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October, 2007:

Best Practices for Comprehensive Tobacco Control Programs

Tobacco* use is the single most preventable cause of death and disease in the United States. People begin using tobacco in early adolescence; almost all first use occurs before age 18. An estimated 45 million American adults currently smoke cigarettes. Annually, cigarette smoking causes approximately 438,000 deaths. For every person who dies from tobacco use, another 20 suffer with at least one serious tobacco-related illness. Half of all long-term smokers die prematurely from smoking-related causes. In 2004, this addiction costs the nation more than $96 billion per year in direct medical expenses as well as more than $97 billion annually in lost productivity. Furthermore, exposure to secondhand smoke causes premature death and disease in nonsmokers. In 2005, the Society of Actuaries estimated that the effects of exposure to secondhand smoke cost the United States $10 billion per year.

Nearly 50 years have elapsed since the first Surgeon General’s Advisory Committee concluded: “Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action.” There now is a robust evidence base about effective interventions. Yet, despite this progress, the United States has not yet achieved the goal of making tobacco use a rare behavior. A 2007 Institute of Medicine (IOM) report presented a blueprint for action to “reduce smoking so substantially that it is no longer a public health problem for our nation.” The twopronged strategy for achieving this goal includes not only strengthening and fully implementing currently proven tobacco control measures, but also changing the regulatory landscape to permit policy innovations. Foremost among the IOM recommendations is that each state should fund a comprehensive tobacco control program at the level recommended by the Centers for Disease Control and Prevention (CDC).

We know how to end the epidemic. Evidencebased, statewide tobacco control programs that are comprehensive, sustained, and accountable have been shown to reduce smoking rates, tobaccorelated deaths, and diseases caused by smoking. Recommendations that define a comprehensive statewide tobacco control intervention have been provided in the Surgeon General’s reports Reducing Tobacco Use (2000) and The Health Consequences of Involuntary Exposure to Tobacco Smoke (2006), the Task Force for Community Preventive Services’ Guide to Community Preventive Services (2005), IOM’s Ending the Tobacco Problem: A Blueprint for the Nation (2007), the Public Health Service’s Clinical Practice Guideline Treating Tobacco Use and Dependence (2000), and the National Institutes of Health’s State-of-the-Science conference Statement Tobacco Use: Prevention, Cessation, and Control (2006) and President’s Cancer Panel Annual Report Promoting Health Lifestyles: Policy, Program and Personal Recommendations for Reducing Cancer Risk (2007).

A comprehensive statewide tobacco control program is a coordinated effort to establish smoke-free policies and social norms, to promote and assist tobacco users to quit, and to prevent initiation of tobacco use. This comprehensive approach combines educational, clinical, regulatory, economic, and social strategies. Research has documented the effectiveness of laws and policies in a comprehensive tobacco control effort to protect the public from secondhand smoke exposure, promote cessation, and prevent initiation, including increasing the unit price of tobacco products and implementing smoking bans through policies, regulations, and laws; providing insurance coverage of tobacco use treatment; and limiting minors’ access to tobacco products. Additionally, research has shown greater effectiveness with multi-component intervention efforts that integrate the implementation of programmatic and policy interventions to influence social norms, systems, and networks.

This document updates Best Practices for Comprehensive Tobacco Control Programs—August 1999. This updated edition describes an integrated programmatic structure for implementing interventions proven to be effective and provides the recommended level of state investment to reach these goals and reduce tobacco use in each state. It is important to recognize that these individual components must
work together to produce the synergistic effects of a comprehensive tobacco control program. Based on the evidence of effectiveness documented in scientific literature, the most effective population-based approaches have been defined within the following overarching components:

I. State and Community Interventions
State and community interventions include supporting and implementing programs and policies to influence societal organizations, systems, and networks that encourage and support individuals to make behavior choices consistent with tobacco-free norms. The social norm change model presumes that durable change occurs through shifts in the social environment, initially or ultimately, at the grassroots level across local communities. State and community interventions unite a range of integrated programmatic activities, including local and statewide policies and programs, chronic disease and tobacco-related disparity elimination initiatives, and interventions specifically aimed at influencing youth.

