Select Committee on Economic Affairs Written Evidence

Memorandum by the Tobacco Manufacturers' Association


Environmental Tobacco Smoke and Risk

  Part 1 of the Health Bill currently in Parliament bans smoking in all public and work places, subject only to a few minor exemptions that will be determined by Parliament, in the first instance in the primary legislation, and later in regulations made under the Act that will be subject to the affirmative procedure. Smoking or permitting smoking in a smoke free place, and failing to display required notices, will become criminal offences.

  Justification for the ban is claimed to lie in scientific evidence concerning the risk that environmental tobacco smoke may have for the health of the non-smoker. However, the legislation is also seen and promoted by its proponents as an important means of substantially reducing the prevalence of smoking in the population, by creating circumstances—much reduced opportunities for the smoker to smoke—that it is claimed will influence many smokers to quit the habit.

  On tobacco issues—including environmental tobacco smoke—government has been advised by the Scientific Committee on Tobacco and Health, but the future of the committee is now uncertain. In its reports of 1998 and 2004, SCOTH concluded that, on the basis of the published scientific evidence, environmental tobacco smoke is a serious hazard to the health of the non-smoker. Whilst minutes of certain meetings of the SCOTH have been made available after requests under the Freedom of Information Act, those papers have been redacted, most particularly where it has been considered that content falls under s.35 of the Act which protects information relting to the formulation of public policy. Thus the proceedings of the SCOTH are far from being transparent.

  Anti-smoking activists—most now part of a formal alliance led by Action on Smoking and Health (ASH)—have long campaigned for a comprehensive smoking ban. Their campaign has concentrated on media activity which has been successful in convincing the public that environmental tobacco smoke is a substantial hazard to the health of the non-smoker.

  From 1997 (and in its 1998 White Paper, Smoking and Health) to the beginning of 2004, the Government gave its support to voluntary action as being the most appropriate means of achieving its tobacco targets. It endorsed the Public Places Charter which sought to achieve best practice in the hospitality sector. Although the most significant targets of the Charter were met, in the face of intense pressure from anti-smoking activists and perceived public opinion, in 2004 the Health Secretary launched a major consultation, Choosing Health, of which smoking policy was one major part.

  The outcome was a White Paper in 2004 that proposed a smoking ban in all public and work places, subject to certain exemptions, one of which was licensed premises that did not prepare and serve food. This became an election manifesto commitment.

  After the election, there was public consultation on the framework of the smoke-free provisions of a Bill and possible regulations. A Bill was then introduced (together with a Partial Regulatory Impact Assessment) and was argued in Committee in the Commons in the terms that it was originally drafted. However, it emerged that the proposed legislation did not have the wholehearted support of the new Health Secretary, certain other Ministers, and a body of government backbenchers, all of whom wanted a more inclusive smoking ban. The outcome was the declaration of a "free vote" at Consideration of the Bill on 14 February. The free vote is to be on amendments standing in the name of the Health Secretary and Public Health Minister. These provide three options—the ban to include genuine private membership clubs; to include all licensed premises; or the exemption provisions to stand as originally stated in the Bill (exempting genuine private membership clubs and exempting certain licensed premises meeting the conditions stated in regulations).

  Given this very brief re«sume«, it might be reasonable to presume that in determining public policy and legislation, the scientific evidence on environmental tobacco smoke has been considered in detail in a thorough and objective manner and that the conclusions that have been drawn are robust; that there can be confidence in the Regulatory Impact Assessment that has been made on the legislative proposals; that the facts have been accurately and fairly reported by the media; and that there is public support for the policy that is being promoted.

  Such presumptions would be wrong.

  There has not been a thorough and objective assessment of the scientific evidence that is available. Even on the basis of the pronouncements of the SCOTH and others to the effect that there is an elevated risk of serious diseases (lung cancer and heart disease) in non-smokers exposed to environmental tobacco smoke, the level of risk is of such a low order that most epidemiologists would generally refuse to acknowledge it as worthy of even the slightest concern were it not to be such a useful tool in the "war" against smoking.

  The main components of the Regulatory Impact Assessment published with the legislation were inevitably largely speculative as to the outcome of the proposed ban on health and smoking prevalence. Major items were based on estimates of health gain derived from the application of the insecure and very low relative risks found in the epidemiology.

  The public has a poor perception and understanding of the ways in which risk can be measured and expressed, and understandably so in the case of environmental tobacco smoke which involves complex epidemiological and statistical methods and manipulation. Public understanding has not been assisted by the way in which the scientific evidence has been reported. That has invariably been in headline terms that have alarmed by misinterpreting or misunderstanding the original research, or by using prepared press handouts rather than relying on analysis or questioning of the research paper(s).

  The decision made in the White Paper Choosing Health and in the Health Bill as introduced in Parliament, to exempt licensed premises that did not prepare and serve food from the smoke free provisions of the Health Bill, was one of a political nature. It was a means of providing a small measure of choice and freedom for smokers and, most importantly, also a means of responding to public opinion. The latter was expressed formally by the Office for National Statistics in its report, Smoking Behaviour and Attitudes: when offered a choice of options, a substantial majority of people favoured facilities being provided for smokers and non-smokers in licensed premises. The state of public opinion was deliberately confused by the publicity afforded to repeated opinion polls that were not representative of the population as a whole and deliberately did not offer respondents a choice of smoking policy options, but only asked whether a ban was favoured or not.

  The proposed compromise that the exemptions clause of the Bill represented was, however, disrupted by disagreement amongst Ministers and government backbenchers. For the Prime Minister, the issue of smoking was sui generis.

  In the case of environmental tobacco smoke:

    the population has not been provided with an accurate portrayal of the scientific evidence on risk upon which preferences and attitudes could be determined and expressed properly; nonetheless, the majority of the public favours facilities for smokers and non-smokers being provided in licensed premises and does not favour a comprehensive ban on smoking;

    it is virtually impossible to attribute monetary values that have any real validity to environmental tobacco smoke as a risk factor, if risk factor it is at all: the order of risk reported in epidemiological studies is inconsistent, uncertain and, in any event, of a very low order and may be accounted for by bias and confounding; furthermore, there are no relevant data on the actual, real world impact of environmental tobacco smoke on the health of the non-smoker, if there is any effect at all;

    if the same "principles" were to be deployed consistently elsewhere, there would be cause for the banning of a very great many other activities, products etc.;

    there has not been independent, objective, expert assessment of risk and what has been promoted to the public has been further distorted by the nature of the reporting of the available evidence.

  In 2004, the Tobacco Manufacturers' Association made two major submissions—to the Health Department for England and Wales and to the Scottish Parliament, respectively in response to the Choosing Health consultation and to a request from the Health Committee of the Scottish Parliament for supplementary evidence on the scientific evidence on environmental tobacco smoke and the health of non-smokers. These submissions were identical in many respects but, whilst the submission in England and Wales summarises the scientific evidence, that to the Health Committee in Scotland provides detailed listings. Copies of the two submissions follows.[45]

13 February 2006

45   Evidence submitted but not printed. Documents can be found at Back

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