Second-hand smoke and babies: how to keep your home, car and baby smoke-free

You can protect your baby from second-hand smoke, even if someone in the family still smokes. Keep your flat and car free of smoke and vapes, every day. Anyone who smokes goes downstairs, then changes their top and washes their hands before holding the baby. HealthHub says there's no safe level of second-hand smoke, and babies and children are the most sensitive to it.

How to keep smoke away from your baby, step by step

1. Make your flat and car smoke-free and vape-free for everyone. HealthHub says don't let anyone smoke anywhere in or near your home, or in the car, even with the windows down.
2. Smoke downstairs in an open space, away from the block. NEA bans smoking in HDB common corridors, lifts, lobbies, void decks and stairwells, so the corridor outside your door doesn't count as outside.
3. Don't rely on an open window or a fan. The AAP says neither one stops smoke from settling in the room.
4. Change your top and wash your hands before you pick up the baby. HealthHub asks family members who smoke to change clothes afterwards, and the AAP says babies take in the chemicals when adults hold them.
5. Don't share a bed with your baby if you smoke or vape. The AAP says the risk of sudden infant death syndrome (SIDS) is especially high then, even if no one smokes in bed.
6. Tell everyone who looks after the baby the house rule, and why. The AAP asks families to hold every carer to the same rules.
7. Keep vapes and heated tobacco out of the house. HSA lists both as prohibited. The vape ban has been in force since 1 February 2018, and it covers buying, owning and using one.
8. Move your baby away from smoke when you're out. KKH's Dr Teoh Oon Hoe says that if you can smell tobacco smoke, it irritates the airways, even for a moment.
9. Get help to quit when you're ready. Call HPB's QuitLine on 1800 438 2000, or sign up for the I Quit programme on HealthHub.

Why second-hand smoke affects babies more

Your baby can't walk away from smoke, so the adults around them decide how much they breathe. HealthHub lists what second-hand smoke does to babies and children:

• A higher risk of sudden infant death syndrome (SIDS)
• More chest infections, such as pneumonia and bronchitis, in younger children
• More wheezing and asthma, with attacks that come more often and hit harder
• More middle ear infections and glue ear, which can lead to partial deafness
• Slower lung growth
• More coughs and colds, so children fall sick more often

KKH's respiratory team says regular exposure puts every child at higher risk of chest infections. In a child whose asthma isn't well controlled, even a short whiff can bring on coughing or trouble breathing.

If your child has asthma, our guide to asthma in children covers inhalers and attack plans. Ear pain and glue ear are in our child ear infection guide, and the cot set-up is in our safe sleep guide. Smoke during pregnancy is a separate topic, and our guide to alcohol and smoking in pregnancy covers it.

Thirdhand smoke: what stays on clothes, sofas and car seats

Thirdhand smoke is what stays behind after a cigarette goes out. HealthHub says the particles linger on a smoker's hair and clothes, on curtains, carpets and rugs, and on floors. Dr Teoh at KKH adds skin, bedding, furniture and cars, and says it stays long after the smoking stops.

Babies get more of it than adults. They crawl, touch everything and put their fingers in their mouths, so they swallow or breathe in what's on those surfaces, KKH says.

Airing the room won't fix it. KKH says open windows, fans and air-con can't remove the residue, and only a smoke-free home and car will. Researchers are still working out how harmful thirdhand smoke is, Dr Teoh notes. A fresh top and clean hands before every cuddle cost you a minute.

Where smoke reaches a baby, and what to do

The law still allows smoking inside homes, NEA's list shows. So in your own flat, the family rule is what protects your baby.

Vaping around babies, and the law in Singapore

Vapes are illegal here. HSA says buying, owning and using them has been prohibited since 1 February 2018, and heated tobacco products are on the same prohibited list. HSA's vaping enforcement page lists the current penalties.