II. Health Communication Interventions
An effective state health communication intervention should deliver strategic, culturally appropriate, and high-impact messages in sustained and adequately funded campaigns integrated into the overall state tobacco program effort. Traditional health communication interventions
and counter-marketing strategies employ a wide range of efforts, including paid television, radio, billboard, print, and web-based advertising at the state and local levels; media advocacy through public relations efforts, such as press releases, local events, media literacy, and health
promotion activities; and efforts to reduce or replace tobacco industry sponsorship and promotions. Innovations in health communication interventions include more focused targeting of specific audiences as well as fostering message development and distribution by the target audience through appropriate channels.

III. Cessation Interventions
Interventions to increase cessation encompass a broad array of policy, system, and populationbased measures. System-based initiatives should ensure that all patients seen in the health care system are screened for tobacco use, receive brief interventions to help them quit, and are offered more intensive counseling services and FDA-approved cessation medications. Cessation quitlines are effective and have the potential to reach large numbers of tobacco users. Quitlines also serve as a resource for busy health care providers, who provide the brief intervention and discuss medication options and then link tobacco users to quitline cessation services for more intensive counseling. Optimally, quitline counseling should be made available to all tobacco users willing to access the service.

IV. Surveillance and Evaluation
State surveillance is the process of monitoring tobacco-related attitudes, behaviors, and health outcomes at regular intervals. Statewide surveillance should monitor the achievement of overall program goals. Program evaluation is used to assess the implementation and outcomes of a program, increase efficiency and impact over time, and demonstrate accountability. A comprehensive state tobacco control plan—with well-defined goals; objectives; and short-term, intermediate, and long-term indicators—requires appropriate surveillance and evaluation data systems. Collecting baseline data related to each objective and performance indicator is critical to ensuring that program-related effects can be clearly measured. For this reason, surveillance and evaluation systems must have first priority in the planning process.

V. Administration and Management
Effective tobacco prevention and control programs require substantial funding to implement, thus making critical the need for sound fiscal management. Internal capacity within a state health department is essential for program sustainability, efficacy, and efficiency. Sufficient capacity enables programs to plan their strategic efforts, provide strong leadership, and foster collaboration between the state and local tobacco control communities. An adequate number of skilled staff is also necessary to provide or facilitate program oversight, technical assistance, and training.

The primary objective of the recommended statewide comprehensive tobacco control program is to reduce the personal and societal burden of tobacco-related deaths and illnesses. Research shows that the more states spend on comprehensive tobacco control programs, the greater the reductions in smoking—and the longer states invest in such programs, the greater and faster the impact. States that invest more fully in comprehensive tobacco control programs have seen cigarette sales drop more than twice as much as in the United States as a whole, and smoking prevalence among adults and youth has declined faster as spending for tobacco control programs has increased.

In California, home of the longest-running comprehensive tobacco control program, adult smoking rates declined from 22.7% in 1988 to 13.3% in 2006. As a result, compared with the rest of the country, heart disease deaths and lung cancer incidence in California have declined at accelerated rates. Due to the program-related reductions in smoking, lung cancer incidence has been declining four times faster in that state than in the rest of the nation. Among women in California, the rate of lung cancer deaths decreased while it increased in other parts of the country. Because of this accelerated decline, California has the potential to be the first state in which lung cancer is no longer the leading
cancer cause of death.

Implementing a comprehensive tobacco control program structure at the CDC-recommended levels of investment would have a substantial impact. For example, if each state sustained its recommended level of funding for 5 years, an estimated 5 million fewer people in this country would smoke. As a result, hundreds of thousands of premature tobaccorelated deaths would be prevented. Longer-term investments would have even greater effects.

The tobacco use epidemic can be stopped. We know what works, and if we were to fully implement the proven strategies, we could prevent the staggering toll that tobacco takes on our families and in our communities. We could accelerate the declines in cardiovascular mortality, reduce chronic obstructive pulmonary disease, and once again make lung cancer a rare disease. If we as a nation fully protected our children from secondhand smoke, more than one million asthma attacks and lung and ear infections in children could be prevented. With sustained implementation of state tobacco control programs and policies (e.g., increases in the unit price of tobacco products), IOM’s best-case scenario of reducing adult tobacco prevalence to 10% by 2025 would be attainable.

View the entire document on the Best Practices for Comprehensive Tobacco Control Programs here.

Blind Eyes Towards Ban

By ADRIAN WAN CHUN-HO – Hong Kong Baptist University

Though the smoking ban has been in effect for about a year in Hong Kong, smokers are still to be found lighting up in public places.

