1 Introduction |
1. Smoking is bad for health; so is inhaling other
people's smoke. An extensive epidemiological literature over the
past 30 years has established the risks, ranging from cot death,
glue ear and respiratory disease in infants to lung cancer and
heart disease in adults. Recent research estimates that at least
12,000 deaths per year in the UK can be attributed to secondhand
smoke. The author of
the report considers this a conservative estimate. A series of
reports in this country and elsewhere have reviewed the evidence
and reached unambiguous conclusions. The World Health Organisation's
International Agency for Research on Cancer (IARC) categorised
secondhand smoke as a human carcinogen. In November 2004 the Scientific
Committee on Tobacco and Health (SCOTH) concluded in its report
on Secondhand Smoke: Review of evidence since 1998:
Knowledge of the hazardous nature of SHS (secondhand
smoke) has consolidated over the last five years, and this evidence
strengthens earlier estimates of the size of the health risks.
This is a controllable and preventable form of indoor air pollution.
It is evident that no infant, child or adult should be exposed
to SHS. This update confirms that SHS represents a substantial
public health hazard.
2. As a result of these and other findings, it is
now widely recognised that non-smokers need to be protected from
other people's smoke in the workplace.
Some argue that this can be achieved by ventilation. However,
according to most scientific opinion while ventilation can make
the atmosphere seem more pleasant, it cannot in practice adequately
remove the carcinogens. Many western governments have therefore
begun to impose smoking bans in public places and the workplace.
The most contentious aspects of such policies are bans where smoking
is popular, particularly in pubs and bars. Nevertheless, an increasing
number of governments have taken the view that bar workers, who
suffer from some of the highest exposure levels, should be protected.
In Ireland a comprehensive ban which included pubs was introduced
in March 2004; the Scottish Executive has decided on a similar
ban which will begin in March 2006.
3. In its Public Health White Paper, Choosing
Health, the Government announced its intention to ban smoking
in enclosed public places in England from 2008. However, there
were to be a number of exemptions, most controversially for pubs
and bars which do not prepare and serve food and for membership
clubs. The White Paper claimed that in surveys and opinion polls
only "20% of people chose 'no smoking allowed anywhere' and
the majority tended to be opposed to a complete ban".
4. In the Queen's Speech of May 2005, the Government
announced its intention to introduce legislation to restrict smoking
in enclosed public places and workplaces. In June 2005, the Department
of Health issued a Consultation on the Smokefree Elements of
the Health Improvement and Protection Bill. Following the
General Election, the Health Committee was re-appointed in July
2005 and at its first meeting decided to hold an inquiry into
smoking in public places in order to inform Parliamentary scrutiny
of the legislation. We invited submissions but also announced
that we would obtain copies of responses to the Department of
Health's Consultation. The submissions were published on 24 November
5. The Bill was published on 27 October and had its
second reading on 29 November, when the Government indicated the
general nature of the exemptions. However, their precise form
is not known because they are to be specified in regulations.
In October and November we took evidence from 40 witnesses, including
the Chief Medical Officer, the Chairman of the Health and Safety
Commission, the Royal College of Physicians, the Royal College
of Nursing, tobacco companies, trade unions, several organisations
representing the hospitality industry, the Director-General of
the Prison Service, the Ministry of Defence, and Northern Ireland,
Home Office and Health Ministers.
6. In November, the Chairman of the Committee appeared
on You and Yours on BBC Radio 4. Many listeners sent their
views on the subject to the programme team who compiled a submission
to the inquiry based on an analysis of the contributions.
Further detail of this analysis is provided in Annex 2.
7. During the inquiry we did not attempt to look
at all the issues raised in the consultation referred to in paragraph
4, but decided to address the following key concerns:
- the health effects of secondhand
- ways of dealing with such effects: ventilation
or a ban?
- the justification for a ban
- the Government's proposals
- whether the proposed exemptions for institutions
which are also dwellings are justified
- whether the proposed exemptions for non-food
pubs and membership clubs are justified
- how to best ensure compliance
- conclusions: what the government should do.
8. In November 2005 we visited Dublin to examine
the consequences of the total ban in Ireland. We are very grateful
to the assistance provided by the staff of the British Embassy
who facilitated this visit and to all the people we met there
for providing us with crucial evidence for our inquiry. We also
thank our specialist advisers, Professor John Britton of Nottingham
University and Professor Martin Jarvis of University College London
for the objective advice they gave us and for helping us disentangle
the complexities of a difficult subject.
2 Royal College of Physicians, Going smoke-free:
The medical case for clean air in the home, at work and in public
places, July 2005, ISBN 1 86016 246 0. Back
For example, World Health Organisation International Agency for
Research on Cancer, Tobacco Smoke and Involuntary Smoking,
IARC Monographs Volume 83, 2004; Report of the Scientific Committee
on Tobacco and Health, Secondhand Smoke: Review of evidence
since 1998, November 2004; US Office on Smoking and Health,
The health consequences of involuntary smoking: a report of
the Surgeon General, 1987; Australian National Health and
Medical Research Council, Effects of passive smoking on health,
Report of the NHMRC working party, 1987; United States Environmental
Protection Agency, Respiratory Health Effects of Passive Smoking:
Lung Cancer and Other Disorders, December 1992; California
Environmental Protection Agency, Exposure to Environmental
Tobacco Smoke, September 1997. Back
Department of Health, Choosing Health: Making healthy choices
easier, Cm 6374, November 2004, pp 98-9. Back
Ev 119, Volume III Back