Comment upon References to be read alongside the document downloadable from: http://www.publications.parliament.uk/pa/cm200506/cmselect/cmhealth/485/485.pdf
I hope the comments and emboldened sections of this page shed some light on the weakness of some reports, witnesses and committee members but most of all on the willingness to accept the many biased facts put forward by ASH. Please note the groups that have written these reports and ask whether any owe their existence, funding or futures to the DoH.
Where in the whole document was the any real consideration of NO BAN?

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The Report from the Health Committee, Smoking in Public Places

First Report of Session 2005–06, Volume I

Summary

1.Professor Sir Liam Donaldson:- "It also signals to the public that a drink and a smoke go hand-in-hand when all the efforts on smoking and tobacco control have been aimed at de-normalising smoking and I think it puts Britain amongst the laggards of public policy health making internationally rather than global leaders.”

------------------ This was in response to a question about partial v total ban but a response that recognizes the 'nature and frailties of the people' might put Britain as global leaders in 'responsive' Government!! A drink and a smoke do go hand in hand for a large proportion of people and while smoking is still a legal activity some reject ‘efforts on smoking & tobacco control’. They will still smoke and drink after the ban but simply somewhere else.

Earlier a Committee member had to chastise this person – “This is a Select Committee. It is up to us to ask the questions. It is not for the Chief Medical Officer to determine which questions he would feel comfortable with or not. I am very disappointed and surprised that you cannot refer me to any scientific evidence base in terms of this inquiry. I would have thought it was an obvious question.” – This helps indicate the arrogance and lack of broader considerations of some medical experts. It appears the CMO was upset at his treatment and threatened resignation. (Shame)

1 Introduction

2 Royal College of Physicians, Going smoke-free: The medical case for clean air in the home, at work and in public places, July 2005, ISBN 1 86016 246 0.

3 For example, World Health Organisation International Agency for Research on Cancer, Tobacco Smoke and Involuntary Smoking, IARC Monographs Volume 83, 2004; Report of the Scientific Committee on Tobacco and Health, Secondhand Smoke: Review of evidence since 1998, November 2004; US Office on Smoking and Health, The health consequences of involuntary smoking: a report of the Surgeon General, 1987; Australian National Health and Medical Research Council, Effects of passive smoking on health, Report of the NHMRC working party, 1987; United States Environmental Protection Agency, Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders, December 1992; California Environmental Protection Agency, Exposure to Environmental Tobacco Smoke, September 1997. ……………. Recognized by Health Professionals NOT by all Lay People, smokers, the public, sociologists etc

4 Department of Health, Choosing Health: Making healthy choices easier, Cm 6374, November 2004, pp 98-9. TRUE and has increased to 33% little changed from the previous year

5 www.dh.gov.uk/Consultations/ResponsesToConsultations/fs/en -See Consultation Bias taken from 'Leading up to the Bill'

6 Ev 119, Volume III – oddly enough most respondents will have been at home not the workplace and may not be of a broad socio economic spectrum!!

2 The health effects of secondhand smoke

7 Royal College of Physicians, Going smoke-free: The medical case for clean air in the home, at work and in public places, July 2005, ISBN 1 86016 246 0.

8 Q 72 Dr Taylor: The aim, as has been said before, is to affect the smoking of all the people rather than just to attack passive smoking?- The short answer was YES from Prof Dame Carol Black Pres of Royal Col of Physicians, &  Dr Edwards lecturer in Public Health, Manchester

9 See, for example, Report of the British Medical Association Board of Science and Education and Tobacco Control Resources Centre, Towards smoke-free public places, November 2002, p. 1. – From BMA

10 See Ev 4, 6, 9, 17 and 23, Volume II –Asthma UK, CLC Sargent, The Roy Castle Lung Cancer Foundation, Cancer Research UK& British Heart Foundation – ………….exposure to SHS is likely to cause most, if not all of the diseases caused by active smoking………… All Charities with self interest/bias and full-time employees to promote their opinion.

11 First Report of the Scientific Committee on Tobacco and Health, March 1998. SCOTH published by DoH

12 Report of the Scientific Committee on Tobacco and Health, Secondhand Smoke: Review of evidence since 1998, November 2004; see also World Health Organisation International Agency for Research on Cancer, Tobacco Smoke and Involuntary Smoking, IARC Monographs Volume 83, 2004.

13 Royal College of Physicians, Going smoke-free: The medical case for clean air in the home, at work and in public places, July 2005, ISBN 1 86016 246 0.  - AGAIN

14 Also known as coronary artery disease; the accumulation of fatty deposits on the walls of the coronary arteries, limiting the supply of oxygen to the heart muscle.