The Tobacco Control Office (TCO) of Department of Health began working round the clock after citizens’ unlawful smoking sprees were found to run rampant when Tobacco Control Inspectors (TCI) and telephone receivers all went off duty.

Although implementation has been stepped up, smokers are still found lighting up in many entertainment premises such as game centres, high-rise cafes, internet cafes, karaoke lounges and private clubs in districts such as Mongkok, Tsim Sha Tsui and Causeway Bay.

Paul Wong Tai-long, a smoker said he smokes only if he sees other people do it in the same place.

“People smoke and never get caught. Why should I obey the law?” he questioned, pointing at other smokers in a game station in Hung Hom.

Being one of the regulars at the station, he visits three times a week, two hours each time. He said he has seen TCIs check up on smokers only three times since the ban was in place, thus seems rather safe to smoke.

A non-smoker named Joey commented in an internet cafe in Mongkok, “[The smokers] are utterly selfish. They disregard the law and disrespect themselves. I don’t like people smoking next to me when I’m having fun here.”

As only half of all the internet cafes in Hong Kong are lawabiding, and they charge higher prices. The rest, which offer lower prices, indulge their customers in a smoky and obscure milieu, left Joey with no choice.

When filing a complaint to the TCO was suggested, she replied, “I don’t think it is going to be useful. My friends tried. They always say they will investigate.”

James Middleton, a member of Clear The Air, a volunteer group committed to combate against air pollution in Hong Kong, commented on the situation, “[The TCO] are massively understaffed. By the time a complaint is made and TCIs get there, the offenders are long gone.”

“The government should make use of other employees such as those from the Leisure and Cultural Services Department (LCSD) to enforce the law,” he said.

An official from the TCO explained, “Once we receive a complaint, we will investigate the case by obtaining relevant information from the complainant. This is then followed by conducting a field inspection of the alleged premises.”

Where smoking is not allowed, ash trays are not supposed to be seen. However, smoke and ash trays are all over the place in a snooker club in Wong Tai Sin.

The club manager, who requested anonymity, said it is necessary because if ash trays are not provided, the cigarette ash and butts that customers leave over will catch his club on fire.

Mr Li Bo-lung, a client, lighting up in the club, claimed he was only “making use of the facilities provided”. He said, “Don’t ask me why I smoke. Ash trays are provided here. Ask the manager.”

When the suggestion was made to remove the ash trays, so that customers can be more aware of the law, the manager said he does not want the carpet damaged by cigarette ends, while puffing away at a cigarette himself.

Ash trays are not only seen in that particular club, they are everywhere, sometimes appear in different forms.

Some restaurants have adopted a way to get around the law : supplying smaller bowls instead of those obvious ash trays. It begs the question whether venue managers should be liable to a penalty when customers are caught lighting up.

Middleton said, “In licensed premises there should be a fine for the licensee if he does not enforce the ban, with loss of his license for subsequent offences.”

The TCO official said, “TCIs will liaise with the venue manager to identify any deficiency in anti-smoking measures such as the lack of no-smoking signs, inadequate legal knowledge and insufficient law enforcement skills”.

The ban, introduced on January 1, applies to all indoor public places, such as restaurants, workplaces, schools and karaoke lounges. Smoking outdoors, at public beaches, swimming pools, and sports grounds, is also forbidden.

In spite of this, about 750 facilities have been given deferment of the ban, thus are allowed to permit smoking on their premises until July 1, 2009.

The requirements for being able to defer the ban are minimal at best, with the stated criteria simply calling for no one under the age of 18 being allowed to enter the premise, having an exclusive entrance for clients to enter in by, and an age limit sign prominently displayed in Chinese and English at each entrance.

“It’s a laughing stock that any bar or restaurant which applies is granted a smoking exemption, while the law is intended to save lives of the bar and restaurant workers,” Middleton said.

According to their website, the TCO has issued altogether 1,975 summonses from 1 January 2007, the day when the ban became effective, to 30 September 2007. Violators are subject to a maximum penalty of $5,000. Venues are not liable to any penalty.

Philip Morris’s Website And Television Commercials

Tobacco Control 2007;16:e9; doi:10.1136/tc.2007.024026

RESEARCH PAPER

Philip Morris’s website and television commercials use new language to mislead the public into believing it has changed its stance on smoking and disease

Lissy C Friedman

Correspondence to:
Lissy C Friedman, Public Health Advocacy Institute, 102 The Fenway Cushing Hall, Room 117, Boston, MA 02115, USA; lissy@tplp.org

Received 25 October 2007

Accepted 25 October 2007

Abstract:

Objectives: This paper analyses Philip Morris’s evolving website and the legal strategies employed in its creation and dissemination.

