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Baroness Trumpington: My Lords, your Lordships may be surprised to know that the noble Baroness, Lady Howarth, and I are really very good friends. We agreed that we would be mortal enemies today, but we have now declared our situation.
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As it is now three years since I gave up smoking, your Lordships may think that I am rather impertinent to stand up and speak today. Just for the record, however, I gave up smoking not for health reasons but because the habit had become too expensive.
In all this talk about the Guest Room, a very good case has been made for the return of the Pugin Room, perhaps as a smokers' paradise. I respect the feelings of those who abhor cigarette smoke, but I also respect the feelings of those who wish to indulge in what, after all, is a legal occupation in this country. I find it very hard to believe the passive smoking theory. Here I agree entirely with the noble Lord, Lord Monson. If it were true about passive smoking, many of us here should be pushing up the daisies. I bet that most of our parents smoked.
I do not like to be bullied for "my own good". If there is a vote, I suggest that there is a little tolerance on both sides of this vexatious question. If there is a vote, I shall most certainly support the amendment of the noble Lord, Lord Stoddart.
Lord Faulkner of Worcester: My Lords, I declare an interest as a trustee of the Roy Castle Lung Cancer Foundation. In view of the comments of the noble Baroness, Lady Trumpington, I can say that both my parents were smokers: my mother died at 60 and my father at 65, both of diseases related to smoking. I think that that counters the point that our parents lived long because they were smokers or because it did not affect them.
It seems to me that there are two central themes in the Administration and Works Committee report, the bulk of which I very strongly support. I thank the Lord Chairman for producing such a thoughtful and helpful report. The first theme is that not only is passive smoking unpleasant for everyone—or almost everyone—who has to put up with it but the committee agrees with the Chief Medical Officer and every other objective medical expert that it is dangerous to health.
It is interesting that the code of practice on workplace smoking contained in the Houses of Parliament Health and Safety Risk Management Manual states:
"Evidence suggests that those exposed to passive smoke are at increased risk of illness including lung cancer, nasal cancer and heart disease. In addition, passive smoking can trigger or aggravate respiratory conditions such as asthma or bronchitis. It can also irritate eyes, cause coughs or headaches and generally make non-smokers feel ill, uncomfortable and unpleasant".
In making my second point, I quote from the minutes of the Administration and Works Committee held on 16 November. They state:
"The Committee recognised that staff had valid health concerns, and agreed the principle that staff should be entitled to work in a smoke-free environment".
I suggest that today we must judge the recommendations and proposed amendments against those criteria. If we do so, we can quickly decide that the amendments in the names of the noble Lord, Lord Stoddart, Lord Palmer and Lord Monson, fail to meet the criteria set by the committee and the code of practice.
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How do the committee's recommendations match up to its own criteria and that of the code of practice? They match up pretty well, except in one important respect. If our aim is to protect our staff from the effects of passive smoking, there can be no justification for exempting the Peers' Guest Room from the new arrangements. There is no air extraction system in the room, apart from opening the windows. It would be completely useless to install one, even if it could be done without destroying the fabric of the room.
All the evidence suggests that unless an extraction fan has the power of a tornado and is located over the heads of all smokers, it does not reduce the pollution of the air for everyone. Imagining that an extraction system can remove smoke in a room such as the Peers' Guest Room is like assuming that you can swim in a chlorine-free path in a swimming pool.
I shall certainly support the amendment in the name of the noble Baroness, Lady Howarth, and the remainder of the report.
Lord Harris of High Cross: My Lords, I want to make a serious confession. Not only am I a life-long pipe smoker, but for some 10 years the chairman of an organisation known as FOREST—the Freedom Organisation for the Right to Enjoy Smoking Tobacco. It is well represented in the better parts of this House.
I want to go to the central point made by the noble Lord, Lord Falkland, on the Roy Castle Foundation. We are not talking about the admitted and acknowledged hazards of direct smoking. We are talking about passive smoking—the illusive, will-o'-the-wisp passive smoking—and few people in this House will understand how epidemiologists go about trying to identify it. I shall therefore tell your Lordships.
The big idea is summed up in the phrase "spousal smoking". In order to estimate the long-term, even life-time, effect of smoking, the epidemiologists take two groups. They take a control group of non-smokers who are selected from a cross-section of the population. They take an equal number of lung cancer cases and non-cancer cases and they set about identifying the exposure of those cases to environmental tobacco smoke—ETS. In a way, it is almost comic because you cannot get hold of, measure, calibrate or identify tobacco smoke in a scientific fashion.