15 Q 83 [Dr Hackshaw] -Deputy Director of Cancer Research UK and UCL Cancer Trials Centre

16 Q 136 Dr Stotebury-Industry Affairs Manager and Chief Scientist, Imperial Tobacco Ltd (UK),

17 Q 147 -You are a scientific officer. You are a trained person. Are you saying they got it wrong? Are you saying they misled us? Are you saying the evidence has been interpreted wrongly? I am not clear exactly what you are saying.

Dr Stotesbury: I am saying there is insufficient evidence. - That's clear enough surely

18 James E. Enstrom and Geoffrey C. Kabat, Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960–98, British Medical Journal, vol 326 (May 2003), p 1057.

19 Q 442 The sentence before he explained the real reason!! -Quite honestly, I do not think that study stands up to any scientific scrutiny whatsoever, leaving aside the conflict of interest in the funding which to me is tantamount or comparable to a research study on organised crime being funded by the Mafia.-All the accepted medical evidence and especially that of ASH and Cancer Research UK must also be considered as having a conflict of interest since their very existence depends on Government funding and proving the case for Tobacco damage.

20 Going smoke-free, p 26. - Royal College of Physicians but some do dispute!

21 Qu 65–66 --- Deputy Director of Cancer Research UK and UCL Cancer Trials Centre

22 Q 433 Sir Liam Donaldson - Chief Medical Officer,(again)

23 Q 434 Sir Liam Donaldson - Chief Medical Officer (again)

After all this they conclude “24. We are convinced by the evidence of experts, including the Chief Medical Officer, the Royal College of Physicians, SCOTH, the US Surgeon General and the World Health Organisation, that secondhand smoke is a serious and preventable cause of death and ill-health.”----------Serious, preventable maybe but at what social, emotional commercial cost – these may be of little importance to those immersed in and dependent on medicine.

3 Dealing with the health effects of secondhand smoke

24 Q 316; for the view of the Gallaher Group, see Q 158.

25 Q 318 NOTE the committee wrote about ‘the total answer’. Total answers might not be the best answers yet this appears to be the only answer that is acceptable

26 Ev 19, Volume II.

27 Andrew Geens and Max Graham, No ifs or butts, Building Services Journal, March 2005.

28 Q 73 [Dame Carol Black] –President of Royal college of Physicians – expertly commented on her specialist subject!!!!!

29 Q 418 – Bill Callaghan H & S – This is where Debrah Arnott of ASH added that They had already taken QCs opinion

30 Smoking ban in all public places and workplaces, 17 October 2005,  www.northernireland.gov.uk/press . The Federal Occupational Safety and Health Administration (OSHA) in the US and the American Conference of Government Industrial Hygienists (ASGIH) have concluded that even proposed new technologies, such as displacement ventilation systems, which may reduce secondhand smoke exposure levels by 90% still leave exposure levels which are 1,500 to 2,500 times the acceptable risk level for hazardous air pollutants (see HC Deb, 14 December 2005, col 2104W).

31 Q 73 [Dr Edwards]

32 ibid.

33 Qq 73 [Dr Edwards], 75, 83 [Dr Edwards]; for Dr Geens’ response, see Ev 89, Volume III.

34 Q 510 What is very interesting is that “the Government has stongly hinted, a comprehensive ban is only a few years away” This assumes a ‘rightness’ to this being an acceptable policy

35 Q 454 – Yet other countries like Spain found a total ban unworkable and swiftly accommodated the wishes of the people

36 Smoking ban forced on Italy’s cafes, 10 January 2005,  www.telegraph.co.uk/news

37 Cigar friendly New York, 21 April 2003, www.cigaraficionado.com/cigar

38 Marie Killeen, Acting Director of Communications, Office of Tobacco Control, meeting with the Committee. –Is this truly reflecting the view of the Irish people or simply one of those rather biased reports we see so often in the papers.

39 Q 429 and see Annex 2. - again it could be thought that this sort of figure could be as biased as others such as the 71% YouGov one

4 Justification for a ban

40 There are 5.1 m  people in the UK with asthma, and cigarette smoke is the second most common asthma trigger in the workplace. 20% of people with asthma feel excluded from parts of their workplace because other people smoke there. Department of Health, Consultation on the Smoke-free Elements of the Health Improvement and Protection Bill, p 22, Ref: 269278 1p 1k Jun 05 (CWP). –This may apply to the workplace but it is also reasonable that those with an allergy should avoid the avoidable – unlike some Public Buildings no one is forced to enter a public house. Smoke-free premises could be encouraged. Simple logic also suggests that the other 55(?) m people do not suffer from asthma, 14m people smoke yet they must be inconvenienced for the sake of the few

41 Q 529 –Good for him but many have not given up nor can many of them give up at all

42 ibid, p 20.

