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December 31st, 2007:

Protection From Exposure To Second-Hand Tobacco Smoke

Protection from exposure to second-hand tobacco smoke. Policy recommendations.

Scientific evidence has firmly established that there is no safe level of exposure to secondhand tobacco smoke (SHS), a pollutant that causes serious illnesses in adults and children. There is also indisputable evidence that implementing 100% smoke-free environments is the only effective way to protect the population from the harmful effects of exposure to SHS.

Moreover, several countries and hundreds of subnational and local jurisdictions have successfully implemented laws requiring indoor workplaces and public places to be 100% smoke-free without encountering significant challenges in enforcement. The evidence from these jurisdictions consistently demonstrates not only that smoke-free environments are enforceable, but that they are popular and become more so following implementation.

These laws have no negative impact – and often have a positive one – on businesses in the hospitality sector and elsewhere. Their outcomes – an immediate reduction in heart attacks and respiratory problems – also have a positive impact on health.

These experiences offer numerous, consistent lessons learnt, which policy-makers should consider to ensure the successful implementation
of public policies that effectively protect the population from SHS exposure. These lessons include the following:

  1. Legislation that mandates smoke-free environments – not voluntary policies – is necessary to protect public health;
  2. Legislation should be simple, clear and enforceable, and comprehensive;
  3. Anticipating and responding to the tobacco industry’s opposition, often mobilized through third parties, is crucial;
  4. Involving civil society is central to achieving effective legislation;
  5. Education and consultation are necessary to ensure smooth implementation;
  6. An implementation and enforcement plan as well as an infrastructure for enforcement are essential; and
  7. Implementation of smoke-free environments must be monitored and, ideally, their impact measured and experiences documented.

In light of the above experience, the World Health Organization (WHO) makes the following recommendations to protect workers and the public from exposure to SHS:

  1. Remove the pollutant – tobacco smoke – by implementing 100% smoke-free environments. This is the only effective strategy to reduce exposure to tobacco smoke to safe levels in indoor environments and to provide an acceptable level of protection from the dangers of SHS exposure. Ventilation and smoking areas, whether separately ventilated from non-smoking areas or not, do not reduce exposure to a safe level of risk and are not recommended;
  2. Enact legislation requiring all indoor workplaces and public places to be 100% smokefree environments. Laws should ensure universal and equal protection for all. Voluntary policies are not an acceptable response to protection. Under some circumstances, the principle of universal, effective protection may require specific quasi-outdoor and outdoor workplaces to be smoke-free;
  3. Implement and enforce the law. Passing smokefree legislation is not enough. Its proper implementation and adequate enforcement require relatively small but critical efforts and means.
  4. Implement educational strategies to reduce SHS exposure in the home, recognizing that smoke-free workplace legislation increases the likelihood that people (both smokers and non-smokers) will voluntarily make their homes smoke-free.

WHO encourages Member States to follow these recommendations and apply lessons learnt to advance the goals of public health through legislated implementation of 100% smoke-free environments in workplaces and public places.

Download the entire document on Protection From Exposure To Second-Hand Tobacco Smoke here.

Banning smoking in cars carrying children

Banning smoking in cars carrying children: an analytical history of a public health advocacy campaign

Objective: Framing public health policy reform in ways that attract public and political support is a core skill of advocacy. In this paper we summarise the 12- year Australian history of advocacy for banning smoking in cars carrying children, culminating in the governments of the
Australian States of South Australia and Tasmania enacting legislation.

Method: ‘Smoking in cars’ was searched on the print news media database, with returns limited to Australian newspapers published before 1 June 2007.

Results: The issue of smoking in cars received extensive and emotive media coverage, primarily in support of legislating a ban. Invoking the protection of vulnerable children in the debate about smoking in cars was a powerful and persuasive theme. Unlike all other advocacy for smoke-free areas, this debate was not contested by the tobacco industry or other commercial interest groups.

Conclusions: Even in the absence of a co-ordinated advocacy campaign, public opinion studies on support for such legislation have been consistently strong. Communities view the protection of children as paramount and non-negotiable.

Implications: Smoke-free cars legislation can and should be fast tracked in order to capitalise on this community support.

See the full document on  Banning smoking in cars carrying children here.

Hong Kong Smoking Ban

What do you think about the smoking ban after a year?

