Lovely legislation - England goes smokefree on July 1st

Lovely Legislation

From July 1st 2007, smoking in enclosed public places will be prohibited. This represents one of the most important post-war public health acts and follows the lead taken by Ireland and Scotland.

Why ban smoking in public places?

Smoking is now the principal avoidable cause of preventable illness and premature deaths in the UK. Smoking kills over 120,000 people in the UK a year - more than 13 people an hour. The UK Government has set new targets for health improvement. One of the targets is to reduce cancer deaths. Another is to reduce heart disease deaths. Cancer and heart disease are the two most common fatal diseases in this country. Smoking is a major cause of cancer and heart disease.

Most non-smokers are not exposed to levels of second-hand smoke sufficient for them to incur significant extra risk, many thousands are, such as those living with smokers or working in particularly smoky atmospheres for long periods of time. Several hundred people a year in the UK are estimated to die from lung cancer brought about by inhaling second-hand smoke. Second-hand smoke almost certainly also contributes to deaths from heart disease - an even bigger killer than lung cancer.

Exposure to second-hand smoke can cause illness. Asthma sufferers are more prone to attacks in smoky atmospheres. Children, more vulnerable than adults and often with little choice over their exposure to tobacco smoke, are at particular risk.

Children whose parents smoke are much more likely to develop lung illness and other conditions such as asthma than children of non-smoking parents. The Royal College of Physicians has estimated that as many as 17,000 hospital admissions in a single year of children under 5 are due to their parents smoking. They also estimate that up to 25% of cot deaths might be caused by mothers smoking. Women who smoke while pregnant are likely to reduce the birthweight, and damage the health, of their baby.

What is second-hand smoke? downloaded from: www.smokefreeengland.co.uk

Secondhand smoke is simply other people’s tobacco smoke and is also known as passive smoke or ‘environmental’ tobacco smoke. Secondhand smoke consists of side stream smoke from the burning tip of the cigarette, and mainstream smoke exhaled by the smoker. Side stream smoke typically makes up nearly 85% of the smoke in a smoky environment. This type of smoke contains a much higher concentration of toxins, such as hydrogen cyanide, ammonia, carbon monoxide and acrolein, than mainstream smoke. Secondhand smoke contains a cocktail of over 4,000 different chemicals, many of which are toxic and harmful including more than 50 known carcinogens such as benzo(a)pyrene, chromium, vinyl chloride, and benzene.

The invisible killer

Evidence shows that ventilation cannot control exposure to secondhand smoke:

• We know that 85% of secondhand smoke is invisible and odourless
• Secondhand smoke is made up of gases and microscopic particles
• Research has shown that to remove the risks of secondhand smoke, an enclosed premises would need wind tunnel-like rates of ventilation.
• Ventilation can actually distribute secondhand smoke throughout buildings

Dramatic reduction in exposure to secondhand smoke

• Irish hospitality workers experienced significant reductions in the levels of both levels of airborne pollutants and levels of carbon monoxide concentrations (70% decrease) during the first 6 weeks after the introduction of a smokefree policy in Ireland
• Levels of carbon monoxide decreased by 45% in non-smoking Irish bar workers one year after the legislation was introduced
• Before smokefree legislation was in place, 68% of Irish workers reported having over 21 hours of secondhand smoke exposure per week. This changed to 70% of workers reporting no exposure to secondhand smoke at work
• In a survey of 104 hospitality workers in New York, subjects reported an 89% decrease in exposure to secondhand smoke at work as a result of the Clean Indoor Air Act; this was confirmed by cotinine tests of the workers. Cotinine is an indicator of exposure to tobacco smoke
• A report issued on the third anniversary of New York’s smokefree law showed that New Yorkers' exposure to secondhand smoke had declined by 50% overall

Measurable improvement to workers’ health

• A Dundee University study showed bar workers’ lung function increased by as much as 10% just two months after smokefree legislation was introduced. Those showing secondhand smoke-related symptoms fell from 80% to fewer than half
• The Journal of the American Medical Association documented a significant improvement documented in respiratory health among bartenders after the passage of the Californian smokefree workplace legislation

Marked decrease in air pollution

• A Global Study of Irish Pubs found the level of air pollution inside Irish pubs in smokefree cities was 93% lower than the level in pubs in cities where smoking is permitted
• A Global Air Monitoring Study of 1,212 indoor workplaces in 24 different countries found that the level of indoor pollution was 89% lower in places that were smokefree compared to those where smoking was observed

Smoking and inequalities

Smoking more than any other identifiable factor contributes to the gap in healthy life expectancy between those most in need, and those most advantaged. While overall smoking rates have fallen over the decades, for the least advantaged they have barely fallen at all. In 1996, 12 per cent of men in professional jobs smoked, compared with 40 per cent of men in unskilled manual jobs.

Such differences are reflected in the impact of smoking on health. A higher rate of smoking among people in manual jobs is matched by much higher rates of disease such as cancer and heart disease. Between 1991 and 1993, among men aged 20 to 64 in professional work, 17 in every 100,000 died of lung cancer, compared with 82 per 100,000 in unskilled manual work. For the same period and age group, among professional workers, 81 per 100,000 died from coronary heart disease compared with 235 per 100,000 in unskilled manual jobs.

The close link between smoking and health inequalities was highlighted again in the Acheson Report, an independent inquiry into health inequalities chaired by Sir Donald Acheson. The report concluded that the relatively stable rate of smoking in the least advantaged groups suggests that simply intensifying current approaches would not be sufficient to tackle the problem.

In addition to these emerging challenges, there are longstanding problems that need fresh approaches. We also need to focus specifically on tackling inequalities in health. Although on average we are living healthier and longer lives, health and life expectancy are not shared equally across the population. Despite overall improvements, there remain big – and in some communities increasing – differences in health between those at the top and bottom ends of the social scale. Some parts of the country have the same mortality rates now as the national average in the 1950s (Choosing Health).

I’m a smoker, what should I do?

The best way to protect your family and others from secondhand smoke is to give up smoking. For anyone considering stopping there is plenty of help and support available. Call the free NHS Smoking Helpline on 0800 169 0 169 for practical advice, including a free information pack on how to stop smoking and the different options available.

To find about the local NHS Stop Smoking Service nearest you, phone the NHS Smoking Helpline free on 0800 169 0 169 or in the following ways:

• Web: http://www.gosmokefree.co.uk/
• Mobile: text ‘GIVE UP’ and your full postcode to 88088
• In person: ask at your local GP practice, pharmacy or hospital