SCOPE OF THIS CHAPTERThis policy has been written as a result of the BAAF Practice Note 51 guidance on Reducing the Risk of Environment Tobacco Smoke for Looked After Children and their Carers.
1. Children Under 5 Years of Age
Children under 5 years of age must not be placed in a smoking household. The exception to this may be if the child is to be placed with a family member or friend. In this case, advice should be given on the effects on health of passive smoking and this should be monitored.
In a situation where the child under 5 is to be placed with older siblings, every endeavour must be made to place the sibling group in a non-smoking household. The fostering social worker must monitor how the carer's manage their smoking habits, and encourage the carers to attend cessation classes.
2. Children with a Disability and other Health Issues
Any child with a Disability which means they are often physically unable to play outside, all children with respiratory problems such as asthma and all those with heart disease or glue ear should not be placed with smoking families.
3. Long-term Fostering, Kinship and Adoptive Placements
The additional health risks to a child being placed in a smoking household needs to be carefully balanced against the benefits of the placement for the child. This is because the significant risks of exposure to passive smoking increase with time. In cases where children are being placed with known family or friends, the social worker should advise the carer on the risks of smoking and giving up where possible.
4. Views of Children and Parents
The views of birth families and children should be taken into account when children are being placed. The following points should be given consideration as a matter of good practice:-
- All older child who are able to express a view about their placement must be given a choice to be placed with a non-smoking family;
- Children from non-smoking birth families should not be placed with substitute carers who smoke.
Whilst limited resources may prevent children being matched to non-smoking carers at the time of placement, every endeavour should be made to remedy this. This may mean identifying an alternative placement as a matter of priority or ensuring that smoking in the household is limited to specific areas of the house or garden, and there are smoke-free rooms. The decision must be recorded on the child's file. In any event, the situation must be reviewed.
5. Approved Carers who Smoke
It is recommended that where possible, carers be encouraged to give up smoking altogether. The fostering service should offer advice and assistance in relation to some of the avenues of support available such as consulting their GP, cessation classes, nicotine patches, etc. They should also be given information in relation to increased risk of fires and burns from smoking.
Carers and other members of the household who do not wish to give up should be advised of the need to keep areas of the house smoke-free where the child or young person will play, eat, sleep, or study. Children should not be exposed to excessive smoking when visiting friends or relatives of the carers, or when carers have visitors to the home. Carers should also be advised that continued smoking may limit their fostering opportunities.
Carers should be reminded that it is illegal to smoke in a private vehicle which is carrying children or young people under 18 years. The driver is liable to be found guilty of an offence if they fail to stop someone smoking in these circumstances.
The fostering social worker must monitor and record through carer supervision. The issue of smoking must be discussed at the carer's annual review and decisions and any recommendations recorded by the Chair.
6. Recruiting Prospective Carers
Assessment of prospective foster and adoptive carers should be considered on their individual merit. It is important to balance the positive qualities of prospective carers who smoke against the adverse effects of smoking on children and their own health. Smoking should be covered at an early stage with prospective carers, and they should be advised that the primary consideration will be given to the welfare and health of a child being placed.
During the recruitment and assessment process, prospective carers should be advised of the following:
- The Department's policy of not placing children under 5 years of age, children with a disability or children with certain medical conditions with carers who smoke;
- The known effects of smoking on young children;
- The need to ascertain the extent of the household's smoking habits, to inform the assessment and potential approval;
- Their intentions or otherwise regarding stopping smoking and the limitations this may place on the variety and frequency of placements.
7. Placing Children and Young People who Smoke
Where carers are looking after young people who smoke, every effort should be made to encourage them to give up. Clear "house-rules" about smoking should be drawn up and agreed by young person, carers, social worker and parent(s) and should be discussed and recorded at the placement agreement meeting. This is particularly significant where carers themselves are non-smokers. However, in the case where carers smoke, it should be established that they should not smoke with the young person, and should still observe smoke-free areas of the house.
Carers and social workers must never buy cigarettes for children and young people.
Carers should be reminded that they can provide positive role-models for the children they care for, so can assist the young person to give up smoking by doing so themselves. Similarly, social workers should consider themselves good role models by not smoking in front of young people, and providing them with access to health-education and cessation programmes where needed.
8. Carers who have Successfully Given Up - Change of Approval
Carers should continue to receive support and encouragement in their decision in order to prevent relapse. Carers may wish to offer placements to children under 5 years of age, with a disability or other health problems and feel that their approval should be changed to reflect this. BAAF recommend that carers in this situation should not be allowed to adopt or foster a child in these categories until they have a proven minimum period of 12 months as a non-smoker.
This is because of the potential for relapse, and the risks are as follows:
- First 3 to 6 months - high;
- 6 to 12 months - high/medium;
- 12 months plus - minimal, most people will be permanent non-smokers.
It is worth noting that after 10 years, an applicant is classed as a non-smoker for insurance purposes.
It is important to monitor smoking habits of carers and young people.
Details of the carer household smoking habits and strategies for managing this should be explicit in the following:
- Form F assessment;
- Foster carer database;
- Carer profile;
- Placement Decision Record;
- Placement Agreement Meeting;
- Annual review;
- Foster Carer supervision forms.
Details of young person's and parent's smoking habits should be included in the following:
- Child's profile (fostering);
- Referral for placement.