Advantages A reduction in death and ill-health associated with passive smoking
Disadvantages Enforcement may prove difficult
I've read several opinions now on this subject, many of which question the need for a ban, and would like to put the case for why I think smoking should be banned in public places. I live in Scotland, where a smoking ban has already been agreed and will be implemented on March 26 2006, under the Smoking, Health and Social Care (Scotland) Act 2005. I'm delighted that this legislation has been passed and feel that it does reflect a progressive approach to the issue and a genuine concern for public health on the part of the Scottish Executive.Why is a ban necessary? First I'd like to look at the proven dangers of smoking. My data relates to Scotland, which admittedly does have a poor public health record. However the situation is not all that different in England and Wales.
Smoking is the biggest cause of premature death and ill-health in Scotland. 13,000 people die annually due to the effects of smoking - that represents one in four deaths overall. I don't know about you, but I find that an absolutely terrifying figure for something that is preventable.Passive smoking causes an average of 865 deaths yearly in Scotland among people who have never smoked - that's from the main causes of death associated with smoking - lung cancer, respiratory diseases, heart conditions and stroke. Taking into account other diseases related to smoking, the figures reach 1,500 to 2,000 per year.
Would a ban on smoking in public places affect the prevalence of smoking as a whole? Well, research suggests that it would: bans in public places are associated with reductions in the total number of cigarettes smoked, and reductions in smoking prevalence. Reducing the number of places where it is acceptable to smoke provides an incentive to many people to smoke less or give up. In the words of Thomas Houston of the American Medical Association (quoted in the Guardian): "A ban accelerates the rate of cessation because it gives people another reason not to smoke."It has been estimated that for lung cancer and heart disease alone, the effect of eliminating second-hand smoke in public places in Scotland would represent a reduction of 219 deaths per year. Further reductions in death from stroke and respiratory illnesses is estimated at 207. That may not sound like all that many compared to the population as a whole, but set alongside a reduction in the number of non-fatal conditions caused by passive smoking, it starts to look like a very significant improvement.
Some owners of pubs, clubs etc have expressed concerns that their business will be negatively affected by the ban. (Interestingly, the campaign against the ban has been conducted mainly by the "hospitality" industry and - surprise! - tobacco companies.) It's impossible at present to say how this will work out in practice, but data from other countries suggests that this will not be the case: not one study or survey based on objective data has ever reported an economic downturn following a ban... except for the tobacco industry, which frankly I feel is probably big enough, rich enough and unscrupulous enough to look after itself. Information from a comprehensive review carried out in New York, one year on from a ban being implemented, shows that turnover and sales have increased and, significantly, that smoking levels in the general population fell by 3% - that represents 100,000 fewer smokers.Personally I feel that any possible reduction in the numbers of smokers frequenting pubs etc is likely to be offset by an increase in the number of non-smokers who are more inclined to socialise in a smoke-free environment. I do like going out to pubs and to see bands, but don't do so very often any more. This is partly due to the fact that I am getting old and boring and would often rather stay at home with a good book than traipse the streets looking for a taxi at 3a.m., but also partly because I absolutely loathe being in a smoky environment. I hate coming home from a night out and realising that my clothes, and even my hair, smell like the bottom of an ashtray. Smoke-free pubs and clubs would definitely be more likely to attract my custom.
We've heard a lot of opinions on the subject of smokers' rights. I find it hard to understand what many people mean by this. Do smokers have the right to pursue a habit which is likely to have a seriously detrimental effect on their own health? Yes, they do. Do they have the right to pollute and create an unpleasant environment for others and place non-smokers at risk of contracting smoking-related illnesses? No, I would suggest that they do not. Do non-smokers have the right to socialise, work and eat in an environment which does not put their health at risk? Yes, I believe they do. I also believe that children have the right to grow up in a smoke-free environment, but sadly there is little that can be done to prevent parents from endangering their own children's health in this way.Of course it's not just, or even mainly, about legislation - health promotion and the availability of smoking cessation services are of absolutely vital importance in encouraging people to give up and of course many smokers do give up every day. However these measures don't go far enough - many people don't want to or don't feel able to give up. That's their choice, but there is no reason why their habit should be inflicted on the 70% of the population which does not smoke. I recognise that there are many smokers who do have consideration for others and confine their smoking to places where it will not affect non-smokers - however, there are many more who do not.
I'm delighted that the Scottish Executive has taken the brave and difficult step of deciding to implement this ban, which I believe to be one of the most radical and far-reaching public health decisions of recent years. It remains to be seen how it will work out in practice and how the ban will be enforced. Inevitably, doom and gloom has been predicted from some quarters, but like any other controversial issue, this was never going to be popular with everyone. It's more than time that something really effective was done to tackle the huge public health problem represented by smoking - hopefully this is it.
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