(Last reviewed 19/09/2023)
Introduction
This document sets out the agency’s policy in relation to smoking by staff, those living in fostering households and young people in placement.
It takes account of the Fostering Services National Minimum Standards, the Health Act 2006 and BAAF’s 2007 Practice Note about smoking and looked after children.
Smoking and exposure to second hand smoke increases the risk of lung cancer, heart disease and other serious illness. This is recognised by legislation which bans smoking in all enclosed public places.
Fostering services and foster carers have a fundamental duty to protect children from harm and to promote their health.
The agency seeks to take a holistic approach to children’s needs when matching them to foster placements and seeks to promote placement stability. The agency recognise that there are some excellent foster carers who smoke and that in the context of a shortage of foster carers, there may be occasions when the positive elements of a placement, or potential placement, have to be balanced against the negative impact of smoking.
Nevertheless, it is the agency’s policy to actively promote non-smoking and to move progressively to a situation where no more smoking foster carers are recruited.
Background
The National Service Framework for Children intends that all children should have the support they need to be healthy and stay healthy and the framework is aimed at all who come into contact with children and young people. Similarly, the Fostering Services National Minimum Standards set out the foster carers’ central role in promoting good health. Foster carers and social work staff can play an important part in helping children to make well informed choices about healthy life styles, both by giving information and by example.
The serious health risks associated with smoking are well known, but over the last decade the dangers to non-smokers of breathing in second hand smoke (“passive smoking”) have also become better understood. This has led to the Health Act 2006 which bans smoking in all enclosed public places.
Children are particularly vulnerable to the effects of second-hand smoke because their lungs and airways are small and their immune systems are immature. There are both immediate and long-term health risks arising from this. Unlike adults, children have little choice about being in a smoky environment and the younger they are the more likely they are to spend a substantial proportion of their time physically close to their foster carer.
The agency seeks to promote placement stability and recognises the potential tragedy if a positive placement had to end because of a foster carers preventable illness or premature death. We recognise the immediate and long-term health benefits when smokers give up the habit.
Many young people come into the care system as smokers or become smokers while in care. The earlier children take up smoking, the greater the risk of developing heart disease and lung cancer in later life. There is also a greater immediate incidence of lung problems and sub-arachnoid brain hemorrhage.
The underpinning principle of the Children Act 1989 is that the ‘welfare of the child is paramount’. It follows that children have a right to be protected from second hand smoke and that all those involved in fostering should seek to model and promote healthy choices in order to discourage children from taking up smoking or help them to give up. Children growing up in smoking households are three times more likely to take up the habit than those who do not.
Please note as of the 1st October 2015 a law banning smoking in vehicles carrying children has come into force in England and Wales. Drivers and passengers who break the law could face a penalty fine of £50. Whenever an under-18 is in the car, smokers will still be liable even if the windows are down or sunroof open.
The law will not apply to people who are driving in a convertible which has the roof down, nor does it apply to Electronic Cigarettes (also called e-cigarettes and vaporisers).
Staff
The agency offices are smoke free, and all employees have the right to work in a smoke free environment. This policy applies to all employees, consultants, contractors, foster carers, young people, panel members and visitors.
Supervising Social Workers promote positive health messages, both by what they say and what they do. They do not smoke/vape outside the area in front of the office building or outside meetings in which a young person is attending; do not smoke/vape in a car which is to be used later to transport children; and do not smoke/vape with or in the view of children.
Young People
The agency brings a foster carers smoking to the attention of a placing authority so that children who are old enough to express a view can be told before placement.
Foster carers do all that they can to prevent children taking up smoking and support those who already smoke to give up. They do not buy cigarettes for young people or use them as a reward for good behaviour.
Foster Carers
The agency requires foster carers homes to be smoke free. This means that foster carers, other members of their household and visitors to their home cannot smoke in the house.
The agency does not approve smokers to care for children under five because of the very high health risks for young children. However, should the foster carer/s stop smoking and have ceased for six months then the ToA can be reviewed in the Annual Review.