Methods: Internal tobacco documents were searched and examined and their substance verified and triangulated using media accounts, legal and public health research papers, and visits to Philip Morris’s website. Various drafts of website language, as well as informal discussion of the website’s creation, were located in internal Philip Morris documents. I compared website statements pertaining to Philip Morris’s stance on cigarette smoking and disease with statements made in tobacco trials.

Results: Philip Morris created and disseminated its website’s message that it agreed that smoking causes disease and is addictive in an effort to sway public opinion, while maintaining in a litigation setting its former position that it cannot be proved that smoking causes disease or is addictive.

Conclusions: Philip Morris has not changed its position on smoking and health or addiction in the one arena where it has the most to lose—in the courtroom, under oath.

In 1999, Philip Morris, Inc, the largest and most powerful multinational cigarette manufacturer in the world, launched an advertising campaign publicising its new website, which contained information about the harmful effects of smoking. The website included an extraordinary statement that appeared to admit that Philip Morris now believed that the issue of causation between smoking and disease had been proved. It referred viewers to various governmental and public health resources, including the Surgeon General’s Report and the Centers for Disease Control and Prevention, as well as major public health advocacy organisations such as the American Cancer Society. Moreover, Philip Morris appeared to admit that smoking is addictive, conceding that quitting can be difficult, and referring website users to various cessation resources.

The initial reaction from the press, the public and plaintiffs’ litigators was a mixture of guarded optimism, scepticism and incredulity. Was Philip Morris raising the white flag and ready to concede that its products caused the sickness and death of its consumers for more than half a century? Would this perceived concession cause a seismic shift in the products liability landscape, resulting in possibly thousands of plaintiffs’ verdicts that could bankrupt the company? Did Philip Morris intend to set an example for the rest of the tobacco industry and take responsibility for its past bad conduct? A recent study by Balbach et al examined tobacco industry trial testimony and how the tobacco industry misuses its website and advertising campaigns to be a source of specious information for consumers and the public.1 The study found that the information was conveyed without taking any responsibility for the quality, veracity or accuracy of that information, thus allowing the tobacco industry’s witnesses to claim disingenuously that consumers made an “informed choice” to smoke. Balbach et al concluded that this places the “moral responsibility” on the smoker: if the smoker ends up being injured as a result of smoking cigarettes and sues for compensation, then the tobacco industry defendant can claim that the consumer was fully informed yet made the wrong choice, thus shifting the blame away from the tobacco products and their manufacturers to the consumer.

This paper will focus on Philip Morris that, of all the major tobacco companies, has made the most visible use of its website with an accompanying advertising campaign supporting its website’s message, at www.philipmorrisusa.com. Extending beyond the specific information provided on the tobacco industry’s websites and the industry’s fluid definition of “truth” and “information,” as discussed by Balbach et al, this paper will focus less on the substance of Philip Morris’s website and more on its litigation strategy and how it hoped to use the website to manipulate and deceive juries to influence the outcome of litigation. The paper will demonstrate through trial testimony how plaintiffs’ lawyers repeatedly revealed the deceptive nature of this campaign. It will examine how this litigation strategy may have influenced the verdicts of cases, with several juries finding against Philip Morris and awarding huge punitive damages awards, and in one case a federal judge finding that Philip Morris, along with its tobacco company co-defendants, were racketeers. Unmasking Philip Morris’s deceptive strategy that drove the creation of its website has been and should continue to be a useful tool for plaintiffs’ litigators in holding Philip Morris and other tobacco companies accountable in the arena where it counts most—the courtroom.

See the full research paper here: http://tobaccocontrol.bmj.com/cgi/content/full/16/6/e9

Water Margin OSA Air Quality

The following letter was sent to the Food and Environmental Hygiene Department over concerns of contamination due to smoking in the outdoor areas of restaurants in Discovery Bay’s Water Margin complex. 

Dear Sir

We are informed the Water Margin OSA is continuing to be used daily by the restaurants since our initial complaint.

Neither have we received any update from you as promised in the letter.

We reiterate our objection under OSA guidelines for licences to be granted for OSA to these existing premises if smoking is allowed under our previously stated reasons copied below.

