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Behind the smokescreen: the myths and the facts

April 2005

Introduction
The BMA has conducted a review of reasons given for why legislation for smoke-free public places should not be introduced, and this report sets out to challenge them. Four key themes have been identified including: choice; public opinion and enforcement; health and science; and economics. This document considers statements made by opponents to smoke-free legislation and explains why these arguments are not credible.

Foreword
Mr James Johnson, Chairman of Council, British Medical Association
Second-hand smoke causes illness and death. Throughout the world, governments are taking action to ban smoking in enclosed public places and workplaces. In the UK, smoke-free legislation is progressing at different paces, but the level of protection will depend on where you live. Public support continues to grow despite objections from a vociferous minority including the tobacco industry, the profits of which would be hard hit by such legislation. The tobacco industry has much to lose. Smoke-free public places will cost them an estimated £310 million in lost sales every year in the UK [Go to reference 1].

The medical profession is united in its call for a UK-wide ban on smoking in all enclosed public places and workplaces. Recent research reports that passive smoking kills 30 people each day [Go to reference 2]. The true cost of delaying legislation is not financial, it is human. Governments must act now.

As doctors we contend with the devastating effects of second-hand smoke on patients on a daily basis. Legislation to ban smoking in all enclosed public places is the single most effective way that a Government could improve the health of its people.

This report provides information to counter arguments made by those who oppose a comprehensive ban on smoking in enclosed public places and workplaces. It seeks to dispel the myths that lie in the way of such legislation. It is time our Governments followed the example of Ireland, Norway and New York and lifted the burden of passive smoking on its citizens.

Dr Peter Terry, Chair of Council, BMA Scotland
I am proud that in Scotland, we are leading the rest of the UK in the smoking debate. This is a tribute to devolution.

Legislation is currently progressing through the Scottish Parliament and I hope that by next spring, all enclosed public places in Scotland will be smoke-free by law.

The myths highlighted in this document are well rehearsed in Scotland but that doesn’t make them true. There is no choice for non-smokers who have to socialise and work in smoke-filled rooms. Piecemeal measures to restrict smoking in public places will fail to protect the health of the people of Scotland. Economic arguments flounder in the face of international experience, and scientific evidence clearly links exposure to passive smoke with potentially disabling illness such as asthma and potentially fatal illnesses such as lung cancer and coronary heart disease.

The time has come to clear the air. Here is the information to counter the arguments made by those who oppose a comprehensive ban on smoking in enclosed public places and workplaces. The evidence is clear, smoke-free public places save lives.

I hope that our politicians continue to demonstrate strong leadership in the face of such opposition and continue to lead the way with progressive legislation that will undoubtedly improve the health of the people of Scotland.

Dr Tony Calland, Chair of Council, BMA Wales
The National Assembly for Wales voted for a ban on smoking in public places as far back as 2003. They then set up a committee to look into the issue, and that committee will present its report to the full Assembly in May. Having weighed up all the evidence, it seems to me inevitable that they will have no option but to support a complete ban in Wales. However, they lack the necessary legal powers to enforce such a ban.

Earlier this year, BMA Cymru Wales asked the Welsh public to sign a country-wide petition calling on the UK government to give the National Assembly the power to exercise a ban. Over 12,000 people signed that petition – which was presented to 10 Downing Street. If the health of the people of Wales is a priority for politicians – then a complete ban on smoking in enclosed public places is the only answer.

Dr Brian Patterson, Chair of Council, BMA Northern Ireland
The Republic of Ireland faced similar arguments to those contained within this publication when considering, and subsequently introducing, a ban on smoking in the workplace. Yet the survey commissioned last year by the Department of Health & Children in the south showed that public support for smoke-free workplaces was unwavering.

The Office of Tobacco Control (OTC) in the Republic of Ireland found, in May of last year, that there was a 97% compliance with smoke-free workplace legislation.

The OTC also published findings on public attitudes and behaviours in respect of the new law. This indicated that the number of non-smokers visiting pubs/bars had increased slightly since the introduction of the new law, while the number of smokers visiting had remained the same.

A survey carried out in 2004 by the Health Promotion Agency in Northern Ireland found that 70% of all respondents thought indoor public places should be smoke-free.

Northern Ireland has just gone through a public consultation on whether or not smoking should be banned in enclosed public places and workplaces. In response to this the BMA, the Royal College of Nursing (RCN) and a range of healthcare organisations, came together and through a six week campaign delivered 35,000 votes, in favour of a ban, to the NI Health Minister, Angela Smith MP.

We urge Government to pay heed to the huge groundswell of support for a ban and take the same bold and brave decision as the Republic of Ireland.

There is no time for prevarication. Every day we delay, people are dying from breathing in second-hand tobacco smoke.

References
1. Fichtenberg CM and Glantz SA. Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ 2002;325:188.
2. Jamrozik K. Estimate of deaths attributable to passive smoking among UK adults: database analysis. BMJ 2005;330:812.