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Hong Kong Smoking Ban

Dec 20th, 2007
by AdminCTA.
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How do you feel about the smoking ban after a year?

Updated on Dec 20, 2007 SCMP

The “smoking ban” is a farce that panders to the business whims of the Liberal Party.

Any licensed premises wishing to get an exemption can do so until July 1, 2009, by simply filling out a form and applying to our “health department”.

This ludicrous exemption is not only unjust under any sensible, fair competition law, it obviates the total idea of the anti-smoking legislation, which is to protect the health of catering workers forced to breathe the equivalent of a packet of cigarettes a day.

Meanwhile, their employers remain liable under existing workplace health and safety laws for not keeping the workplace safe from dangers to the health of the workers.

The slow-burning side-stream smoke from the tip of a cigarette is four to six times more toxic than the smoke inhaled by the smokers, and this comprises 85 per cent of the cigarette smoke in a room at any one time.

A University of Hong Kong study shows passive smoking kills an average of 1,324 innocent people a year of the 6,000-plus tobacco deaths in Hong Kong.

James Middleton, Clear the Air Hong Kong

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

Passive Smoking Report

Jul 1st, 2005
by AdminCTA.
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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, July 2005

Tobacco smoke kills more people in the UK than any other avoidable cause. Therefore, effective tobacco control policies have a major part in improving public health. Since publishing the White Paper Smoking kills in 1998, the Government has made progress in many areas, particularly in developing smoking cessation services and banning the advertising and marketing of tobacco products. But much more can be done.

One important area is the harm caused by passive smoking. The 1998 White Paper recognised this and contained proposals for a voluntary code of practice to prevent passive smoke exposure in most workplaces, and a Public Places Charter to reduce exposure to smoke in pubs, restaurants and other hospitality industry venues. Although the voluntary code of practice was drafted it was not implemented, and the Public Places Charter has failed.

This report sets out in detail the impact of passive smoking in the UK. It reviews the effectiveness, and the ethical and economic implications of legislating to prevent exposure, and concludes that the only viable solution is legislation to make all workplaces and public places smoke-free. The Scottish Parliament has already decided on this approach.

The primary reason for smoke-free workplaces and public places is to protect individuals against involuntary exposure to passive smoking and the associated health risks. However, comprehensive smoke-free policies offer more than simple protection against passive smoke. Smoke-free policies help smokers to give up smoking, and discourage young people from starting to smoke in the first place. They also protect children at home by helping parents to quit, or at least by encouraging them to make their homes smoke-free. The particular benefit to children and other vulnerable or disadvantaged people in our society are important additional justifications for smoke-free legislation.

This report demonstrates how smoke-free legislation will save lives, reduce health inequalities, and improve public health. Smoke-free policies are popular and they are highly effective. Introducing comprehensive smoke-free legislation should be a public health priority for the UK.

Email us for the full report: webmaster@cleartheair.org.hk 

Why Workplaces Should Be Smokefree

Jun 1st, 2003
by AdminCTA.
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Published by ash June 2003:

Why Workplaces Should Be Smokefree 

Reasons why

  • There is now incontrovertible evidence that secondhand smoke is a killer – at least 1,000 people die from secondhand smoke exposure each year in the UK 1.
  • Some three million people 2 are still exposed to secondhand smoke in the workplace yet have little protection in law. Policies that aim to protect employees from tobacco smoke will also improve conditions for consumers.
  • Expert advice by the World Health Organisation states that ventilation is not effective in protecting people from secondhand smoke as there is no safe level of exposure below which there are no adverse effects.3
  • Public opinion supports smokefree workplaces – 78 per cent of the population 4 now believe that all employees should be able to work in a smokefree environment.
  • 80 per cent of the population don’t smoke 5. If smokers make an informed decision to smoke then that’s their decision – but it should not be allowed to impact on other people’s health.
  • 70 per cent of smokers would like to quit 6 and most believe smoke-free environments would help them in their quit attempts.
  • The UK is lagging a long way behind many other countries in protecting non smokers from secondhand smoke 7.

Health Arguments

  • Tobacco smoke is a potent cocktail of over 4,000 chemicals, including more than 50 known to cause cancer such as benzene and arsenic 8.
  • Secondhand smoke exposure (equivalent to just 1 percent of that of active smoking) carries a risk of coronary heart disease of almost half that of smoking 20 cigarettes a day 5.
  • People with particular illnesses are vulnerable to secondhand smoke, and they represent a substantial proportion of the population. For example there are 5.1 million people with asthma and 3 million with other types of lung disease, 2.1 million people with angina and 1.3 million people who have had a heart attack 5.
  • Secondhand smoke is a major trigger of asthma attacks and worsens respiratory conditions like bronchitis 5.
  • Exposure to secondhand smoke during pregnancy is linked to low birthweight and prematurity 9.
  • The health of workers improves immediately when smoking is banned in the workplace 10.