43 Ev 117, Volume III

44 Q 88 – The opposing views have opinion attributed to them – “this argument is relatively popular, if decreasingly so.” – this is biased by inaccurate poll evidence

45 Department of Health, Choosing Health: Making healthy choices easier, Cm 6374, November 2004, p 97, suggests that these views were based on an Opinion Leader Research survey, but no question on this issue is included in the survey.

46 Q 545

47 Q 383

48 Q 379 – Evidence from ONE young bar worker who says young people don’t know the risks and that of ONE person that STILL works in a pub and suggests that smoking adverts DO WARN people of the dangers – anyone taking a bar job now will know the dangers - -- The second negates the first!!!

49 Q 383 – Ms Robson of TGWU

In balancing the economic effects on businesses and smokers’ rights against workers’ rights, we have to weigh up the likely effect on each group. The experience in Ireland suggests that the economic consequences of the ban on the hospitality industry have been slight and that smokers’ suffering has been relatively trivial: if smokers want to smoke they go outside and do not seem to mind too much……………

5 The Government’s proposals

50 Department of Health, Choosing Health: Making healthy choices easier, Cm 6374, November 2004.

51 ibid., p 97 -Opinion Leader Research (OLR) survey commissioned by the King’s Fund.

52 ibid., p 99

53 Minutes of Evidence taken before the Health Committee, The Government’s Public Health White Paper (Cm 6374) 23 February 2005, HC 358–i, Session 2004–05,Q 7.   ,- He said a lot more besides especially –“the legislation was introduced to protect the public, not to force you to live a certain lifestyle - there will be a displacement (as in Ireland) from people who previously went to the pub who will take drink home”

54 ibid., Q 51 ----------He also said in answer to Qu 54 -  “I have reached a different decision from my chief adviser on medical affairs, yes, because as you know advisers in this country advise and ministers decide precisely because we have to balance the health outcomes—which I would not dream of disputing with my Deputy Chief Medical Office or Chief Medical Officer in terms of their assessment. That is their job, to tell me the health outcomes. My job, as Secretary of State, is to balance that with my custodianship of the freedom and the democratic society of our people.”

55 Minutes of Evidence taken before the Health Committee, Responsibilities of the Secretary of State for Health, 27 October 2005, HC 623, Session 2005–06, Q 4.

56 Health Bill, clause 2 (1–2) [Bill 69 (2005–06)]

57 ibid., cl. 3 (1)

58 ibid., cl. 3 (2)

59 In Wales, this will be a matter for the National Assembly to decide.

JUMPING ON TO SECTION

7 Exemptions for licensed premises

84 For licensed premises which do not prepare or serve food and for membership clubs in respect of which a club premises certificate (according to the Licensing Act 2003) is in force.

85 Minutes of Evidence taken before the Health Committee, The Responsibilities of the Secretary of State for Health,

7 October 2005, HC 623, Session 2005–06, Q 10 - The Manifesto commitment and for many the reason they gave a vote to Labour rather than, say, the LibDems who promised a total ban.

86 Q 545 – also “ part of the reason why the voluntary bans and restrictions have been so successful is that they have gone with the grain of public opinion and therefore they have been pretty much self-enforcing.”

87 HC Deb, 29 November 2005, col 236

88 www.dh.gov.uk/Consultations/ResponsesToConsultations/fs/en - This is the highly biased consultations where we could be sure that on the say so of Cancer Research UK alone over 24,000 would have disagreed.

89 Q 547

90 See Annex 2 for details. Annex 2 ignores Governments own independent ONS results and relies heavily upon unofficial (but convenient) results that are now shown NOT to echo public opinion

91 Q 6 – Why should it be on health evidence grounds? Or - So what?

92 Q 367 – simply the opinion of one man - a union officer - Mr Michael Ainsley, London Region Organiser, GMB

93 Q 72  - Senior Lecturer in Public Health, University of Manchester, Maybe not to him but again he’s a medical man with anti-smoking zeal

94 Q 360 [Mr Thomas]- Mr Simon Thomas, Managing Director, Thomas Holdings Ltd, - and representing gaming operators from across the current leisure market, including bingo halls, adult gaming centres, - Obviously an expert witness for making this statement

