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Doctors urge full car smoking ban

harbutt_smokingLast updated: March 24, 2010

Source: BBC News

Smoking should be banned in all cars as well as in public places where young people congregate, doctors are urging.

The Royal College of Physicians wants England’s imminent review of anti-smoking laws to consider such measures to protect the young.

It says passive smoking results in 300,000 extra child visits to GPs in the UK every year for problems such as asthma and bacterial meningitis.

But driving and smoking lobby groups say cars are a “private space”.


A number of medical bodies have supported a ban on smoking in cars transporting children, but the RCP goes a significant step further, urging a blanket ban on anyone lighting up in a vehicle – regardless of whether children or indeed any other passengers are inside.

This report isn’t just about protecting children from passive smoking, it’s about taking smoking completely out of children’s lives
Professor John Britton RCP

It is calling for a two-pronged approach which would see children protected from second-hand smoke and shielded from the sight of adults smoking – whether in the playground or on the TV.

The RCP’s report – Passive Smoking and Children – is being released ahead of the three-year review of the ban on smoking in enclosed public spaces in England. Similar bans have been introduced across the UK, with Scotland having led the way.

Drawing on a series of studies, the report suggests that in the UK, tens of thousands of youngsters are falling ill as a result of exposure to cigarette smoke.

Exclusion zones

These calculations include 20,000 chest infections, some 22,000 new cases of asthma and wheezing, as well as 200 cases of bacterial meningitis and 40 cases of Sudden Infant Death Syndrome – or cot death.

Each year it claims these account for more than 300,000 visits to a GP – some of which end up in hospital – costing the NHS £23.3m.
The car is a private space and it crosses a line to start interfering in it, however much one disapproves of smoking
Nigel Humphries Association of British Drivers

The report does concede that these figures are only estimates, but says it is confident they give an “indication” of the number of children who become ill.

The doctors acknowledge that a ban on smoking in the home, however desirable it believes this to be, would be neither politically or practically possible, but sees the car as an intervention in the private sphere which the public would tolerate.

But it argues that the only way to make it practically enforceable would be to introduce it as a blanket ban on all private vehicles – regardless of their passengers, as exemptions would prove too complex.

In addition, it wants to see smoking banned in places frequented by children, such as parks and outdoor swimming pools – and exclusion zones outside school gates.

Campaigns to explain to parents the importance of a smoke-free home, price hikes and generic cigarette packaging are also among the recommendations issued.

“This report isn’t just about protecting children from passive smoking, it’s about taking smoking completely out of children’s lives,” says Professor John Britton, head of the college’s Tobacco Advisory Group and lead author of the report.

Parental responsibility

A Department of Health spokesman stressed the role that anti-smoking legislation had played in curbing exposure, but added: “The government is looking at ways to go further to reduce the 9,500 children admitted to hospital every year as a direct result of exposure to second-hand tobacco smoke.

“Parents have a responsibility to protect their children by stopping smoking around them in enclosed spaces like their cars and in their homes.”

The Welsh Assembly Government said it had commissioned a tobacco control group to advise specifically on how to protect children, while a Scottish Government spokeswoman said it was conscious smoking in cars was a source of exposure that needed highlighting but had no plans for a ban. Northern Ireland is to conduct its own review.

The driving and smoking lobby groups expressed their anger at the recommendations, arguing that adults did not needs laws regulating every aspect of their behaviour.

Simon Clark, of Forest, which campaigns for smokers’ rights, questioned the figures used in the report, noting that cases of asthma had been rising as the number of smokers had fallen.

“It’s unacceptable to single out smokers and imply that they are solely responsible for the cost of asthma treatments, hospital admissions and asthma drugs for children up to the age of 16.

“We want smokers to be considerate towards those around them, especially children, but changing people’s behaviour should be achieved by education and encouragement not by legislation and enforcement.”

Nigel Humphries, spokesman for the Association of British Drivers, said the car should be seen as an extension of the home and treated as such.

“The car is a private space and it crosses a line to start interfering in it, however much one disapproves of smoking.”

Written by Clare Murphy

Vox Populi: Further tobacco tax hike needed

tax hikeLast updated: March 11, 2010

Source: SCMP

Despite a series of government measures aimed at reducing smoking in Hong Kong, our tobacco tax is still very low compared with other places. Most smokers can still afford to buy packets of cigarettes. There is no incentive for them to quit.

It is clear that second-hand smoke is harmful, and it is unfair that non-smokers should be exposed to it in areas where people can still light up.

I believe the administration has to impose further increases in the tobacco tax. If it does this we will all eventually be able to breathe cleaner air.

