Select Committee on Health First Report

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.[2] 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.[3] 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]

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 2005.[5]

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.[6] 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 smoke
  • 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

3   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

4   Department of Health, Choosing Health: Making healthy choices easier, Cm 6374, November 2004, pp 98-9. Back

5 Back

6   Ev 119, Volume III Back

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Prepared 19 December 2005