Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 420-431)


24 NOVEMBER 2005

Q420 Dr Stoate: You will have heard the question from Charlotte Atkins that one of the Government's contentions is that smoking in public places is popular and therefore should be allowed to continue. We understand ASH has done a number of surveys gauging public opinion. Can you tell us more about the results of your surveys?

  Ms Arnott: It does depend a bit how you word it. You get much more support if you ask people if they support the idea that all workers should have a right to a smoke-free workplace and the sort of level of support we got for that was 90% of the public, whereas if you ask people whether they support legislation to make all enclosed workplaces smoke free it drops to around 80%. One of the things we would see interesting—and we have done a lot of public polling over the last couple of years—is the way that public opinion has begun to move on this and move quite considerably, particularly on smoking in pubs and bars. The Government in its smoking related behaviour and attitudes survey in 2003 started asking the questions, "What sort of restrictions would you support in pubs? Do you think pubs should be allowed to be entirely smoking throughout, mainly smoking throughout but partially smoke free, partially smoke free or entirely smoke free?" In October/November 2003 20% only of the public wanted pubs to be entirely smoke free. A year later, in 2004, that figure rose to 31%. We asked the same question in August this year and 41% of the public supported pubs and bars being entirely smoke free. When you gave people some peer reviewed evidence about the harm caused by second-hand smoke that proportion rose to 52%, the majority of the public wanting pubs and bars to be smoke free. If you look at the difference between 2003 and 2005, not taking into account what happens if you give people more information, you are already seeing a doubling in the amount of support for pubs and bars going entirely smoke free. I think the key point there is not just the results but the speed and direction of change. I do not think the Government has really taken account of the fact that public opinion has moved significantly in support of this measure.

Q421 Dr Stoate: The industry would say that you are an organisation dedicated to a reduction in smoking and therefore "you would say that, wouldn't you". How robust do you think your findings are?

  Ms Arnott: We only use reputable market research companies and sample sizes of 1,000 or above, at which point the 95% confidence level is about 2-3%, which means you are within 2-3% of public opinion, and it is representative not just as regards demographics but also the split between smokers and non-smokers. ONS do their survey with around 3,500 people and it is a face-to-face survey. We repeated the ONS survey using YouGov on the internet because we wanted people to be able to separate out this question about whether they knew what the evidence was and what your opinion was afterwards.[1] YouGov is widely regarded to be very robust. It was a sample of 2,200. If you look at the YouGov predictions of the general election, for example, they were within 1% of the actual result.

Q422 Dr Stoate: You are saying that your figures are pretty robust.

  Ms Arnott: Yes, they are.

Q423 Dr Stoate: The evidence we have had put to us by the hospitality industry is that they have got data that says exactly the opposite to yours and their surveys show that most people are not in favour of an outright ban. How do we try and get to the real facts of this?

  Ms Arnott: I think you have to look at how the questions are framed and in what context. If you look at the polls that have been done by the Tobacco Manufacturers Organisation using populars, they tend to frame them in a very different context in terms of actually saying "Do you think this is an important issue?" or "Would it not be much more important to do X?". I think you need to look at the specific questions asked as well as the sample size and everything else. The Tobacco Manufacturers Association wrote to MPs saying that only 3% of the public supported completely smoke-free workplaces in the last ONS survey done in 2004. They misquoted that survey because it was only 3% of heavy smokers and the percentage at that time of all the population was 31%.

Q424 Jim Dowd: They did circulate a correction.

  Ms Arnott: They did circulate a correction, but I am not sure everyone would have seen that correction.

Q425 Mike Penning: If you saw the first one you will see the second.

  Ms Arnott: Their misuse of statistics is not effective. They only did that after the Department of Health wrote to them. They were not going to do it on their own account.

Q426 Dr Stoate: The Government has said that smoking is popular and therefore should be continued. Would you say that the general public is in favour of an overall ban or in favour of a partial ban? How would you see the public mood?

  Ms Arnott: When we are talking about all workplaces, the majority are in favour. When you talk about pubs and bars, it is moving and I think with the right information the majority of the public will support it. It is not about public opinion, this is about health and safety of workers and that is the key point. However, popularity is important in determining whether or not it is easily enforceable and seatbelt legislation showed that. If you compare seatbelt legislation to mobile phones and the fact you are not supposed to use your mobile phone driving in the car, you can see what happens. What we want is legislation that is easily enforceable. What the levels of public support and the shift in public opinion shows is that this will be easily enforceable.

Q427 Jim Dowd: Mr Gray, you said there had been a universality of public health law previously and that what the Government is proposing would breach that universality. How does that apply to the exemptions for what are regarded as domiciliary premises, ie homes, hotel rooms, etcetera, where people will still have to work?

