An outdoor platform?
The recent introduction on bans on smoking in bars and restaurants
in New York, Ireland and Norway has given fresh impetus
to the debate on how best to reduce the toll of premature
smoking-related deaths in the United Kingdom. The Scottish
first minister, after returning from a visit to Ireland, has raised the
real possibility of implementing a ban in Scotland.1
This debate has long been characterized by the public health
and tobacco control communities on one side and the tobacco
industry, supported by hospitality industry organizations, many
of which have been established by tobacco companies to voice
opposition to a ban. The alignment of forces is, however, changing
as the voice of the general public is at last being heard. Contrary
to the myths that have been peddled by the tobacco industry,
public consultations are revealing the true extent to which the
British people oppose being subjected to second-hand smoke. For
example, the ‘Big Smoking Debate’ organized by the London
Health Commission involving over 30 000 respondents indicated
that the vast majority (76 per cent) wanted completely smoke free
public places, including both smokers and non-smokers.2
These findings are unsurprising, given the unpleasant physical
effects of exposure to concentrated tobacco smoke. However,
public opinion is also being galvanized by growing recognition of
the adverse health effects of second-hand smoke, something the
tobacco industry has striven hard to refute as part of a campaign
sustained over many years to prevent the introduction of bans on
smoking in public places. There is now an overwhelming consensus
among independent tobacco researchers that exposure to
second-hand smoke causes many deaths, with recent research
using more precise measures of exposure revealing how exposure
to second-hand smoke is considerably more dangerous than was
previously believed.3 This is consistent with recently discovered
tobacco industry documents showing that second-hand smoke is
even more harmful, volume for volume, than directly inhaled
smoke.4 Yet the industry continues to place the highest priority
on preventing the introduction of restrictions on smoking in public
places and has been especially active in spreading misinformation
about the effects of the bans in Ireland and New York.
The main reason it has pursued this policy with such tenacity
is clear; bans, together with increased taxation, are the most
effective ways of reducing smoking overall.5 However, it is also
concerned that to concede that second-hand smoke is harmful
would undermine its argument that smoking is a matter of
personal choice.
The strategy pursued by the industry has several elements.
One, now largely discredited, has been to attack the link between
second-hand smoking and disease has included commissioning
research, some of which was fraudulent and some simply designed
to mislead, undermining the communication of research showing
the harm caused by second-hand smoke, and lobbying governments
and regulators.6,7
Another is to argue that any irritation (again denying the
possibility of harm) can be dealt with by ventilation. This too is
incorrect, with extensive evidence that the force of ventilation
that would be required is far beyond the capacity of existing
systems and would be similar to sitting outside during a gale.8 It
is important to be aware that many harmful components of
tobacco smoke are odourless and the tobacco industry has put
much effort into masking the smell and visibility of environmental
tobacco smoke.9
The third argument, and one with which it has had some
success so far in the United Kingdom, is that the introduction of
smoking bans in bars and restaurants will reduce takings, and
thus sales tax and employment. To sustain this, it has engaged in
a wide-ranging campaign directed at the hospitality industry.
Yet, like its other arguments, this too is false. The most recent
evidence is from New York where, in the 9 months after a ban on
smoking in public places was introduced, sales tax receipts on
food and drink increased by 12 per cent and employment in the
hospitality industry increased.10 However, the most convincing
evidence comes from a systematic review of research on the
impact of bans on bar and restaurant revenue.11 The details
results merit study. The authors examined 97 studies of the
economic impact of smoking bans. Every one of the 37 studies
Why we need to ban smoking in public places
now
Martin McKee, Helen Hogan and Anna Gilmore
Journal of Public Health Vol. 26, No. 4, pp. 325–326
doi:10.1093/pubmed/fdh187 Printed in Great Britain
Journal of Public Health vol. 26 no. 4 © Faculty of Public Health 2004; all rights reserved.
1
London School of Hygiene and Tropical Medicine, Keppel Street,
London WC1E 7HT, UK and 2
North East London Strategic Health Authorit
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| +1, Horatio Gonzales.
Is the society winning and silly, or is the EF? I really have my doubts. How many times did you hear people in real life complaining about smokers or other insignificant inconveniences. If I haven't travelled quite a lot so far I would believe that EFers come from paradisiac countries, where angels live not people, and everybody behaves considerate at all times. | |
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