Vape aerosol isn't clean air. HSA says vapes contain fine particles and cancer-causing chemicals such as formaldehyde and benzene, and their main job is to deliver nicotine. The AAP says e-cigarette aerosol contains chemicals too, and asks families not to let anyone vape in the home, the car or near a child. Its safe sleep advice treats vaping the same as smoking where SIDS is concerned.

If someone at home vapes, HPB's I Quit programme signs up vapers as well as smokers.

How to ask a grandparent, visitor or helper not to smoke near the baby

Children breathe in smoke from grandparents and other carers too, HealthHub notes. Keep the ask short. Talk about the baby, and leave the smoker's habit out of it. Some lines you can borrow:

• To a grandparent: "Ma, KKH says smoke stays on clothes and the baby breathes it in. Can you smoke downstairs and change your top before you carry her?"
• To a visitor: "We keep the flat smoke-free for the baby. You can smoke at the open area downstairs."
• To your helper: add "no smoking or vaping near the baby" to the house rules on the first day, with the reason.
• For everyone: keep a spare top and a bottle of hand soap by the door, so the change takes a minute.

If they're ready to quit, they can sign up for I Quit and name you as a supporter, HealthHub says. QuitLine is 1800 438 2000; calls are free from a landline, and airtime charges apply on a mobile. HealthHub says staying smoke-free for 28 days makes a smoker 5 times more likely to quit. HPB adds that medication with counselling can double the chance of quitting for good. Many people need several tries, HPB notes, so a slip isn't the end. Our pregnancy smoking guide lists the hospital and pharmacy quit services.

When to see a doctor

See your GP or a polyclinic if you notice any of these. They're reasons to get checked, and only a doctor can say what's causing them.

• Your child wheezes or coughs often, or finds it hard to breathe. HealthHub says to talk to your doctor about asthma.
• Chest infections that keep coming back. HealthHub links second-hand smoke with pneumonia and bronchitis in younger children.
• Ear pain, or your child doesn't seem to hear you well. HealthHub links smoke with middle ear infections and glue ear. It can also cause partial deafness.
• A child with asthma who coughs or struggles to breathe after even brief smoke. KKH's Dr Teoh says this can happen when asthma isn't well controlled.
• Your child can't speak, struggles to breathe or gasps for air, or has blue lips or fingertips. HealthHub says a severe asthma attack needs a doctor immediately or an ambulance.

For the last sign, go to KKH or NUH Children's Emergency, or call 995. Call 995 for any emergency such as trouble breathing, a seizure, or a child you can't wake. Our paediatrician map helps you find a clinic near you.

Frequently asked questions

What are the secondhand smoke effects on children?

HealthHub lists more coughs and colds, chest infections such as pneumonia and bronchitis, wheezing and asthma, middle ear infections and slower lung growth. Babies also have a higher risk of SIDS. KKH says regular exposure raises the risk of chest infections for every child.

Is thirdhand smoke on clothes harmful to my baby?

It can be. KKH says thirdhand smoke clings to hair, skin and clothes, and babies take it in when they touch things and put their fingers in their mouths. Researchers are still studying how harmful it is. That's why HealthHub asks smokers in the family to change their clothes after smoking.

Is vaping around babies safer than smoking?

Don't vape around your baby. HSA says vapes contain harmful chemicals, including formaldehyde and benzene, and the AAP says the aerosol contains chemicals too. Vapes are also illegal in Singapore, so keep them out of your home.

What can I do if a grandparent smokes around my baby?

Ask them to smoke downstairs, away from the block, then change their top and wash their hands before carrying the baby. Keep it short and about the baby. If they want to quit, HPB's QuitLine is 1800 438 2000, and they can name family members as supporters on I Quit.

Can my partner smoke in the corridor outside our HDB flat?

No. NEA bans smoking in HDB common corridors, lifts, lobbies, void decks and stairwells. An open space downstairs, away from the block, is the place to smoke.

Is haze the same as second-hand smoke?

No. KKH says haze isn't second-hand smoke, but it carries fine particles and toxic gases too. Our guide to haze and kids covers what to do on haze days.