As regards an application for OSA – Outside Seating Accommodation guidelines :
http://www.fehd.gov.hk/howtoseries/forms/new/OSA%20Guide.Eng(4.2006).pdf

“The operation of OSA should not create any environmental nuisance (such as water pollution, air quality nuisanceand noise nuisance).”

It is quite clear that allowing smoking in partially enclosed and covered outdoor areas like this constitutes an environmental nuisance as regards air quality nuisance to workers , passers by using the walkway who are frequently also children and non smoking patrons alike.

Accordingly Clear the Air objects to any current use of the OSA whilst smoking is permitted by the licensees in the OSA area and to any subsequent application by them to include the OSA in their licences under these legal ‘air quality nuisance’ grounds.

In addition, food is carried through and deposited in the OSA to be served to customers :
4. Adequate measures should be taken to protect food from risk of contamination during conveyance to the OSA.

The micron sized particles of cancerous environmental cigarette smoke will pass through any type of food service cover and will also contaminate the food when placed on the tables of the OSA for consumption. None of these premises other than McSoreleys has a smoking deferral approval in place.

7. The licensee should comply with the provisions of the laws of Hong Kong

The podium has numerous parasols which constitute a cover or roof under Cap 371. As such under Hong Kong laws the employers have a legal duty to protect their workers from unsafe work environments; the lethal dangers of passive cigarette smoke are documented and proven beyond contest, even acknowledged on the major tobacco company websites. ” An employer who fails to maintain the workplace in a condition that is, so far as reasonably practicable, safe and without risks to health – intentionally, knowingly or recklessly – commits an offence and is liable on conviction to a fine of $200,000 and to imprisonment for 6 months.”   Chapter: 509 Title: OCCUPATIONAL SAFETY AND HEALTH ORDINANCE Gazette Number: L.N. 230 of 1998 Section: 6 Heading: Employers to ensure safety and health of employees Version Date: 01/06/1998

Allowing smoking in  partially covered area workplaces is definitely not a condition that is ‘safe and without risks to health.’

kind regards
James Middleton
Clear the Air

Cafe Duvet Smoking Experience

This letter was sent to Lewis Ho of Hong Kong Resorts International Ltd in regards to smoking concerns at Cafe Duvet in Discovery Bay’s Water Margin complex by one of Clear The Air’s members, Nigel Bruce. 

Dear Mr. Ho,

I was informed by a neighbour that the new Cafe Duvet has opened on the raised podium in the Plaza.

He told me he had to leave shortly after sitting down, as the cafe was full of people smoking. I was not surprised, as this was sadly to be expected, given your response to my earlier email (see below).

You said in that email: “we, as the landlord, are not entitled during the tenancy period to unilaterally impose extra conditions on the own use of the leased premises by the tenants”. But this is a new lease, and surely Management now had the opportunity to attempt to carry out a policy to protect residents’ health?

 I find it disappointing in the extreme that you are again failing to take an opportunity to pursue such a policy.

Also, when you say: “Having said that, however, we would encourage the individual restaurants to allocate non-smoking areas within their leased premises on a voluntary basis so that both the smoking and non-smoking population can enjoy the superb Water Margin outdoor experience”, does this mean that you have not actually entered into any discussions with your tenant restaurants about their smoking policies?

Regards,

Nigel Bruce

The Myths And Reality Of Smokefree England

Published by ash, October 2007:

As the smoke clears: The myths and reality of Smokefree England

In the period leading up to smokefree legislation the hospitality industry and pro smoking organisations claimed the law would spell disaster for their businesses and damage the economy. But what happened in reality? ASH has revisited these claims and assessed the most common scare stories by these organisations, to see what impact the smokefree law has had.

Myth: It will be bad for pubs

Pro smoking groups claimed that the smokefree legislation would be bad for business and we would lead to many pubs closing down. The evidence to date from notable pub groups is that the smoking ban has had ‘little impact’ upon their sales.
Capital Pubs announced profits and that the ‘smoking ban has had no material impact on business’. 1

Greene King said like-for-like sales were up by 2% in managed houses and 1% in tenanted pubs.2

Punch Tavern shares rose by 2.3% and announced the smoking ban as having ‘little impact upon sales. 3

Mitchells&Butler announced that the smoking ban has not affected UK sales with like-for-like sales increasing by 2.6 per cent.4

Furthermore a recent YouGov survey commissioned by ASH found that 20% of non-smokers reported that they visited pubs more often since the smoking ban.

