Association between sociodemographic factors, neighbourhood cigarette smoke exposure and critical illness due to respiratory condition among paediatric population in England, 2014-2023: a retrospective cohort study
In brief
Black and Asian kids have up to 70% higher PICU respiratory admissions
In England, children of Black or Asian ethnicity and those from the most deprived neighborhoods experienced about 70% more intensive-care admissions for respiratory illness than White or affluent peers, and Asian children and the poorest groups also faced roughly double the in-PICU death risk. Living in areas with the highest cigarette-smoke exposure added a further 30% admission risk, underscoring the need for targeted tobacco-control and equity-focused interventions.
- Journal
- Archives of disease in childhood (Q1)
- Published
- 11 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Subashan Vadibeler, Khurram Mustafa, Tatendashe Bernadette Dondo, Hannah K Mitchell, Sarah E Seaton, Richard Feltbower
- PMID
- 42727988
- DOI
- 10.1136/archdischild-2025-330159
Why clinicians should know about it
- Picked for Pediatrics and Child Health (paper of the day, 15 September 2026): Socio‑demographic factors linked to PICU respiratory admissions
Abstract
OBJECTIVES: To investigate the association between sociodemographic disparities and area-level smoking with paediatric intensive care unit (PICU) respiratory admission risk and outcomes. DESIGN: Retrospective cohort study. SETTING: English PICUs. PATIENTS: Children aged <16 years admitted with respiratory illness between January 2014 and December 2023. MAIN OUTCOME MEASURES: Crude incidence of PICU admission and incidence rate ratios (IRRs). ORs for in-PICU mortality. RESULTS: Analysis included 41 859 admissions for 30 442 children. The respiratory admission IRRs were higher in children of Asian and Black ethnicity and in children from the most deprived areas compared with children of White ethnicity and those from the least deprived areas (IRR 1.5, 95% CI 1.3 to 1.7; IRR 1.7, 95% CI 1.4 to 1.9; adjusted IRR 1.7, 95% CI 1.4 to 2.2). Children living in areas with the highest cigarette smoke exposure had a higher respiratory admission IRR (adjusted IRR 1.3, 95% CI 1.1 to 1.5) compared with those in areas with the lowest exposure. Children of Asian ethnicity and those from the most deprived areas had a higher in-PICU mortality compared with children of White ethnicity and those from the least deprived areas (OR 2.1, 95% CI 1.8 to 2.5 and adjusted OR 1.6, 95% CI 1.2 to 2.0). CONCLUSIONS: Ethnicity and deprivation were associated with higher PICU respiratory admission incidence and poorer outcomes. Children from areas with higher cigarette smoke were more likely to require PICU admission for respiratory diseases. Community-focused tobacco control measures to reduce population-level smoking can benefit child respiratory health.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.