenaar, A. C. The value of interrupted time-series experiments for community intervention research. Prev. Sci. 1, 31\u201349 (2000).","journal-title":"Prev. Sci."},{"key":"BFsrep15246_CR30","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1093\/ije\/dyl147","volume":"35","author":"F de Vries","year":"2006","unstructured":"de Vries, F., de Vries, C., Cooper, C., Leufkens, B. & van Staa, T. P. Reanalysis of two studies with contrasting results on the association between statin use and fracture risk: the General Practice Research Database. Int. J. Epidemiol. 35, 1301\u20131308 (2006).","journal-title":"Int. J. Epidemiol."},{"key":"BFsrep15246_CR31","unstructured":"Szatkowski, L. C. Can primary care data be used to evaluate the effectiveness of tobacco control policies? Data quality, methods development and assessment of the impact of smokefree legislation using data from The Health Improvement Network. Nottingham: The University of Nottingham. (2011) Available at: http:\/\/eprints.nottingham.ac.uk\/11902. (Accessed 9th June 2015)."},{"key":"BFsrep15246_CR32","doi-asserted-by":"publisher","first-page":"e495","DOI":"10.1542\/peds.2012-2592","volume":"131","author":"C Millett","year":"2013","unstructured":"Millett, C., Lee, J. T., Laverty, A. A., Glantz, S. A. & Majeed, A. Hospital admissions for childhood asthma after smoke-free legislation in England. Pediatrics 131, e495\u2013e501 (2013).","journal-title":"Pediatrics"},{"key":"BFsrep15246_CR33","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1002\/pds.1115","volume":"14","author":"JD Lewis","year":"2005","unstructured":"Lewis, J. D., Bilker, W. B., Weinstein, R. B. & Strom, B. L. The relationship between time since registration and measured incidence rates in the General Practice Research Database. Pharmacoepidemiol. Drug Saf. 14, 443\u2013451 (2005).","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"BFsrep15246_CR34","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1046\/j.1523-1739.1997.96102.x","volume":"11","author":"L Thomas","year":"1997","unstructured":"Thomas, L. Retrospective power analysis. Conserv. Biol. 11, 276\u2013280 (1997).","journal-title":"Conserv. Biol."},{"key":"BFsrep15246_CR35","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1136\/tc.2010.041608","volume":"21","author":"MJ Jarvis","year":"2012","unstructured":"Jarvis, M. J., Sims, M., Gilmore, A. & Mindell, J. Impact of smoke-free legislation on children\u2019s exposure to secondhand smoke: cotinine data from the Health Survey for England. Tob. Control 21, 18\u201323 (2012).","journal-title":"Tob. Control"},{"key":"BFsrep15246_CR36","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1056\/NEJMoa1002861","volume":"363","author":"D Mackay","year":"2010","unstructured":"Mackay, D., Haw, S., Ayres, J. G., Fischbacher, C. & Pell, J. P. Smoke-free legislation and hospitalizations for childhood asthma. N. Engl. J. Med. 363, 1139\u20131145 (2010).","journal-title":"N. Engl. J. Med."},{"key":"BFsrep15246_CR37","doi-asserted-by":"publisher","first-page":"e22425","DOI":"10.1371\/journal.pone.0022425","volume":"6","author":"MG Semple","year":"2011","unstructured":"Semple, M. G., Taylor-Robinson, D. C., Lane, S. & Smyth, R. L. Household tobacco smoke and admission weight predict severe bronchiolitis in infants independent of deprivation: prospective cohort study. PLoS One 6, e22425 (2011).","journal-title":"PLoS One"},{"key":"BFsrep15246_CR38","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jpeds.2012.06.043","volume":"162","author":"KM Wilson","year":"2013","unstructured":"Wilson, K. M., Pier, J. C., Wesgate, S. C., Cohen, J. M. & Blumkin, A. K. Secondhand tobacco smoke exposure and severity of influenza in hospitalized children. J. Pediatr. 162, 16\u201321 (2013).","journal-title":"J. Pediatr."},{"key":"BFsrep15246_CR39","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1542\/peds.2010-1532","volume":"127","author":"MS Dove","year":"2011","unstructured":"Dove, M. S., Dockery, D. W. & Connolly, G. N. Smoke-free air laws and asthma prevalence, symptoms and severity among nonsmoking youth. Pediatrics 127, 102\u2013109 (2011).","journal-title":"Pediatrics"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/srep15246.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep15246","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep15246.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T15:18:24Z","timestamp":1672931904000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/srep15246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,14]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,12,7]]}},"alternative-id":["BFsrep15246"],"URL":"https:\/\/doi.org\/10.1038\/srep15246","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,14]]},"assertion":[{"value":"2 April 2015","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 September 2015","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2015","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"15246"}}