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The Myths And Reality Of Smokefree England

Oct 1st, 2007
by AdminCTA.
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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

Comprehensive Smokefree Policies

Aug 5th, 2005
by AdminCTA.
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Response to Consultation on the Smokefree Elements of the Health Improvement and Protection Bill

5th August 2005 The Royal College of Physicians UK
Background to response

The Royal College of Physicians (RCP) has long recognised that tobacco smoking is a powerfully addictive and major health hazard. The RCP considers smoking to be an addiction typically established during experimentation with and short term use of smoked tobacco in teenage years, typically resulting in a longterm dependence on cigarettes and sustained smoking for many years. Half of all regular smokers die prematurely as a consequence of smoking.

This burden of entirely avoidable mortality, which currently accounts for over 100,000 deaths per year in the UK 1, falls disproportionately on the poor and disadvantaged in society and contributes more to social inequalities in health than any other known avoidable cause.

Preventing smoking is therefore the most important public health priority in the UK, and the RCP is committed to the promotion of all strategies likely to reduce the prevalence of smoking.

The RCP recognises that passive smoking (exposure to environmental tobacco smoke or secondhand smoke) is a significant public health hazard in its own right, but also that smokefree policies in public and workplaces have a further important health effect through their impact on the incidence and prevalence of smoking. Smokefree policies are therefore an effective means of both health protection and health promotion.

In July 2005 the RCP published a comprehensive report on passive smoking, which recommended the implementation of comprehensive smokefree legislation in all public and workplaces, without exception, throughout the UK 2. The key conclusions and recommendations of that report were:

1. Passive smoking currently kills about 12,000 people in the UK every year. These deaths are entirely preventable.

2. Most of the deaths are caused by passive smoking at home, but about 500 each year are due to exposure at work. Exposure is particularly high for some workers in the hospitality industry, such as bar workers.

3. There is an unanswerable moral case to protect all people from passive smoking at work. All employees have a right to work in a safe environment, and all employers have a duty to ensure that they do.

4. Comprehensive smoke-free legislation, making all public places and workplaces completely smoke-free, without exception, is the only effective means of achieving this.

5. A clear majority of the public supports smoke-free legislation. Where enacted in other countries, smoke-free policies have proved to be extremely popular and attract high levels of compliance.

6. Comprehensive smoke-free policies also improve public health by helping existing smokers to quit, and discouraging young people from starting to smoke. As a consequence, smoke-free legislation will also generate longterm health improvements and reductions in social inequalities in health.

7. Preventing passive smoking at home, particularly for children, is a public health priority. Home exposure is prevented only by encouraging parents and carers to quit smoking completely, and/or by making homes completely smoke-free.

8. By helping smokers to quit smoking, and by changing usual patterns of smoking behaviour, smoke-free policies in public and workplaces increase the number of smoke-free homes. Strong and sustained health promotion campaigns are required to enhance this process. These and other population and individual-level interventions to encourage smoking cessation are the most effective means of reducing ETS [Environmental Tobacco Smoke] exposure at home.

9. Making the UK smoke-free would benefit the economy by about £4 billion each year.

10. We recommend that the UK Government enact comprehensive legislation to make all workplaces and other enclosed public places smoke-free at the earliest possible opportunity.

The RCP thus takes the view that radical and comprehensive smokefree policy is a crucial public health and health protection priority. The RCP therefore welcomes and fully supports the proposal to introduce smokefree legislation in the Health and Health Protection Bill, but disagrees in particular with some of the proposed exemptions.

The RCP responses to the questions posed in the current consultation are as follow. Where appropriate, to provide a source for a review and summary of the evidence supporting our responses, we cite the relevant chapters in our recent report 2 , provided as an appendix to this document in pdf format.

1. Definition of smoke or smoking

Although the evidence on smoking and passive smoking effects relates predominantly to tobacco smoke, many of the major constituents of the tar and vapour produced by burning non-tobacco products are similar to those in tobacco smoke, and are consequently likely to be similarly harmful. The RCP would therefore support the adoption of a definition which includes all products used with intent to inhale smoke.

