Briefing note on ban on smoking in public places
February 2005
Summary
- Research evidence concludes exposure to second hand smoke increases the risk of lung cancer, ischaemic heart disease and adverse health effects in children.
- At least one person dies every week in Northern Ireland due to inhaling other people’s tobacco smoke.
- Passive smoking kills and BMA (NI) is calling for an immediate ban on smoking in all enclosed public places alongside the implementation of effective smoking cessation Programmes.
Second-hand tobacco smoke is called environmental tobacco smoke (ETS) and consists of a gas phase and a particulate phase. Breathing in second-hand smoke is also called second-hand smoking, involuntary smoking or passive smoking. The non-smoker breathes "sidestream" smoke from the burning end of the cigarette, pipe, or cigar and "mainstream" smoke that has been inhaled and then exhaled by the smoker.
Almost 85% of second-hand tobacco smoke is in the form of invisible, odourless gases. One of these invisible, odourless gases is a compound known as benzo[a]pyrene, which is a carcinogenic compound not removed from the atmosphere by air filtration or ventilation
Second-hand tobacco smoke contains more than 4,000 toxins, more than 40 of which are known to cause cancer in humans or animals and many of which are strong irritants.
What toxins?
Apart from nicotine, tar and carbon monoxide, tobacco also contains:
- acetone - used in paint stripper
- ammonia - used in cleaning agents
- arsenic - a poison
- butane - lighter fuel
- DDT - insecticide
- hydrogen cyanide - used as a method of execution in the USA
- methanol - rocket fuel
- polonium 210 - radioactive fallout
- radon - radioactive gas
- sulphuric acid - Used to manufacture nitroglycerine explosive
Adults with asthma can experience a significant decline in lung function when exposed, while new cases of asthma may be induced in children whose parents smoke. Asthma sufferers exposed to second-hand smoke also have a lower quality of life, increased dependence on health services and is cited by up to 80% of asthmatics as a trigger for further attacks.
Short term exposure to tobacco smoke also has a measurable effect on the heart in non-smokers. Just 30 minutes exposure is enough to reduce coronary blood flow. Even a Government document published by the Scientific Committee on Tobacco and Health (SCOTH) concluded, ‘The causal effect of exposure to SHS (second-hand smoke) on risk of lung cancer has been confirmed….the pooled increased relative risk remains in good agreement with that estimated by Hackshaw, Law and Wald at 24%’. It also concludes, ‘The causal effect of exposure to SHS on risk of ischaemic heart disease has been confirmed….. The increased risk associated with exposure to SHS is in the order of 25%’
Pregnant women, babies and young children are particularly at risk of harm. Passive smoking by pregnant women contributes to slower foetal growth, lower birth weight and premature birth.
Smoking in public places
The scientific and medical consensus is clear and incontrovertible. The evidence demonstrates that exposure to second-hand cigarette smoke both causes illnesses - including fatal illnesses - and worsens existing health problems. In 2002 environmental tobacco smoke was classed as a group 1 carcinogen (cancer causing compound) by the World Health Organisation.
There are no known safe levels of exposure
Tobacco smoke drifts into no-smoking areas - unless they are physically separate rooms, no-smoking areas don't provide protection. Even brief exposures can be harmful.
Many of the toxins in tobacco smoke are present as gases and vapours - so they cannot be removed by conventional ventilation or air-filtration systems and are simply spread around. Studies have shown that filtered tobacco smoke has the same potential to cause cancer as non-filtered.
Experience shows that voluntary measures simply do not work. More and more countries are now acting on the evidence and responding to the very real health risks of tobacco smoke by making public places smoke-free by law. Workers require legal protection - and tobacco smoke is the only substance known to cause cancer that is not regulated in the workplace.
Next step
Northern Ireland has one of the highest rates of cardiovascular and respiratory disease in the European Union (EU). Much of this can be attributed to high rates of tobacco consumption.
If the Government and the devolved administrations are serious about reducing smoking related illnesses then they must tackle smoking in public enclosed places in a consistent manner.
Legislation must be introduced to ban smoking in public places
Legislation for smoke-free areas is much more effective in protecting health than voluntary measures. Legislation should be clear and unambiguous making a clear commitment to smoke-free public places by a named date. Restrictions should be clearly indicated, and adequately monitored and enforced. The legislative model in the Republic of Ireland works effectively and equivalent legislation could be introduced with ease.
Successful policies for smoke-free public places rely on an awareness of the health consequences of exposure to environmental tobacco smoke and a level of social support. Legislation is most effective when supported by public information campaigns alongside effective Smoking Cessation Programmes.
Making legislation
A ban on smoking in all enclosed public places could be introduced now through an Order in Council by a Direct Rule Minister. Orders in Council are United Kingdom Statutory Instruments made by Her Majesty, by and with the advice of Her Privy Council and with the endorsement of the UK Parliament, in exercise of powers conferred by Schedule 1 of the Northern Ireland Act 1974 and s.85 of the Northern Ireland Act 1998.
BMA (NI) continues to call upon the Secretary of State for Northern Ireland to introduce an Order in Council to ban smoking in enclosed public places.
In December 2004, the Department of Health Social Services and Public Safety published a consultation document in called ‘A Healthier Future – A Twenty Year Vision for Health and Wellbeing in Northern Ireland’. It asks for views on three options regarding smoking in public places, two of which the BMA (NI) do not believe provide proper protection from second-hand smoke.
The third option is to protect ALL workers by introducing legislation to stop people smoking in enclosed public places. This would cut the risk of contracting lung cancer, heart disease and asthma.
The consultation can be found at http://www.dhsspsni.gov.uk/publications/2004/healthyfuture.asp
Facts
- 71% of NI population do not smoke.
- 73% of NI population are bothered about smoking in public places
- 61% of NI population fully support legislation with a further 20% with no strong views.
- A BBC survey of more than 9,000 people found that 73% wanted a ban on smoking in public places as a way to cut tobacco-related illness.
- Legislation for smoke-free public places has been successfully introduced in a number of countries, including the USA, Canada, and Australia (at both national and local levels). National legislation has been introduced in Finland, Ireland, Brazil, Norway, South Africa and Thailand, among other countries
- UK is the only EU country relying on Voluntary measures to ban smoking in public places.
- Every cigarette is doing you damage, Health Promotion Agency, 2003
- Smoking in Public Places: What the Public Think, Health Promotion Agency, 2004
- Smoking and Your Health, www.quitandwin.net
- Investing for Health – A Five Year Tobacco Action Plan: Consultation Document, DHSSPS, 2002
- Majority back public smoking ban, http://news.bbc.co.uk/1/hi/health/3561483.stm , 24/03/2004
- Policy Paper on Smoking in Public Places, ASH Scotland, 2003
- Towards smoke-free public places, BMA, 2002
- Smoking and Reproductive Life, BMA, 2004
- Second hand Smoke: Review of evidence since 1998, Scientific Committee on Tobacco and Health (SCOTH), 2004
or email BMANorthernIreland@bma.org.uk