95 Q 285 ; see also Ev 1, Volume II.

96 Q 283 –  is this figure simply as a result of  the fear of a threat of claims?

97 Q 325 – Quite selective –He continued “We personally have indicated that we would prefer some form of segregated smoking rooms, and we will work with whatever clear option is introduced, but it has to be clear and operable across an enormous range of the industry:

98 Q 301 – This is related to an inequitable system where conditions are imposed upon the pub/club sector and would be irrelevant if choice was allowed

99 Q 352 – This may be a conservative estimate in light of closures in Scotland – He also added “If we have to choose between partial disaster and total disaster, quite clearly we believe that the health interests that would require a total ban are also in the best interests of our customers.”

100 Q 72 - Dame Carol Black Pres. Royal Coll of Phys Specifically about one medical condition – no mention of increased social, mental, stress etc problems

101 Q 85 She is obviously an expert in Social Sciences!!!!!!!!!!

102 Qq 289–91 – all estimates

103 Anti-smoking bill will push 400 M&B pubs to stop food, 1 December 2005, www.guardian.co.uk

104 ‘Laughable’ ban on smoking will fail, says M&B, 1 December 2005, www.telegraph.co.uk/money

105 Q 410 [Cllr Rogers] No question was asked about WHY this type of Pub exists or is Preferred in these areas, They were simply looked at as a target

106 Q 448 This shows a remarkable lack of broader thinking – So much publicity about smoking, bans, people outside pubs is a free advert for the camaraderie of smoking.

107 Q 113 Expert supposition!! IF – AND – I THINK - = IT DOES NOT SUPPORT a comprehensive ban. All it does is suggest that trying to help people stop smoking and add that to a ban there may be fewer smokers

108 Q 578–80 – It will be interesting to check this when ONS reports during the first 3 years BUT is already proven FALSE by figures from Ireland. A consistant rise over 15 months and in March 2006 on the second aniversary of their ban was only 0.5% below the pre ban figure. Other month to month figures show worse figures than this.

109 Department of Health, Consultation on the Smokefree Elements of the Health Improvement and Protection Bill, June 2005, p 20 – Evidence from Ireland has shown a rise in smoking, if smoking was INSIDE a pub or the ban was less severe there would be less publicity and less free advertising

110 ibid., p.33–34 - Maybe the Partial RIA was wrong - Who prepared it and can we see their workings?

111 Minutes of Evidence taken before the Health Committee, The Government’s Public Health White Paper (Cm 6374) 23 February 2005, HC 358–i, Session 2004–05, Q 8.

112 ibid. - BUT Statistical evidence from Ireland and UCL (and Commonsense) Show he was right

113 Q 571 OH but there is!!!!!

114 Q 36  - Maybe not current BUT there was none to show that it wouldn’t

115 HC Deb, 29 November 2005, col 153  - Fair enough

116 Q 553 – Extremely dubious figures that go against the ONS – IT IS Clear that the Government should defend a partial ban –THERE is NO mandate for the Total one ALSO should even a large majority deny the rights of a minority. The poll was an ASH one - http://politics.guardian.co.uk/homeaffairs/story/0,11026,1572786,00.html

117 See Annex 2 as above – and we now know how accurate that was – Should an Internet Poll of which some may have prior knowledge be acceptable since these can be biased by interest groups

118 Q 406 – A simple rule may be easy to enforce but it may not be a good rule

119 Q 407 –Yet a voluntary approach would cost nothing

THE Following CONCLUSIONS are a bit presumptuous ADD MORE
What about some consideration of NO BANS?

The Government’s proposals for a ban which exempts ‘drink-only’ pubs and membership clubs are unfair, unjust, inefficient and unworkable, because:
-all workers should be protected from SHS; -- TRUE if SHS is dangerous but to what extent? Must an employer change his business to remove all risk or should he be allowed to keep his chosen clientele etc by ensuring 'reasonable ' measures are taken? Many workers are required to face known and certain danger? Should the RLNI change their role to protect lifeboat personel?
-children, who have access to clubs, should not be exposed to SHS; - Surely some parental choice. Must every place that a child goes be SHS free? How far will this be pushed?
-It is likely that a partial ban will be disputed in the courts by bar workers; Can it be said that any bar worker doesn't know that smoke is not a good thing? They took the job knowing this.
-a partial ban will create unfair competition; It depends which partial ban. No Ban at all would not create unfair competition.
-a partial ban will widen health inequalities; Much disputable - commonsense suggests that many pubs in poorer areas will close so residents in those areas would suffer alienation etc
-public opinion now supports a comprehensive ban; - It depends if you prefer ASH figures or the truth.
-legislation should be clear and simple if it is to be easily enforceable. Good legislation would require little enforcement
A broad range of opinion has argued that a comprehensive ban would achieve the Government’s stated aims in a much more satisfactory fashion than a complex partial ban, and that from the commercial perspective of the hospitality and gaming industries, a comprehensive ban is also the preferred option. We find it hard to understand how the strong evidence base, clear public support, and the results of the Department’s own Regulatory Impact Assessment can be ignored. -------Very untrue! A NARROW range of opinion has supported a comprehensive ban. AND the commercial perspective does not prefer a comprehensive ban - It PREFERS a voluntary non-ban solution. I find it hard to accept any support for the whole paragraph and the last sentence is unbelievable.