Source of the claim: Freedom2choose
Weblink: http://www.freedom2choose.org.uk/

Myth: It will be bad for bingo

In the lead up to the smoking ban, pro smoking groups argued that the smokefree legislation was going to be particularly detrimental for both the profitability and long term outcomes of Bingo, with smokers more likely to stay home and use online gaming sites.

Reality: Gaming group Rank, which has 86 clubs in England said it was encouraged by performance at its Mecca bingo, with company shares up by 8.75%.5

Myth: There will be large scale non-compliance

Critics argued that a total ban on smoking in public places would not be possible to police and there would be large scale non- compliance.

Reality: However two independent surveys tell a different story. The first by the Department of Health, released in August, found that 97% of businesses are complying with the new smoking legislation.6 Secondly a YouGov survey recently released by ASH, Asthma UK and the British Thoracic Society found similar results with 97% of pub goers saying they had not smoked in a pub or enclosed space since the ban came into force, while 86% of pub goers said that they had not seen anyone smoking in a pub. The evidence dismisses the arguments by critics surrounding large scale non-compliance.

Source of the claim: The Telegraph
Weblink: http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/06/03/nsmoke03.xml

Myth: There will be heavy handed enforcement with undercover officers and covert filming.

Pro smoking organisations and landlords reasoned that the smoking ban would result in heavy handed enforcement, covert filming and armies of undercover enforcement officers. Simon Clarke a FOREST spokesperson argued that it will be like a ‘sledgehammer cracking a nut’ and the British Beer and Pub Association believed that enforcement would be too heavy handed.

Reality: What has happened in practice is that council officials have approached the situation as they said they would, in a reasonable manner applying a ‘softly softly’ approach with relatively few fines being issued. Further, Lambeth council have recently reported that they issued their first fine 7 while Staffordshire have yet to issue a single fine8, providing further evidence that these claims were unsubstantiated.

Source of the claim: BBC and Forest
Weblink: http://news.bbc.co.uk/1/hi/health/6346435.stm

Myth: Working men’s clubs and shisha bars will close

Claims and protests that the smoking ban would result in mass closures of shisha bars and working men’s clubs, threatening the livelihood of the owners were unfounded. Working men’s clubs feared that the smoking ban would see one in five of its clubs closing down following the smoking ban whilst shisha bars argued that they would be unable to operate if smoking was banned in enclosed places.

Reality: There have yet to be any reported closures as a result of the ban.

Source of the claim: Save the Shisha campaign
Weblink: http://savetheshishacampaign.com/page2.htm

Myth: People won’t really quit

Reality: The survey by ASH, Asthma UK and the British Thoracic Society found that 12% of smokers have attempted to quit since the 1st July. Primary Care Trusts in Lancashire9, Brighton and Hove, and Barking and Dagenham have all reported a 100% increase in people using stop smoking services.10

Source of the claim: Forest
Weblink: http://society.guardian.co.uk/health/story/0,,2079120,00.html

Myth: Smoking is a victimless crime/ Claims about the health impact are flawed.
Pro smoking groups continue to dispute credible medical evidence regarding the dangers of secondhand smoke and the health consequences of smoking.

Reality: Numerous international reports from bodies such as the WHO, IARC and the UK’s Scientific Committee on Tobacco and Health found that exposure to secondhand smoke was responsible for an increase in heart disease, lung cancer and reduced lung function.11

Recently released research from Scotland shows that admissions to hospital for heart attacks have declined by 17 per cent since the introduction of the smoking ban in public places. 12

Independent tests and research have also been carried out on bar staff. A BBC investigation tested bar staff prior to the ban and found they had cotinine levels which were the equivalent of smoking 300 cigarettes a year.13 A study in Leicestershire of carbon monoxide levels in non-smoking bar staff found that prior to the ban they had readings between 10 -15 molecules per million air particles, the equivalent to 3 to 5 cigarettes a day. After the ban they had between 0-1 molecules per million air particles, which is the equivalent to that of a non smoker.14 A study by The Tobacco Control Collaborating Centre in Warwick visited 59 pubs, cafes and bingo halls and found staff exposure to harmful secondhand smoke has fallen by 95 per cent since the introduction of smokefree legislation.15

Source of the claim: FOREST
Weblink: http://www.forestonline.org/output/page16.asp

Myth: House fires will increase as people will stay at home to smoke

Preceding the smoking ban, claims were made that the legislation was going to cause people to stay at home and smoke instead of going out to a pub or club and this would result in a greater number of house fires.