Michelle Chan Yin-ching, To Kwa Wan


Should The Smoking Ban Be Delayed?

Updated on Jan 24, 2009 – SCMP

Your correspondents Michael Pieper and Anthony Hedley (Talkback, January 14 and 20) and columnist Christine Loh Kung-wai (“Silence is not golden”, January 15) are misinformed if they believe that only drivers of diesel-powered commercial vehicles and buses are the main culprits responsible for Hong Kong’s atrocious roadside air pollution readings.

I must take issue with their suggestion that petrol-powered cars (or even hybrids) do not emit poisonous gases and particulates in significant quantities.

Fine particulates from petrol engine exhausts may not be as easily visible to the naked eye as the black sooty smoke churned out by old and poorly maintained diesel engines, but these particulates are even more likely to be inhaled and end up deeply embedded in our lungs.

That petrol engines produce greater concentrations of poisonous gases (volatile organic compounds and carbon monoxide) than diesels is not even disputed by scientists. And have your correspondents never heard of a car driver’s contribution to global warming?

Our most traffic-congested areas are usually Central, Causeway Bay and Mong Kok, and it is no coincidence that these are the districts with the highest levels of roadside air pollution.

These are also the very areas with the highest concentrations of private cars, exacerbating the congestion and slowing down other vehicles.

Unless we wish to shut down all commerce, we have to accept that goods vehicles and buses are needed in these areas, but we do not need so many private cars on the streets there. The public transport system is adequate.

If we removed most of the private cars from downtown areas and the cross-harbour tunnels, we could relieve a considerable part of traffic congestion – and this would lower the pollution from diesel trucks and buses that are forced to idle or crawl in slow-moving traffic.

The “near empty” buses some of your correspondents complain about would carry more passengers and the increased fare revenue would then permit the bus companies to upgrade to buses with improved emission standards much earlier.

Private car drivers are contributing more to outside air pollution than any smoker.

Other contributors to these columns have used the word “hypocrisy” for car drivers who think otherwise. I can think of no better description myself.

P. A. Crush, Sha Tin

Should The Smoking Ban Be Delayed?

Updated on Jan 20, 2009 – SCMP

I can understand why P. A. Crush (Talkback, January 10) and Cynthia Henderson (Talkback, January 15) want to try to dismiss my arguments for protection from tobacco smoke as churned statistics, because they would not want this issue to be encumbered with facts.

With more space we could discuss the distribution of the more than 40 tonnes of exhaled and sidestream tobacco smoke in Hong Kong between lungs, furniture, fittings and outdoor air.

In the meantime I am grateful to Mr Crush for his colourful description of one of the consequences of smoking indoors as “yellow filth” which “clings to the walls”. I am confident that a large majority would not regard this as any longer legitimate or want the air space in their building to be threatened by the creation of such a toxic waste dump.

Our parks should be smoke-free for several reasons and Ms Henderson underestimates the impact of tobacco smoke on air quality in the vicinity of smokers. For example, in Finland tobacco smoke particulates in outdoor cafes were 5 to 20 times higher than on pavements of busy streets.

On cruise ships, exposure to cancer-causing tobacco chemicals tripled despite strong wind and unlimited space for dispersion. At the University of Maryland, outdoor tobacco smoke was measurable 7 metres from the source ( .

Ms Henderson does make a strong point about vehicle emissions and we have consistently demonstrated the monetary and health benefits of cleaner air and building railways rather than roads in Hong Kong.

While I certainly regard restriction of private car use as a public health benefit and use public transport whenever possible, Hong Kong’s main traffic polluters are outdated diesels in commercial and public transport which (as Christine Loh Kung-wai points out in her column) the government refuses to regulate on a mandatory rather than voluntary basis (“Silence is not golden”, January 15). Whether my current occasional use of a car amounts to “hypocrisy”, others can decide.

If Ms Henderson wants to campaign for traffic-free zones in Sai Kung or anywhere else I will support her, but she should not be willing to trade off one potent source of pollution for another.

Anthony Hedley, school of public health, University of Hong Kong

Should The Ban On Smoking Be Delayed?

SCMP – Updated on Jan 15, 2009

P. A. Crush (Talkback, January 10) is absolutely right to question the use of statistics churned out by the Anthony Hedley/Judith Mackay camp on passive smoking.

A little park at the side of Hiram’s Highway in Sai Kung has been designated a no-smoking zone. This banning of smoking outdoors is a further encroachment on the lives of the old and poor who gathered here to enjoy their hard-earned leisure time and to smoke if they so wished. It would be ridiculous to suggest that their cigarettes contributed more “poison” to the outdoor air quality than the endless stream of private cars that shuttle between Clear Water Bay and Sai Kung, both of which are linked by public transport.