8 Compliance

120 Q 414 [Mr Jukes] Chartered Institute of Env Health

121 See Annex 3

122 Q 545 –something of sense

123 Q 420 - Arnott ASH Surveys – Should a Government Committee accept these figures? Surely ASH have a conflict of interest in an unbiased investigation.

124 See Annex 2 -Sponsored You Gov Internet Figure

125 Q 429 ASH evidence again – Dr Naysmith called her Deborah!!!!

126 Q 408 [Mr Allen] - Executive Director, Local Authorities Coordinators of Regulatory Services - ASH commissioned Jane MacGregor of Jane MacGregor Associates (and the Local Authority Coordinating Office for Regulatory Services: LACORS) to survey seven authorities, representing London Borough, Unitary, Metropolitan and District Councils

127 Q 408

128 Q 303

129 Q 304 [Mr Bish] -Cheif Executive, Association of Licensed Multiple Retailers

130 Marie Killeen of the Office of Tobacco Control told the Committee that well over 90% of premises in the Republic of Ireland were compliant with the ban there. -------is this to do with respect for the legislation or fear of the fines

131 Qq 305–06

132 Q 387 [Mr Ainsley] Does the Government Wish to change the ‘culture’ of the British People?

133 Q 416

134 Q 415

135 Department of Health, Consultation on the Smokefree Elements of the Health Improvement and Protection Bill, June 2005, pp 29–30.

136 ibid, p. 31.

137 Q 594

138 The Committee found that, in the Republic of Ireland, 93% of hotels were compliant with the legislation; 99% of restaurants; 90% of licensed premises; and 97% of other premises. The Office of Tobacco Control noted that 96% of all indoor workers reported having smoke-free workplaces. The number of prosecutions was very small (13 to the end of 2004). All of this indicates very widespread compliance. Compliance does not support the Bill nor does is mirror the many changes people have made to avoid proscecution.

139 Q 448

140 Q 72

Annex 1

141 Shane Allwright, G. Paul et al., Legislation for smoke-free workplaces and the health of bar workers in Ireland: before and after study, British Medical Journal, vol 331, pp 1117–19

Annex 2: Public opinion
-Some text and figures are emboldened for emphasis

1. The Office of National Statistics carries out a multi-purpose survey called the Omnibus Survey to provide data to Government departments and other public bodies. The survey is carried out most months. The results for 2004 were used to create a picture of public attitudes towards smoking in public places and restrictions thereon.

2. 64% of respondents supported restrictions on smoking in pubs, an increase from previous years (56% in 2003, 48% in 1996). When asked in more detail about smoking restrictions, 47% thought that pubs should be mainly non-smoking with smoking allowed in designated areas, while only 16% thought that pubs should be mainly smoking with designated non-smoking areas. 31% thought that smoking should not be allowed anywhere, a significant increase in the figure from the previous year (20%).

3. Choosing Health referred to the findings of an Opinion Leader Research (OLR) survey, which, it said, demonstrated that people “do not […] believe that this [protecting workers from SHS] requires a complete ban in all licensed premises”. The survey was published in June 2004 and was commissioned by the King’s Fund. However, the research does not seem explicitly to support this contention. 68% of respondents thought that a ban on smoking in workplaces, including pubs, bars and restaurants, would be the most effective way to reduce the health risks of smoking. There was no question inquiring whether or not people believed that something less than a complete ban is necessary.