Published in the SCMP – Updated on Dec 31, 2007

We should look ahead at how to make the prohibition of smoking in restaurants and other places in Hong Kong more effective in 2008 and beyond.

The ban has resulted in smoke-free shops, hotel lobbies and some (but not all) bars and restaurants. Dining out in a smoke-free atmosphere makes for a great improvement but too many bars-cum-restaurants have exemptions, making the visitor obliged to inhale smoke emitted by others.

That carries with it even greater health risks to the unfortunate staff, who are obliged to breathe in second-hand smoke every day at their workplace. The long-term effects of this will sadly mean illness, even death, for some of them.

The sooner these numerous exemptions are withdrawn, the better.

In public areas where smoking is supposed to be prohibited, smokers are often seen indulging their habit. These include train stations and the Central escalator, for example.

More effective enforcement action is clearly needed in such places.

Many restaurants have set up smoking areas outside their entrances, with an open frontage to the street. Consequently, patrons inside are still subjected to smokers’ fumes, blown in off the street. Clearly, such smoking areas should be out of range of the restaurants.

Office building approaches are now littered with discarded fag ends and when you visit an office block, you often have to pass by people smoking heavily on both sides of the entrance. Firms should make provision for smokers on a rooftop or terrace, and there should also be in-house quitting campaigns.

As the intention of the legislation is to see a general reduction in smoking, the duty-free allowance for cigarettes should be withdrawn.

More sustained campaigns against smoking are clearly needed. But this first year of partial prohibition has generally been accepted and is certainly to be welcomed.

What is now needed is to stiffen the provision of anti-smoking methods, as outlined above, with the intention of better safeguarding the health of us all, smokers and non-smokers alike.

Paul Surtees, Mid-Levels

Federal Trade Commission Cigarette Report For 2004 and 2005

This report is the latest in a series on cigarette sales, advertising, and promotion that the Federal Trade Commission (“the Commission”) has prepared since 1967.

The statistical tables appended to this report provide information on domestic sales and advertising and promotional activity for U.S.-manufactured cigarettes for the years 1963 through 2005. The tables were compiled from raw data contained in special reports submitted to the Commission pursuant to compulsory process by the five major cigarette manufacturers in the United States: Altria Group, Inc. (the ultimate parent of Philip Morris); Houchens Industries, Inc. (the ultimate parent of Commonwealth Brands, Inc.); Loews Corp. (the ultimate parent of Lorillard Tobacco Co.); Reynolds American, Inc. (the ultimate parent of R.J. Reynolds Tobacco Co. and Santa Fe Natural Tobacco Company, Inc. and which acquired Brown & Williamson Tobacco Corp. in 2004); and Vector Group Ltd. (the ultimate parent of Liggett Group, Inc. and Vector Tobacco, Inc.).

View the entire Federal Trade Commission Cigarette Report For 2004 and 2005.

Smoke-Free Policy Legislation Failure

The Editor
South China Morning Post

Dear Sir

Paul Surtees (Talkback 31 Dec) provides an excellent summary of the frank failure of the current smoke-free policy legislation to protect large numbers of people from tobacco smoke. The catering industry ,while not fully supportive of the policy, did ask the government to at least give them a level playing field. They didn’t get it and since then the Department of Health has expended considerable resources trying to deal with manoeuvres to by-pass the legislation.

One way of doing this is simply to change the venue’s name to include the word “bar”. Others pretend they can be non-smoking at certain hours of the day or days of the week when they want to attract different clientele, including families and offer children’s menus. At the same time they defend their exempted status with spurious arguments about the proportion of their revenue from alcohol sales. All this is understandable given the vagaries of the Bill and the unequal constraints placed on their ability to compete for custom.

The government will privately argue that covert deals with vested interests were needed to push through the tobacco control Bill. In doing so they abrogated their duty of care to the workforce and with over 1300 exemptions subjected thousands of workers to irreversible harm to their heart and lung function. The government ignored the overwhelming global evidence that second-hand smoke kills and that comprehensive smoke free policies ultimately benefit the hospitality sector.

Paul Surtees rightly looks to make the policy more effective, but the government is now looking at proposals by The Hon. Tommy Cheung Yu Yan and British American Tobacco to create smoking rooms in catering venues. Nothing could be more
damaging to the industry, workers, patrons and the health care system of Hong Kong.

Anthony Hedley
School of Public Health
University of Hong Kong