If they are forced to give up the habit of a lifetime for the public good, it is very little to ask of the zealous protectors of our air quality that they too make sacrifices by abandoning their private vehicles and cycling to their important public health meetings.

I should like to be assured through these columns by Dr Mackay and Professor Hedley that they do not affect the quality of the air I breathe in Sai Kung parks by driving private cars past the very places they have been so vociferous in advocating as no-smoking areas.

It would be unacceptable to be involved with clean air and public health and drive a private car without being deemed hypocritical. I use public transport and am a non-smoker.

Cynthia Henderson, Sai Kung

Should The Smoking Ban Be Delayed?

Jan 14, 2009 – SCMP

I refer to the letter by P.A. Crush (Talkback, January 10).

Your correspondent said: “Smokers are not `compelled’ by their addiction to continue smoking as Clear the Air suggests.”

Why is it then that so many people try to quit, but cannot. Throwing in a recent statistic, why is it that a smoker needs to try to give up smoking 10 times before managing to quit? Smoking is clearly an addiction, much like crack cocaine, which has in fact been said to be easier to give up than smoking.

In terms of your correspondent’s reference to polluting vehicles on the road, most private vehicles do not run on diesel fuel and therefore do not spew out particulate matter (PM-2.5), which can travel directly into our lungs when we breathe, much like tobacco smoke or the smoke that escapes from coal-fired power plants.

This pollution from buses and goods trucks is therefore the most harmful to public health and should be targeted first, before private vehicles, especially given the high number of buses concentrated around the most (roadside) polluted areas.

Besides that, Hong Kong has become the dumping ground for vehicles from Japan, South Korea and elsewhere due to the fact that the Hong Kong government has not enforced any emission standards on diesel vehicles, of which many have exceeded their normal operating lifespan.

Rather than offering a subsidy to convert or replace the 49,161 pre-Euro and 25,206 Euro I diesel vehicles (which will create 74 per cent and 38 per cent less vehicle emissions of particulates and nitrogen oxides) to stricter emission standards, the government should set a deadline for these to be implemented and, if they are not, fines or emission taxes should be promptly put in place.

Michael Pieper, Discovery Bay

Should The Full Smoking Ban Be Delayed?

Jan 10, 2009 – SCMP

A. J. Hedley, Clear the Air and Dr Judith Mackay continue to mislead Hong Kong residents about the comparative dangers of second-hand smoke.

Anti-tobacco crusaders, some of whom depend on promoting these views for their living, love dusting off long-forgotten files to extract meaningless statistics. Did you know for instance that someone once concluded that 67 per cent of all statistics are wrong?

But coming back to Professor Hedley’s “40 tonnes of highly poisonous chemicals” spewed out by Hong Kong’s smokers (Talkback January 8), most of this smoke with its poison never reaches the outside air you and I have to breathe.

It gets deposited in the lungs of smokers or clings to the walls as a yellow filth inside smoking premises. This is the legitimate choice of those who smoke, enter or permit smoking premises.

Smokers are not “compelled” by their addiction to continue smoking as Clear the Air suggests. If this were the case, how is it that thousands of smokers successfully quit each year? Clear the Air has to accept people choose not to give up smoking and this is their right.

I challenge every person who has condemned smokers in these columns to verify that they never travel in a private car in Hong Kong. Since your correspondents are so beholden to statistics, here are some for them.

The University of Tennessee’s Centre for Energy, Transportation and Environment, after years of research, concludes the “personal automobile is the single greatest polluter” and “driving a private car is a typical citizen’s most polluting activity”.

The Calor Gas Company of Britain goes even further and states that by just walking about in the streets of Oxford, for instance, one of Britain’s most traffic-congested and vehicle-emission-polluted cities, you will inhale in one day the equivalent of smoking 60 cigarettes.

So let’s get things into perspective. It is outside air quality that Clear the Air and company should be concerned with, not a few guys who wish to enjoy a cigarette at their own risk in a smoky bar.

Clear the Air has in the past consistently rejected requests to add private cars to the list of polluters. Its committee prefers to attack smokers and “polluting” buses, which provide seating accommodation for 150 passengers.

P. A. Crush, Sha Tin

Should The Full Smoking Ban Be Delayed?

Jan 08, 2009 – SCMP

Markus Shaw (Talkback, January 3) asserts that tobacco is not an environmental problem, but he is badly informed and seriously out of his depth on this issue.

A few minutes on the internet and perusal of previous issues of the South China Morning Post (SEHK: 0583, announcements, news) will reveal the massive consequences for the social, economic and physical environment caused by tobacco smoking, including poverty and harm to wildlife from smokers’ litter. In Hong Kong alone, 850,000 smokers deposit more than 40 tonnes of highly poisonous chemicals annually into our indoor and outdoor air.

