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Ms Hewitt: As I have already said, I think that the arguments are extremely finely balanced. In the spirit of the free vote that we on the Government Benches will have, I intend to listen to the debate very carefully.

If both the amendments and the new clause are passed, the smoking ban will cover all public places and workplaces, including all licensed premises and private membership clubs. Only a few specific exemptions will be made, mainly for places that are essentially a person's home or personal space. If the amendments fall but the new clause is passed unamended, the smoking ban will cover all public places and workplaces, including licensed premises, but not genuine private members' clubs. If the new clause falls, the smoke-free provisions that are set out in the current draft of the Bill will remain—in other words, in that situation we will introduce regulations to exempt both membership clubs and licensed premises that do not prepare and serve food.

I stress that in order to fulfil the promises that we made to the public in our manifesto, the Government are not prepared to accept any smoke-free provisions that are less comprehensive than those set out in the Bill when it was first published. I wish that there was similar clarity on the Conservative Benches, where the hon. Member for South Cambridgeshire (Mr. Lansley), who speaks on health, said 10 months ago that he favoured
 
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self-regulation and opposed a ban, but has I think now decided that he supports a ban—no doubt he will tell us—while the leader of the Conservative party continues to say that he opposes a ban, unless, of course, the hon. Member for South Cambridgeshire is going to tell us that there has been a further flip-flop since this morning.

4.15 pm

Whatever the outcome of the votes on these two specific issues, this Bill marks a huge step forward for public health. It will make smoke-free the norm. It will protect non-smokers from passive smoking, make it easier for smokers to give up and save thousands of people's lives. I look forward to a fruitful debate and to hon. Members making their views known on exactly how far the smoke-free legislation should extend. I commend new clause 5 to the House.

Sir Patrick Cormack (South Staffordshire) (Con): On a point of order, Mr. Speaker. I rise just for clarification, which we did not get from the Secretary of State. She has just commended new clause 5 to the House. There is, of course, a rule in the House that the voice and the vote must go together, so do we infer from that that she will indeed vote for new clause 5?

Mr. Speaker: I am reliably informed that that is what the right hon. Lady would shout, because she has recommended the new clause. [Interruption.] Order. This is a confusing day, so let us not push our luck.

Mr. Lansley: I am sure that the Secretary of State has added very little to the clarity, so let us see where we get to.

I should like to give the Secretary of State our thanks for the kind remarks that she directed to my right hon. Friend the Member for Witney (Mr. Cameron) and to Samantha. Opposition Members are delighted at the safe arrival of a baby boy for Samantha and David at St. Mary's, Paddington, this morning. If I may, I shall trespass a moment and also express our good wishes to the family of my hon. Friend the Member for Windsor (Adam Afriyie) and their baby boy; to my hon. Friend the Member for Hammersmith and Fulham (Mr. Hands), who has a baby girl; and, in expectation, to my hon. Friend the Member for Monmouth (David T.C. Davies). Opposition Members are doing our bit to defuse the demographic time bomb.

David Taylor: They are all in labour wards.

Mr. Lansley: Better than the Labour party.

I am sure that the House is pleased to see the Secretary of State here after her indisposition last week, although I think that she might have preferred to be diplomatically ill today. As I said on Second Reading, I believe that the Bill can contribute to a significant reduction in smoking. On Second Reading, the House resolved to achieve that reduction by means of a legislative ban. We did indeed debate on Second Reading and in Committee the question of whether it could be achieved on a self-regulatory basis. Of course, there is evidence of a significant increase in the number of smoke-free places that are being established without
 
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legislation being enforced, but the issue before us today is in practice not whether we should have a ban, but what its extent should be.

Let me be clear: smoking kills and it remains the largest cause of avoidable deaths in this country, and that mortality includes several thousand people each year who we believe die as a consequence of exposure to second-hand smoke. The greatest element of that problem is exposure to second-hand smoke in the home, to which the Secretary of State referred. The figures were clearly set out in November 2004 in the Scientific Committee on Tobacco and Health report: there is a 24 per cent. increase in the risk of developing lung cancer for non-smoking women whose partners are smoking men; there is a 37 per cent. increase in the risk of developing lung cancer for non-smoking men whose partners are smoking women; and there is a 19 per cent. increase in the risk of developing lung cancer for those who are exposed to passive smoke in the workplace.

The risk of lung cancer is well understood; the risk of cardiovascular disease is less well understood, but arguably much more significant. The risk of developing lung cancer increases in direct proportion to the number of cigarettes smoked and the duration of smoking. Damage to the heart and arteries, however, seems to occur disproportionately at lower exposures, such as those experienced through exposure to second-hand smoke. Although passive smokers may have an uptake of tobacco smoke equivalent to only about 1 per cent. of that of an active smoker, the risk of their developing heart disease increases by 25 per cent.

Last year, a study in the British Medical Journal estimated on that basis that more than three times as many people die from ischemic heart disease as a result of passive smoking as die from lung cancer. Evidence produced in the past four or five years suggests that small amounts of exposure to second-hand smoke can lead to substantial increases in the risk of developing cardiovascular disease.

Hugh Bayley (City of York) (Lab): Will the hon. Gentleman remind the House what that article said about the number of people who die each year because of passive smoking in the workplace—can he remember?

Mr. Lansley: The BMJ report refers to some 1,500 people dying from passive smoking as a result of the increased risk of lung cancer, some 5,500 people dying from passive smoking as a result of the increased risk of cardiovascular disease and about 4,000 people dying from the increased risk of stroke—interestingly, the Scientific Committee on Tobacco and Health did not find on the evidence that there is an established relationship between exposure to second-hand smoke and an increased risk of stroke.

Hugh Bayley: Perhaps I can remind the hon. Gentleman that it has been estimated that more than 600 people a year die from inhaling second-hand smoke in the workplace, which is significant given that only 130 people a year die from asbestosis.

Mr. Lansley: I recall the figure to which the hon. Gentleman has referred, although I think that it
 
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appeared in a different BMJ study. I do not dispute that a significant number of deaths have been and continue to be associated with exposure to second-hand smoke in the workplace, which is one of the reasons why we have always supported protection in the workplace. As we set out in our manifesto, the objectives of policy should be to reduce the incidence of smoking, to ensure that non-smokers are not exposed to smoke unless they want to be, to protect workers in the workplace and to ensure that children are not exposed to second-hand smoke. We set out that position in our manifesto; I said it again on Second Reading and I have not departed from it. We are debating how those objectives will be achieved and the balances to be struck, which I shall discuss in a moment.

As shadow Secretary of State for Health, I must say—not least to my hon. Friends—that it is imperative on health grounds to stop unwanted exposure to second-hand smoke and potentially reduce the prevalence of smoking, especially among young people whose smoking habits tend to become entrenched in the workplace. The Secretary of State accepted that point when she introduced the Bill at the end of last year, but she then made a perverse and bogus distinction between pubs that serve food and those that do not. On Second Reading, we asked her to explain the health grounds for making such a distinction, but she offered no evidence on that point. However, given the effect of that on health inequalities, which was subsequently exposed in great detail by the Select Committee on Health, we knew that it was wrong when it was presented. I think that most Labour Members knew that it was wrong and, frankly, that the Secretary of State knew that it was wrong, but she would not admit it. Her acquiescence in the Airdrie and Shotts provisions was a failure on her part. She is condemned by the fact that she would not stand by her own instincts and, as Secretary of State for Health, by the views and recommendations of the chief medical officer.

We now have the utter humiliation of the Secretary of State voting against her own legislation. Never before has a Government Minister brought forward a measure and voted against it in this way.


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