Therefore, they ask the control group a whole lot of questions about their background in this smoking lark. How much did their parents smoke? How about others? What about their husbands—how many packets a week did they smoke? They are told, "Write it down and let us have the details of all this". They are asked whether, when all this smoking was going on, the windows were open in the room or firmly shut. One then gets an idea of the kind of exposure as reported by those selected who have lung cancer and who are or were married to a smoker.
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Questions are then asked of their children, of their grand-children and of their nieces and nephews; for instance, "What did Daisy smoke when she was alive? How many a week was she smoking when she died? Write it down. Let's have magnitudes and quantities.". It sounds laborious and, in a manner of speaking, scientific if only you could measure the extra smoke and parcel it up.
However, there are a number of problems. A major one is concerned with the nature of cancer as being multi-factorial. Cancer is caused by a whole host of conditions, circumstances and so forth. Some people will be seriously affected by those and others will not. To compare the cancer group and the non-cancer group, one would need to identify all the differences between them in terms of diet, heredity, background, exposure to radon and noxious fumes and so forth.
The research is conducted through examination and cross-examination and one is faced with the fact that many cancer cases vehemently declare that they are non-smokers. Indeed, research shows that 5 to 25 per cent of professed non-smokers turn out to be former or even current smokers.
In all such comparative investigations, proof of death by ETS turns on comparing two speculative, subjective "guestimates" of long-term exposure. There is the exposure of the non-smoking lung cancer cases compared with the non-smokers who do not have lung cancer. The difference between the two decides the results of exposure to smoke—to passive smoking.
The statisticians get to work on all this data, having their computers brim-full of it. They try to decide on the relative risk to non-smokers who do not have lung cancer compared with the same size group of non-smokers who do have lung cancer. The effort is to identify the relative risk; the risk to those who are non-smokers and the risk to those who are non-smokers but who have lung cancer because they have been exposed to other people's smoke. A figure—a relative risk—is produced. A relative risk of one means that there is no greater hazard. A relative risk of 1.25 means that there has been a 25 per cent increased exposure to passive smoking. The key point is that epidemiologists agree that you need a high difference; not a 1.25 or 1.5 relative risk, but at least 2—a doubling of exposure—to amount to any kind of greater risk.
A study which I recently conducted, soon to be published, of these issues took 80 cases of spousal smoking. I found that of the 80, 57 would not be statistically significant on the strictest interpretation of the "confidence intervals" of the statisticians and that 10 of the 80 cases would imply a protective effect—an immunising effect—of exposure to smoking.
The great authority who has been quoted, Sir Richard Doll, has said:
"When relative risk lies between 1 and 2, problems of interpretation may become so acute and it may be extremely difficult to disentangle various contributions of biased information, confounding of two or more factors".
The National Cancer Institute in 1994 said:
"In epidemiological research, relative risks of less than 2.0 are considered too small and usually difficult to interpret. Such increases may be due to chance, statistical bias or the effects of confounding factors".
When Sir Richard Doll, the doyen of epidemiologists, was interviewed on "Desert Island Discs", he angered the ASH brigade by saying:
If one goes on, one finds evidence that the whole thing is vastly not only exaggerated but twisted. The truth of the matter is that, if we look at the statistics, we can see that there is no risk. There may be inconvenience or discomfort; if one has asthma, like one noble Lord here, there may be more than discomfort. But as a general rule, passive smoking is not a factor with regard to health.
The SCOTH report—the report of the Scientific Committee on Tobacco and Health—strove might and main to discover some evidence of the risk of passive smoking. In the end, it had to acknowledge that it was difficult to find the magnitude of numbers of people exposed to passive smoking, but decided that if we looked hard enough, we might find a relative risk of 1.25—an increased exposure of 25 per cent. The committee said that,
"taking all the supporting data into consideration we conclude that passive smoking in non-smokers exposed over a substantial part of their life, is associated with a 10 to 30 per cent increase in the risk of lung cancer that could account for"—
The report says there is a 10 to 30 per cent increase in risk, whereas we know that epidemiologists say that at least a doubling of the risk would be necessary. It says that there will be, perhaps, several hundred victims of this phantom disease in a population of some 60 million.
There is nothing in it! We need not put the shutters down on the Peers' Guest Room and every other outlet; we can try in a civilised way to separate those who are fussed about it and leave most of us to get on with our lives in an ordinary way.
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