He confuses “pleasure” with relief from craving and ignores the fact that the majority of adult smokers were recruited to nicotine addiction well before their 18th birthdays and the rest shortly after. This kills about 50 per cent of them, but the sustainability of tobacco shareholders’ dividends is entirely dependent on recruiting fresh supplies of addicted young people.

The World Health Organisation has made it very clear that the public health approach to this epidemic must be the destruction of brand value. In this regard Mr Shaw’s assessment of “advertising bans”, “high duties” and “health warnings” can also be shown to be seriously flawed, and Hong Kong still has a long way to go in tobacco control under the WHO’s Framework Convention.

Mr Shaw’s argument that people who need jobs in the catering sector should have to “choose” between polluted and clean work environments, despite being harmed either financially or physically, paints a cynical Dickensian scenario. It is a formula for serious inequity in occupational health.

There is nothing “simple” or “fair” for these workers about being exposed to high risks of cancers and heart disease, wittingly or otherwise, and it is now illegal in an increasing number of countries.

What we need is legislation, not more comments about spurious life-threatening “choices”.

Anthony J. Hedley, school of public health, University of Hong Kong

Should The Full Smoking Ban Be Delayed?

Updated on Jan 07, 2009 – SCMP

I take issue with the twin assertions by Markus Shaw (Talkback, January 3) that “smoking is not an environmental issue” or that it does “not belong in the same debate as air pollution”.

Globally, smoking kills about 5 million people every year and no one has the right to dismiss this as inconsequential; to do so would be inhumane.

Tobacco’s environmental costs include fire damage due to careless smokers; increased cleaning costs; and widespread environmental harm from large-scale deforestation (trees are cut down to cure tobacco), pesticide and fertiliser contamination, and discarded litter. Tobacco’s total economic cost reduces national wealth, gross domestic product, by as much as 3.6 per cent. Smoking causes over a million fires each year, burning down forests and urban property, leading to more than 17,000 deaths, many more injuries, at an estimated global cost of US$27 billion.

In concrete terms, there are 1.4 billion smokers in the world, each discarding cartons, matches, ash and about 20 cigarette ends daily – amounting to more than 20 billion cigarette ends containing carcinogens every single day. About one third of all litter, where litter content has been evaluated, is cigarette litter.

Both indoor and outdoor pollution are serious health, environmental and economic problems that require addressing urgently in Hong Kong.

Dr Judith Mackay, director, Asian Consultancy on Tobacco Control

Should The Full Smoking Ban Be Delayed?

Jan 05, 2009 – SCMP

I write in support of Markus Shaw (Talkback December 29) and in response to Anthony Hedley (Talkback Dec 31), and James Middleton (Talkback December 30). I take exception to Professor Hedley’s description of Mr Shaw as “a self-styled environmentalist”.

As the head of the WWF in Hong Kong, Mr Shaw has a long and distinguished, and indeed successful, record as a defender of our environment.

The same cannot be said in my view of the Clear the Air lobby, which apparently includes Professor Hedley and Mr Middleton. These self-appointed guardians of clean air in Hong Kong have failed us. Hong Kong air is filthy and gets worse daily. No doubt the inevitable reply to this letter will be full of backslapping, self-congratulatory statistics, but just look out of the window. Perhaps it is time for new guardians?

Instead, certain members of the Clear the Air lobby have concentrated their efforts on imposing their will upon people’s lifestyle choices relating to smoking. I agree that those who do not want to eat, drink or travel with smokers should not be bound to do so.

This has now been achieved. But I also agree with Mr Shaw when he says “enough already”. It is time to move on to the issues that are really destroying our environment and to address the interests of those who do smoke.

Mr Middleton says that “less than 12 per cent of Hongkongers are daily smokers”. That is a very significant number of people. Their choices should be provided for, and allowing smoking bars has gone some small way to achieving this.

Mr Middleton further says that “there is no right to smoke in the Basic Law”. There are numerous legal activities for which no “right” is provided in the Basic Law – for example, the right to own and drive private motor vehicles, which quite apart from noise pollution and physical danger, overwhelmingly pollute the atmosphere far more than tobacco smoke.

I would invite members of the Clear the Air lobby to assure the public, through these columns, that they no longer intend to drive or travel in these polluting private motor vehicles but will instead take public transport and thus by their example begin to eradicate vehicular pollution.

However, I rather doubt that the lobby members would be prepared to do this. That would be to interfere with their freedom of choice.

Robert Whitehead, Stanley