2. Definition of ‘enclosed’

In view of the additional value of smokefree policies as a means of ‘denormalising’ smoking and consequently both reducing smoking prevalence and increasing the numbers of smokefree homes [see Chapters 3 and 7], the RCP proposes that the legislation should apply to all public and work places irrespective of whether they are enclosed.

3. Proposal to include some other non-enclosed public places

The RCP would support the inclusion of all public places that are part of or in a built environment. Exemptions, if any, should be restricted to outdoor areas in open countryside.

4. Proposal to delay implementation of smokefree policies in licensed premises

The RCP sees no justification behind this proposal. Experience in Ireland and New York demonstrates that implementation of comprehensive policies in all premises is effective and achieves high compliance [see Chapter 15]. There is no clear advantage in delaying the implementation in licensed premises, but there is disadvantage arising from the health effects of continued exposure of staff and customers to passive smoke. Licensed premises should become smokefree at the same time as all other work and public places.

5. Proposed exceptions to permit continued smoking in licensed premises that do not serve food

The RCP sees no logic or justification for this exemption. All licensed premises are workplaces, and people working there are entitled to the same protection from the health effects of passive smoke as in any other environment. Exposure to passive smoke is especially high in licensed premises [see Chapter 3] so the need for protection of workers in these environments is a particular priority.

6. Exemptions for residential premises

The RCP considers that the only exemption should be the private home of the smoker. Residential accommodation (such as hotels, nursing homes, halls of residence) that is also a workplace, and/or includes non-smoking residents, should be smokefree. There are however some special cases, such as prisons or psychiatric institutions, where smokers are detained against their will and are thus deprived of the option of smoking in their own private home [see Chapter 14]. In these cases exemptions should made, but in a context of provision of maximal cessation support for the smoker to quit if he or she chooses, and of preventing exposure of other residents or staff to tobacco smoke. From a moral and ethical perspective, the human rights of the smoker in all of these circumstances are outweighed by the rights of others to a clean and safe environment [see Chapter 10].

7. Membership clubs

See comments on licensed premises above.

8. Practical implications in the workplace

Experience from the many parts of the world where smokefree policies have been implemented demonstrates clearly that smokefree policies are effective and successful, in almost all circumstances [see Chapters 9 and 15]. It is however crucial in implementing smokefree policies to ensure that as far as possible, smokers are provided with cessation support to encourage and promote quit attempts.

9. Signage

Signage is clearly important for public information but only especially so if there is likely to be confusion over where smoking is and is not permitted. The RCP proposes that non-smoking should be the default in any public or workplace, and that signage should be required to reinforce that message.

10.-12. Penalties, Defences and Enforcement

These are crucially important areas and we would advise the adoption of policies that have proved successful in other countries, and particularly the Irish experience. In Ireland the general approach is similar to that outlined in the consultation but fines are substantially higher. Responding rapidly to episodes of non-compliance in the early days of the smokefree legislation was also crucially important, and appropriate resources need to be made available for this. The experience in Ireland suggests that the need for these resources falls rapidly over time [see Chapter 15].

13. Proposal to restrict smoking at the bar

Smoking in an enclosed place is harmful to everyone. Exposure of staff in pubs and bars is especially high [see Chapter 3]. Making the bar area smokefree does not protect staff from exposure, because smoke drifts. Partial policies such as this, or the use of ventilation, can sometimes improve subjective air quality but does not prevent exposure to harm [see Chapter 5]. This proposal is therefore ineffective and also potentially counterproductive, since it implies that non smoking areas within rooms where people smoker are somehow safer. They are not. The RCP opposes this policy.

14. Timetable

The RCP considers that the optimum time of year to introduce comprehensive smokefree legislation is the spring (in Ireland the date was late March) and that the sooner the legislation is introduced, the better. To give time to prepare the public (and to allow the further increase in public support for the legislation that follows the announcement of legislation, see Chapter 9) the announcement of intent should be made as soon as possible, and the date no later than March 2007.

15. Effects on binge drinking

This concern arises from the proposal to allow exemptions for pubs that do not serve food. The RCP opposes those exemptions. If all pubs are required to become smokefree, this concern is redundant.