Details about a foster carers smoking, or that of any member of the household, are clearly recorded in their Form F. It is brought to the attention of placing authorities so that it is taken into full consideration when placing children, particularly children with mobility difficulties, respiratory problems, heart disease or glue ear.
When contributing to decision making about children to be placed permanently in a household where there is smoking, the agency seeks to balance the benefits of the placement with the increased risks of exposure to second hand smoke over time.
Foster Carers who smoke, or who have other household members who smoke, are only approved if the smoker/s agree not to smoke within the foster home. The safe supervision of children is taken into full consideration when a foster carer is intending to continue smoking outside the home.
The agency seeks to encourage foster carers and potential foster carers who smoke to stop smoking by providing information and support. The commitment that approved foster carers make to a smoke free home is monitored on each home visit, including unannounced visits.
The particular fire risks when foster carers smoke, are considered in the regular health and safety visits to their home. The Health and Safety report considers if a foster carer smokes/ intends to smoke outside the home while responsible for fostered children.
The Preparation Stage of the agency’s Training Programme, Skill to Foster, (for potential foster carers) includes consideration of the impact of fostering on family and friends and prepares potential foster carers for the implications of enforcing changes on the smoking habits of visitors to their home.
The TSDS Programme (which fosters carers complete before the end of their first year’s fostering) includes consideration of how to keep children healthy and helping children and young people make positive health choices.
This policy will be reviewed annually with the objective of moving to the position over time, of no longer recruiting foster carers who smoke.
Electronic Cigarettes
Electronic Cigarettes (also called e-cigarettes and vaporisers), are not tobacco cigarettes, but many of them contain nicotine, which comes from tobacco. Nicotine in e-cigarettes is highly addictive. E-cigarettes can also contain other ingredients such as propylene glycol, glycerine and flavourings. The use of them has become more wide spread in recent years and can provide a route for smokers to help them reduce or give up smoking. Such products have been developed more recently and due to this the evidence about their use in terms of effects of health continues to evolve. NICE – National Institute for Health and care Excellence guidelines (2018) state:
‘The evidence suggest that e-cigarettes are substantially less harmful to health than smoking but are not risk free. The evidence in this area is still developing including evidence on the long-term health impact.
There remains concern about the role modelling effect should foster carers be seen using e-cigarettes, and that the use of these products might normalise “smoking” behaviour.
Although there is agreement internationally that e-cigarettes are significantly less harmful than smoking tobacco at the moment there is no international consensus on the risk/benefits of e-cigarettes’.
Most people using e-cigarettes are recent ex-smokers and are using these products to quit or prevent a relapse.
Concerns have been raised that these products could model smoking for children and therefore encourage them to smoke. An alternative hypothesis is that adults using these products rather than smoking could further de-normalise smoking by demonstrating a preference for safer alternatives.
In light of no conclusive evidence at this time the agency will continue to give the same guidance and recommendations to foster carers who use e-cigarettes/vapes as those foster carers who smoke tobacco, as above. However, the agency will not exclude foster carers who use e-cigarettes from caring for children under five years of age.
Additionally, the following guidelines should be adhered to:
E-cigarettes/vaporisers cannot be sold to children/young people under 18 years in the UK. Foster carers should not purchase such items for young people under 18.
Foster carers must always keep e-cigarette products out of reach of young children as the components can be harmful if swallowed. Equipment used for e-cigarettes/vaporisers must be kept safely and out of reach of young children. There has been an increase of cases of poisoning of young children associated with ingesting the liquid used.
Foster carers who do vape should not vape in the home or in the car. There should be discussion with the carers about their use and consideration given to the risk of providing a model to the children or young people which may encourage smoking.
Foster Carers should ensure that children and young people are educated on what e-cigarettes are, the risks to their health and wellbeing and addiction. Foster Carers should discourage the child or young person from wanting to partake in using e-cigarettes.
Support for smokers
The agency undertakes to support foster carers who smoke as much as possible in recognition of them as a minority group and to support them should they decide to give up smoking. NHS website also has resources in place: https://www.nhs.uk/live-well/quit-smoking/nhs-stop-smoking-services-help-you-quit/