  Mr Gray: The principle that we have espoused in our submission to you is that the protection of the worker should be paramount. So anywhere where there is an exception—and I am using the word exception, not exemption, there are always exceptions to the rules—consideration is then given to how the worker can be protected either by minimising exposure or affording direct protection to the worker. That is what we do in all other work situations. Wherever we are unable to totally eliminate the risk we protect the worker. There are some practical measures. Some employers are already taking these. They are asking people who are receiving services or treatments in their home not to smoke while the worker is there or to keep a room in which they do not smoke where the worker can go. I am married to a health visitor. She always asks to check the baby in a room where people do not smoke. She has a duty of care to the child never mind a duty of care for her own health, and people are cooperative, that is the other surprising thing, I think. When we tell people this is about protecting the health of a worker who is providing a service for you people are cooperative.

Q428 Jim Dowd: Everybody accepts that self-enforcement is the most effective kind where people are prepared to do it. There will be a different level of protection for workers whose jobs take them into domestic premises, hotels rooms, etcetera, compared to those who ought to be totally protected if there was a total ban.

  Mr Gray: There is a difference in order of magnitude here. The bar workers who are working eight or ten hour shifts in a perpetually smoky environment, these are the people most at risk and we are failing to protect the most vulnerable group. There is a difference in order of magnitude between that and the peripatetic worker who will occasionally be exposed to someone else's smoke and has the right either to refuse the service and leave the building or to request some measure of protection.

Q429 Dr Naysmith: I want to pick up on how questions are framed and what sort of answers you get, Deborah, because really the questions determine quite a lot what result you get. In sociology courses in universities there are often units about how to frame questions and so on, so it is quite difficult. However, we are beginning now in this area to get nearer something that tells you clearly what is happening by looking at changes over time and how views change. If you keep asking almost the same questions then you can pick up changes and opinions. How does the strength of public support in England for a smoking ban compare with other countries such as Ireland before a ban was introduced, and after the ban is introduced what kind of changes do you get in the opinions?

  Ms Arnott: I think that is a very interesting question. We asked a question earlier this year in July using BMRB which had been asked in Ireland before their law was brought in, which was, "Do you support legislation to prohibit smoking in public places, including pubs and restaurants?" When they asked it in Ireland prior to the legislation coming in the level of support was 67%. When we asked it here in July the level of support was 73%. I think the interesting point about Ireland as well is that if you look at what happened when they brought the legislation in, the level of support continued to grow. So three months after the legislation was brought in the Irish Department of Health asked the same question again and 82% of the population supported the legislation.

Q430 Dr Naysmith: What happens amongst smokers if you ask that question in Ireland, do you have any statistics on that?

  Ms Arnott: There was some interesting research done in an international tobacco study using a phone poll of respondents in Ireland and I cannot remember the exact figures, I will have to send them to you afterwards, but the level of support amongst smokers for legislation, including pubs and bars, was only about 3% prior to the legislation coming in and it rose to around 50% after it had come in.[2] It is still not the majority of them, but you can hardly expect smokers to support something which stops them smoking in pubs and bars. The level of support has gone up considerably. I have been to Ireland and I have spent quite a lot of time talking to smokers sat outside pubs about what they thought of the legislation. The sorts of things people said to me were, "I'm not very happy me with it but, thinking about it, I am smoking less now and smoking is not very healthy for you. The atmosphere inside the pub is much better than it was." So there are mixed and conflicting views even among smokers themselves.


Dr Naysmith: We got similar opinions from some smokers when we were in Dublin as well.

Q431 Chairman: Do you think we could expect to see further movement in public opinion in this country if the legislation had gone through Parliament and there was a date set for its implementation, no matter what form it is in?

  Ms Arnott: I certainly think we can. I think it is terribly important that the Government takes a lead in saying, "This is a measure being brought in for workers' protection," and if they do that the level of support will rise and it will continue to increase because there is no argument against that. The problem is it is very confusing. The message they are giving out is that it is not really a health and safety issue because they are going to leave the workers who are currently most exposed to continue to be exposed in future. There is something very important I know this Committee is concerned about and that is what happens to smoking in the home in front of children. If you give this confused message that it is okay to carry on smoking because, after all, we are allowing pubs to be places where you can smoke, the message you are giving to parents about what they should be doing in front of their children is mixed and confusing. The message we want to give to them is that this is harmful and if we do that and we make it a uniform policy outside the home it will lead to a reduced exposure of children inside the home, partly because many of their parents will be giving up smoking but also because those who carry on smoking—and we have seen this in Ireland and in this country as more and more workplaces have gone smoke free—will stand outside to smoke rather than smoking inside the home.

  Chairman: Could I thank you all very much indeed for coming along and helping us with this inquiry. Hopefully we will have it published in time to go into one or two people's Christmas stockings.

1   Ms Arnott later informed the Committee that this enabled them to ensure that the respondents were not able to see the information until after they had been asked the question the first time and that they were able to read the information rather than just have it read out to them. Back

2   Ms Arnott later informed the Committee the actual figures were 13% before and 46% afterwards from Fong et al, Reductions in tobacco smoke pollution and increases in support for smoke-free public places following the implementation of comprehensive smoke-free workplace legislation in the Republic of Ireland: findings from the ITC Ireland/UK survey Tobacco Control 2005;000:1-8. Back

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