4. ASH has pointed to other surveys to demonstrate that public support for a ban on smoking in public is substantial and growing. A poll conducted for ASH by BMRB (the British Market Research Bureau) in July 2005 asked: “The Government has announced plans to make most enclosed public places smokefree from 2008. Would you support a proposal to make ALL enclosed workplaces, including pubs and restaurants, smokefree?” It found that 73% of respondents agreed with the proposition (although support was only 42% among smokers). This confirms the findings of a MORI poll of April 2004, which found that 54% strongly supported the introduction of legislation similar to that in Ireland, with 25% tending to support it (79%, therefore, being broadly in favour).
------- Note that it is ASH who put their figures forward yet they are accepted by a committee we expect to act in a balanced manner to protect the interests of the whole country. The Internet polls were commissioned by ASH and Cancer Research UK and are notorious in that they can be influenced by fore-knowledge or an encouraged group of supporters.

5. ASH has also commissioned surveys from YouGov which reinforce the picture of increasing public support for a ban on smoking in public. The way in which the question is framed is important; respondents can be asked whether or not they support the introduction of a ban on smoking in all public places and workplaces, including pubs and bars; or they can be given a list of public places and workplaces and asked which they think should be smoke-free. When YouGov posed the latter question in August 2005, only 41% of respondents indicated that pubs and bars should be smoke-free. However, another YouGov survey conducted in December 2005 asked both questions. In response to the first, more general question, around 70% of respondents supported a comprehensive ban (so-called ‘à la carte’ question was posed, the 71% in England and Scotland, 70% in Wales and 78% in Northern Ireland). When the second, number of respondents choosing pubs and bars as places which should be smoke-free was slightly (but not significantly) lower: 66% in England, 70% in Scotland, 67% in Wales and 71% in Northern Ireland. This indicates firstly that the phrasing of the question affects the results, but also that there is now a substantial majority of opinion in favour of a comprehensive ban. Moreover, favour of a comprehensive ban; support which opinion is clearly moving very swiftly in was at 41% in August 2005 has become 66–70% in the space of four months.
------------------- This evidence is remarkably similar in nature to that promoted by ASH in Scotland during the time leading up to their ban - from 'The Scotsman' -More than half of UK back a ban on smoking - 20 May 2004 and Four out of five support workplace smoking ban - 11 June 2004 ----- NOTE that the latest figure from the ONS published in July 2006 is 33% a swift movement of opinion of only 2% in a year

6. The Chairman appeared on BBC Radio 4’s You and Yours to participate in a phone-in discussion on smoking in public. The BBC subsequently produced an analysis of the responses to the discussion from members of the public.142 Over a two-week period, the producers of the programme received over a thousand e-mails, telephone calls and letters. Of these responses, 60% were in favour of a comprehensive ban. Only 22% favoured no ban. There was no support for the Government’s proposals for a partial ban. Some respondents also expressed concern that the Government’s proposals would widen health inequalities. One wrote “This policy will add to health inequalities between rich and poor as most pubs that don’t serve food are situated within the poorest communities”.143
-Should a radio programme with an audience whose profile is unrepresentative of the country be cited in this context?

7. Responses to opinion polls clearly depend on the questions which are asked. However, what is clear is that there is a trend of growth in public support for the idea of a comprehensive ban on smoking in public places and workplaces. The Committee has also heard from the Director of ASH that public support in the UK is currently higher than it was in Ireland prior to the introduction of the smoking ban there.144 ASH has also pointed out that support for a ban in New York was only 30% when it was introduced. Yet New York and the Republic of Ireland have successfully implemented a ban on smoking in public.
---As seen above it appears that the Committee relied on evidence provided by an organisation with a declared bias. It seems amazing that a blatant anomaly was not picked up by such an esteemed committee. It appears from the above that in June 68% were in favour, in July 73% yet this dropped to only 41% in August and rose again to 70% by December. Might figures like this give a false indication of an attitude change in the country and thus support later decisions. Remember the current ONS is only 33%. Who are ASH that they should be given so much say in the formation of policy and that their evidence alone seems reliable ---- Oh Yes --- they're funded by Government to demonise tobacco NOT to give a balanced view

142 Ev 119, Volume III.

143 Ibid.

144 Q 429 - Ms Arnott:"When they asked it in Ireland prior to the legislation coming in the level of support was 67%. When we asked it here in July the level of support was 73%." ASH

**********The simple fact is that 67% of the public favour either no ban or restrictions and the minority opininion has been favoured by the committee.*********

--------------------------------------------------------

Conclusions and recommendations -(included in full to show how the Committee translated their fiction into fact)

1. We are convinced by the evidence of experts, including the Chief Medical Officer, the Royal College of Physicians, SCOTH, the US Surgeon General and the World Health Organisation, that secondhand smoke is a serious and preventable cause of death and ill-health. (Paragraph 24)