16. Effect on health inequalities

The prevalence of smoking is highest, and the potential benefits of preventing smoking greatest, in the poorest communities 3 . Exposure to passive smoking is also highest in these communities [see Chapter 3]. It is therefore self-evident and particularly important that comprehensive smokefree policies apply in all communities, so that all can reap the maximum public health benefit. The proposal to exclude pubs that do not serve food will in the long run exacerbate health inequalities, since these pubs tend to be located in poorer areas.

17. Comments on Partial Regulatory Impact Assessment

The RCP supports Option 2. We are persuaded by the experience of New York and particularly Ireland that concerns that the policy would not gain public support and may be difficult to enforce are entirely unfounded. We estimate the cost benefits to society of Option 2 at about £4 billion per year [see Chapter 11]. Our analysis is that any adverse effect on the hospitality trade is likely to be extremely small [see Chapter 12].

Conclusion

The RCP supports this legislation but believes strongly that it does not, as proposed, go far enough. We urge the government to learn from the experience of other countries and implement comprehensive smokefree policies in all public and workplaces, without exception, as soon as possible.

References

1. Twigg L, Moon G, Walker S. The smoking epidemic in England. London: Health Development Agency; 2004.
2. Royal College of Physicians. Going smoke-free: the medical case for clean air in the home, at work and in public places. A report on passive smoking by the Tobacco Advisory Group of the Royal College of Physicians. London: RCP; 2005.
3. Royal College of Physicians. Nicotine Addiction in Britain. A report of the Tobacco Advisory Group of the Royal College of Physicians. London: Royal College of Physicians of London; 2000. http://www.rcplondon.ac.uk/news/news.asp?PR_id=276

Please download the full report here :

http://www.rcplondon.ac.uk/pubs/contents/fe4ab715-2689-4a4a-b8c7-53e80386c893.pdf

Thailand curbs indoor smoking

Nov 9th, 2002
by AdminCTA.
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Published in the SCMP on Saturday, November 9, 2002

A tough new anti-smoking law came into effect yesterday in Thailand, making it illegal to light up in virtually every indoor public place including air-conditioned restaurants and shopping malls.

Business establishments that fail to control smoking by patrons will face fines of up to 20,000 baht (HK$3,600) and the smokers will be hit for 2,000 baht under regulations made public in August.

Pubs and other night entertainment places are exempt because they are not frequented by children.

Thailand has had a strong anti-smoking lobby and is one of the few Asian countries to make a serious effort to highlight the dangers of tobacco since the 1970s. Many public places were already smoke-free and the new law widens the scope by including restaurants and other areas.

But realising the difficulty of enforcing the ban uniformly, the Public Health Ministry has said that it would initially focus only on air-conditioned restaurants, sending out inspectors for surprise checks.

“Thailand’s tobacco control efforts are being hailed as among the most successful in Asia, with new regulations implemented every year. How effective these regulations are when put to the test remains to be seen,” the Bangkok Post said yesterday.

The Post noted that tobacco companies continued to promote their products indirectly through sponsorship of sport and entertainment.

According to the Thailand Tobacco Information Centre, 23.4 per cent of Thais, or about 12 million people, smoke.

Apart from anti-smoking laws, Thailand also is trying to prevent youngsters from taking up the habit. The Public Health Ministry says 95 per cent of smokers in Thailand start before they are 24.

The government recently announced plans to replace worded warnings of health hazards on cigarette packs with pictures depicting cancerous lungs and problems such as premature ageing, birth defects and impotence.

Among places made off limits to smokers under the new law are public buses, taxis, lifts, temples and churches, public toilets, libraries and air-conditioned establishments such as shopping malls and gyms.

In schools, museums, hospitals, banks, airports and indoor stadiums, smoking will be allowed only in restrooms and private offices.

Except for Hong Kong, Singapore and Thailand, Asian countries have some of the world’s weakest tobacco control laws, according to the World Health Organisation. It says smoking is the single biggest killer globally, accounting for one in three middle-age male deaths.

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