Reality: There have not been any reports to suggest that smoking related fires have increased. Further evidence that like-for-like sales in pubs have not been affected suggests that smokers have continued to visit pubs.

Source of the claim: Direct line
Weblink: http://www.directlineinsurance.com/ about_us/news_180407.htm

Myth: There will be an increase in exposure of secondhand smoke in the home, affecting children

Pro smoking groups argued that we would see an increasing number of people buying alcohol from supermarkets and off licences and drinking and smoking at home instead of pubs, which would result in exposing children to greater levels of secondhand smoke.

Reality: The YouGov survey by ASH, Asthma UK and The British Thoracic Society asked those who were exposed to smoke before and after the smoking legislation about their levels of exposure to secondhand smoke at home. The results found that exposure had significantly decreased as the law encouraged people to make homes smokefree. Below is a chart of the results which shows that 41 per cent of respondents said exposure to secondhand smoke was ‘a great deal less’ than prior to the smoking ban.

Exposed to secondhand smoke at home since the smoking ban

Source of the claim: Freedom2choose
Weblink: www.freedom2choose.org.uk

Myth: The public do not want a smoking ban or any further tobacco control measures

Groups such as freedom2choose argue that the public are not only against the smokefree legislation but they also do not want further tobacco control measures.

Reality: However the survey commissioned by ASH, Asthma UK and the British Thoracic Society found that there was strong support for further tobacco control measures with 72 per cent supporting Reduced Ignition Propensity cigarettes (firesafer cigarettes), 63 per cent of people supporting picture warnings and 59 per cent supporting banning cigarette vending machines.

Use graphic pictures on the health warning which go on tobacco products. opposeProhibit Cigarette Sales from Vending Machines.

Source of the claim: Forest and freedom2choose
Weblink: http://www.forestonline.org/output/page315.asp
http://www.freedom2choose.org.uk

1 The Caterer, 12 September 2007: http://www.caterersearch.com/Articles/2007/09/12/316039/smoking-ban-has-had-no-financial-impact-on-capital-pub-co.html

2 The Morning Advertiser, 04 September 2007:
http://www.morningadvertiser.co.uk/news_detail.aspx?articleid=49885

3 The Caterer, 06 September 2007 http://www.caterersearch.com/Articles/2007/09/06/315936/smoking-ban-no-significant-impact-on-punch.html

4Planet Retail, Food Service News, 28 September 2007
http://www.planetretail.net/FoodServiceNews/NewsFeed.asp#58737

5 The Scotsman, 31 August 2007,
http://thescotsman.scotsman.com/business.cfm?id=1384522007

6 The Department of Health, Smokefree England one month on, 06 August 2007: http://www.gnn.gov.uk/environment/fullDetail.asp?ReleaseID=305420&NewsAreaID=2&NavigatedFromDepartment=False

7 24dash.com – News for the public sector, 24 September 2007, http://www.24dash.com/news/2/27877/index.htm

8 Medical News Today, 27 September 2007
http://www.medicalnewstoday.com/articles/83752.php

9 The Lancashire Telegraph, 12 September 2007: http://www.lancashiretelegraph.co.uk/display.var.1684321.0.records_numbers_bid_to_quit_smoking.php

10 The Barking and Dagenham Recorder, 06 September 2007: http://www.bdrecorder.co.uk/content/barkinganddagenham/recorder/news/story.aspx?brand=RECOnline&category=newsBarkDag&tBrand=northlondon24&tCategory=newsbarkdag&itemid=WeED05%20Sep%202007%2016%3A17%3A42%3A447

11 The Scientific Committee on Tobacco and Health, Secondhand Smoke: Review of evidence since 1998
www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4101475.pdf

12 The Scottish Government, News Release: Smoking ban brings positive results.
http://www.scotland.gov.uk/News/Releases/2007/09/10081400

13 BBC News, 13 July 2007
http://news.bbc.co.uk/1/hi/magazine/6898124.stm

14Leicester Mercury, 21 August 2007 http://www.thisisleicestershire.co.uk/displayNode.jsp?nodeId=132384&command=displayContent&sourceNode=133130&contentPK=18155666&folderPk=77458&pNodeId=133088

15 The Telegraph, 01 October 2007
http://news.independent.co.uk/health/article3015291.ece