2. We are not convinced that ventilation offers a practical means of reducing SHS to safe levels. The scientific evidence is clear that there is no safe level of SHS. The expert evidence we have heard suggests that at best ventilation can only dilute or partially displace contaminates. Ventilation offers cosmetic improvements but does not represent a sufficient response to the health and safety risks inherent in SHS. (Paragraph 33)

3. The only solution to the problem of SHS exposure is to prohibit smoking in public places and workplaces, including licensed premises. This approach has found increasing favour with governments around the world, and public opinion in the UK is moving very quickly in its favour. Moreover, the experience of the Republic of Ireland shows that smoke-free legislation becomes even more popular once it has been introduced. (Paragraph 40)

4. In balancing the economic effects on businesses and smokers’ rights against workers’ rights, we have to weigh up the likely effect on each group. The experience in Ireland suggests that the economic consequences of the ban on the hospitality industry have been slight and that smokers’ suffering has been relatively trivial: if smokers want to smoke they go outside and do not seem to mind too much. In contrast, there is strong evidence that smoking in the workplace has significant effects. As we have seen, it is estimated that about 500 non-smokers each year die prematurely from inhaling secondhand smoke in the workplace; this is surely too high a price to pay for the right to smoke. We cannot accept that the right to smoke can justify these deaths. Workers have a right to be protected from harmful substances unless there is an overwhelming reason for undertaking the risk. (Paragraph 51)

5. We find the assertions in Choosing Health, supposedly based on the evidence of opinion polls, misleading and unhelpful to the debate about public support. Moreover, recent research, detailed in Annex 2, shows that public support is moving rapidly and decisively in favour of a comprehensive ban on smoking in public places and workplaces. (Paragraph 54)

6. We recommend that two draft regulations be laid before Parliament: one to deal with exemptions for licensed premises and clubs, the other to provide for premises where a person has his home or is living. (Paragraph 61)

7. Neither the Department of Health nor any other Government witnesses made reference to the issue of Crown immunity during our inquiry. It is not mentioned in the Explanatory Notes to the Bill nor was any reference made by Ministers at the Bill’s second reading. We find these omissions extraordinary especially as Crown Immunity removes the necessity for exempting many premises. (Paragraph 62)

8. We acknowledge that prisons represent a particular challenge in terms of smoke-free legislation due to the nature of the prison population. We are not, however, persuaded that preventing SHS exposure in prisons is any less a priority than any other workplace, or that the high prevalence of smoking among prison inmates is either a justification for exemption from the legislation or justification for the continued exposure of staff or prisoners to SHS. Rather, we see the high prevalence of smoking as evidence of a substantial and currently unmet need for effective smoking cessation services in prisons, and a possible failure of duty of care to both prisoners and staff. Furthermore, simply exempting prisons from the decision that workplaces should be smoke-free is unsatisfactory since it will provide no impetus for the Prison Service to go further in working towards increasingly smoke-free environments within prisons. (Paragraph 72)

9. We recognise HM Prison Service’s intention to work towards a smoke-free environment within prisons but are not persuaded that there is any reason why the policies applied in most prisons should be any less comprehensive, or implemented any later, than those for any other workplace. However, we also recognise that compliance may be difficult to achieve in some circumstances. From the date that the legislation comes into force in England, all smoking at work by prison staff should cease and the Home Office should set a target of making the interior of all prisons smoke-free. Prisons should maintain the power to make special provisions for individual prisoners in high-security institutions who are particularly difficult to manage, but this provision must not involve the exposure or staff or other prisoners to SHS. Smoke-free policy in prisons should be supported by the provision of full smoking cessation support to all smokers who want to stop smoking. (Paragraph 73)

9. We recognise HM Prison Service’s intention to work towards a smoke-free environment within prisons but are not persuaded that there is any reason why the policies applied in most prisons should be any less comprehensive, or implemented any later, than those for any other workplace. However, we also recognise that compliance may be difficult to achieve in some circumstances. From the date that the legislation comes into force in England, all smoking at work by prison staff should cease and the Home Office should set a target of making the interior of all prisons smoke-free. Prisons should maintain the power to make special provisions for individual prisoners in high-security institutions who are particularly difficult to manage, but this provision must not involve the exposure or staff or other prisoners to SHS. Smoke-free policy in prisons should be supported by the provision of full smoking cessation support to all smokers who want to stop smoking. (Paragraph 73)