Economic Arguments

  • Smokefree policies cost less to put in place and enforce than policies allowing smoking 11.
  • Insurance, cleaning and maintenance costs are significantly reduced in smokefree workplaces 12.
  • Smokefree policies reduce smoking by employees, and are a cost-effective way of helping people quit smoking 13.
  • Less smoking means less absenteeism, lower worker turnover and fewer accidents 14 15 16.
  • Worldwide smokefree policies have been shown to have a positive or neutral impact on trade in bars and restaurants. The only studies showing a negative economic impact had tobacco industry backing and most were subjective and of poor quality 17.

References

  1. BMA Towards smoke-free workplaces, Board of Science and Education & Tobacco Control Resource Centre November 2002
  2. Survey source: MORI March 1999 Sample size:1,029 respondents
  3. WHO policies to reduce exposure to environmental tobacco smoke 29-30 May 2000
  4. Survey source: MORI Fieldwork dates: 20th – 24th March, 2003 Sample size: 1972 respondents
  5. BMA Towards smoke-free workplaces, Board of Science and Education & Tobacco Control Resource Centre November 2002
  6. Smoking related Behaviour & Attitudes Series OS no.18 June 2002
  7. See ASH website for up to date information at http://www.ash.org.uk/html/workplace/html/smokefreenews.html
  8. WHO International Agency for Research on Cancer (1986) Monograph vol.38 Tobacco Smoke. WHO IARC:Lyons.
  9. Windham GC, Hopkins B, Fenster L, & Swan SH (2000) Pre-natal active or passive tobacco smoke exposure and the risk of pre-term delivery or low birthweight. Epidemiology 11:427-33
  10. Eisner M, Smith A, Blanc P Bartenders respiratory health after establishment of Smoke-free Bars and Taverns JAMA 1998; 280 1909-1914
  11. Ducatman A,McLellan R. Epidemiological basis for an occupational and environmental policy on environmental tobacco smoke, Amer. Coll. of Occup. And Environmental Medicine, 2000
  12. Parrott S. Godfrey C. Cost of employee smoking in the workplace in Scotland. Tob. Control 2000:9(2):187-192
  13. Fichtenberg CM,Glantz SA Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ 2002;325:188-191
  14. McGhee S, Adab P, Hedley A, et al. Passive smoking at work: the short term cost. J.Epidemiol Community Health 2000; 54(9): 673-6
  15. Ryan J,Zwerling C,Jones M Cigarette smoking at time of hire as a predictor of employment outcome J.Occup Environ Medicine 1996;38(9):928-33
  16. Ryan J, Zwerling C, Orav E Occupational risks associated with cigarette smoking: a prospective study. Am J Public Health 1992; 82(1):29-32
  17. Scollo M et al Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. Tobacco Control 2002; 12: 13-20

Further information

Clear the Air Coalition Statement:
http://www.ash.org.uk/html/workplace/html/ctac.html
More Clear the Air Campaign factsheets:
www.ash.org.uk/html/ctac.php
For detailed informaion visit ASH smokefree environments page:
www.ash.org.uk/?smokefree

Passive smoking at work

May 4th, 2000
by AdminCTA.
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Department of Community Medicine, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong

Correspondence to: Dr McGhee (smmcghee@hkucc.hku.hk)

Accepted for publication 4 May 2000

STUDY OBJECTIVE: To estimate the impact of passive smoking at work on use of health care services and absenteeism.
DESIGN: Cross sectional survey.
SETTING: A workforce in Hong Kong.
PARTICIPANTS: 5142 never-smoking police officers in a total sample of 9926.

MAIN RESULTS: A consistently strong association was found among men between length of time exposed to passive smoking at work and self reported consultations with a doctor, use of medicines and time off work. Results for women were similar but most were not statistically significant.

CONCLUSIONS: The exposure of healthy adults to passive smoking at work is related to utilisation of health care services and extra time off work. This results in costs to the health services, to employers and to those exposed.

Passive Smoking At Work A Risk Factor For Coronary Heart Disease

Feb 5th, 1994
by AdminCTA.
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The following study was carried out in China to discover whether passive smoking at work is a risk factor for coronary heart disease. Of course, the results also apply to any other country where smoking at work can risk the health of non-smoking workers.

ttp://www.bmj.com/cgi/content/full/308/6925/380

The conclusion was that passive smoking at work is a risk factor for coronary heart disease. Urgent public health measures are needed to reduce smoking and to protect non-smokers from passive smoking in China.