10. We see no justification for any exemption for Young Offenders’ Institutions. HMYOI Wetherby is an example of good practice which should be applied throughout all similar institutions. The Home Office should set an early target date for making all Young Offenders’ Institutions smoke-free. (Paragraph 74)

11. High levels of smoking in psychiatric institutions are not inevitable. The experience in Norfolk and Waveney is an example of what can be achieved by a creative and positive approach in a difficult environment, and a model of good practice which can be applied to all other institutions. Therefore psychiatric institutions should not be granted a simple exemption from the smoke-free provisions of the Health Bill. An early target date should be set for making such establishments smoke-free, with separate outdoor areas (secure if need be) set aside for patients to smoke at the minimum risk to staff and other patients. In addition, measures should be put in place to tackle the high prevalence of smoking and challenging targets set for its reduction. Psychiatric institutions should become smoke-free workplaces for staff along with other NHS premises by the end of 2006. (Paragraph 80)

12. We welcome the Ministry of Defence’s commitment to controlling smoking in the workplace, and recognise that the MOD is already working towards creating more smoke-free environments. We also welcome the MOD’s ‘golden rule’ that nonsmokers should not be exposed to other people’s smoke. However, we are not persuaded that MOD workplaces should be treated any differently from other workplaces, and are concerned that exemptions in, for example, submarines will lead to continued, avoidable and unnecessary exposure of service personnel to SHS. (Paragraph 86)

13. The Ministry of Defence should eliminate all smoking in the workplace and in public places. Smoking should not be permitted in shared living accommodation or in communal areas of living quarters in any circumstances. Smokers should be allowed to smoke only in individual private quarters. (Paragraph 87)

14. We recognise that there are difficulties. Nevertheless, staff in hospices should be afforded the same protection from SHS as workers in any other sector. Hospices should not be exempt from smoke-free legislation. Compliance with a smoke-free policy should be a condition of admission to hospices and there should be a comprehensive programme of smoking cessation support. Similarly, the staff of nursing homes should be afforded the same protection, and these premises should therefore be smoke-free. (Paragraph 90)

15. We agree with the Royal College of Nursing that care workers who visit patients in their own homes should be protected as far as possible from the harmful effects of SHS. To that end, employers should seek to ensure that patients are aware that they should not smoke while being visited, and that care workers should have the right to refuse to enter a home or room in which a patient is smoking. (Paragraph 92)

16. The Government’s proposals for a ban which exempts ‘drink-only’ pubs and membership clubs are unfair, unjust, inefficient and unworkable, because:

• all workers should be protected from SHS;
• children, who have access to clubs, should not be exposed to SHS;
• it is likely that a partial ban will be disputed in the courts by bar workers;
• a partial ban will create unfair competition;
• a partial ban will widen health inequalities;
• public opinion now supports a comprehensive ban;
• legislation should be clear and simple if it is to be easily enforceable. (Paragraph 116)

17. A broad range of opinion has argued that a comprehensive ban would achieve the Government’s stated aims in a much more satisfactory fashion than a complex partial ban, and that from the commercial perspective of the hospitality and gaming industries, a comprehensive ban is also the preferred option. We find it hard to understand how the strong evidence base, clear public support, and the results of the Department’s own Regulatory Impact Assessment can be ignored. (Paragraph 117)

18. Political support for a smoking ban in the Republic of Ireland is in stark contrast to the approach of the UK Government which has been muddled and vacillating. Policy towards the control of smoking in public places and workplaces has been a litany of good intentions undermined by faint-heartedness. The strong public health message embodied by Smoking Kills, the White Paper of 1998, has been hedged about with so many qualifications and exemptions that the legislation to protect non-smokers from the harmful effects of secondhand smoke has lost its clarity of purpose. Nor has the Government chosen to represent the ban on smoking primarily as an issue of worker protection, as was done in the Republic of Ireland, but instead as a more nebulous ‘public health’ measure. As a result of this failure of leadership, the Chief Medical Officer, who admitted that he considered resigning over the issue, described the Government’s legislation as putting “Britain among the laggards of public health policy-making internationally rather than the global leaders”. (Paragraph 128)

19. We conclude that there are four key components to achieving widespread compliance:

• an adequate level of public support;
• clarity and simplicity in the regulations governing a ban;
• a framework of penalties which adequately and appropriately target those who fail to comply with the law, in particular those who deliberately flout the law;
• strong and committed political leadership. (Paragraph 129 )

20. The last three of these are sorely lacking in the Government’s proposals. Widespread compliance through a high degree of self-regulation will only be achieved by a comprehensive ban without exemptions for any licensed premises or membership clubs. (Paragraph 130)

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