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A BREATH OF FRESH AIR FOR SCOTLAND IMPROVING SCOTLAND'S HEALTH: THE CHALLENGE TOBACCO CONTROL ACTION PLAN

CHAPTER 5: SECOND-HAND SMOKE (PASSIVE SMOKING)

The Challenge

5.1 The health risks posed to non-smokers by exposure to second-hand smoke - also known as 'environmental tobacco smoke' (ETS) or passive smoking - are clear. The review report highlights these dangers and calls for firm action to increase smoke-free zones in all enclosed public places and the workplace.

5.2 The review report highlights the dangers second-hand smoke presents. It also identifies a body of evidence on the links between passive smoking and lung cancer, ischaemic heart disease and the aggravation of conditions such as asthma and chronic bronchitis.

5.3 Despite this clear medical evidence, the review report also notes that a recent study in Scotland found a poor understanding of the risks amongst the public. It highlights the need for more public education and calls for firm action to extend smoke-free zones in enclosed public places and workplaces. In doing so it challenges leading public sector employers, such as the Scottish Executive, local authorities, and NHS Scotland, to show leadership in the creation of smoke-free environments.

Current activity

5.4 Whilst not ruling out statutory restrictions in smoking in public places, the Executive's approach to date has been to work in partnership with business interests to achieve continuous improvement in the provision of smoke-free places through voluntary action. A central plank of the policy has been an industry initiative, the 'Scottish Voluntary Charter on Smoking in Public Places', to drive improvements in non-smoking facilities in the licensed, tourism and hospitality sector by encouraging venue operators to set a formal smoking policy and to highlight this through external signage. Operators could adopt one of five levels of policy:

• Smoking: no special segregation or special ventilation equipment;

• Ventilated: non-defined areas but special ventilation equipment used to improve comfort for non-smokers;

• Designated areas: with spaces clearly defined for smoking and non-smoking;

• Separated: smoking and non-smoking areas separated by walls; and

• Non-smoking: no smoking allowed at any time.

5.5 Supported by the four main industry bodies - the Scottish Beer and Pub Association, the Scottish Licensed Trade Association, the Scottish Tourism Forum and the British Hospitality Association - the Charter was launched in May 2000. Targets were set to achieve - by the end of 2002 - 10% increases in the number of places with smoking policies, written smoking policies, signs indicating smoking policy near entrances, and non-smoking provision.

5.6 An independent evaluation, published on 23 September 2003, ⁹ of smoking policies in the Leisure Industry would suggest the industry had met three out of the four targets set under the Charter, including the key target of availability of smoke-free provision. We welcome the progress made under the Charter and believe that it demonstrates the progress which can be made through partnership with the business community in this most challenging of sectors. We now intend to work with partners to step up these efforts in order to accelerate progress in smoke-free provision across all sectors of business in Scotland.

5.7 The annual cost of employee smoking in Scotland is estimated to be more than 500 million - 450 million for lost productivity (smoking breaks), 40 million from higher absenteeism among smokers and 4 million as a result of fire damage. ¹⁰ A number of studies show smoking restrictions in workplaces reduce smoking rates and tobacco consumption. ¹¹ The Executive has supported Scotland's Health at Work (SHAW) and NHS Health Scotland in efforts to encourage employers to introduce smoking policies in their workplaces. However, legislation covering health and safety at work is reserved to Westminster. Smoking Kills announced the intention to push this agenda forward through the publication by HSE of an Approved Code of Practice and the Executive is disappointed by the lack of progress in this document, believing it to be a missed opportunity for culture change in the workplace.

Way forward

5.8 The review report suggests that an increase in smoke-free provision is unlikely to be achieved without legislation. We acknowledge that legislation can form as well as follow public opinion and understand both the growing strength of opinion and increasing weight of evidence behind such a move. We will continue to pay close attention to the evidence emerging from Australia and the US states such as California and New York about the effectiveness of legal prohibition. In particular, we will monitor the situation in Ireland where a ban on smoking in the workplace, including bars and restaurants, is due to be introduced in early 2004.

5.9 Clearly legislation is one option but, equally, an extension of the voluntary approach remains an option also. Much progress has been made in smoke-free environments in public places in Scotland through voluntary action. Smoke-filled buses, trains and cinemas are a thing of the past and an increasing number of shopping and sports centres, restaurants and other public places have adopted sound smoking policies. Nevertheless, in spite of the inroads made through initiatives such as the Scottish Voluntary Charter, progress has been much slower in the licensed hospitality sector, particularly in pubs, leading many to believe that statutory controls are the only way to make real progress.

5.10 However, in our view statutory controls would only be truly effective - and ultimately enforceable - if they take place in an environment in which the legislation reflects rather than attempts to force public opinion on what remains essentially an issue of personal behaviour. We have to prepare the ground by working to 'de-normalise' smoking within our society. In particular we need to raise awareness of the harm that can be caused to unborn and young children and raise awareness amongst employees of the damage that smoking at work can have upon employees and the potential risks that this poses in terms of possible future litigation. In this way, we need to reverse the traditional paradigm within which young people are tempted to start smoking by the desire to 'fit in' to one in which smoking is not considered to be a normal 'social' behaviour. This will require long-term and sustained communication programmes which raise public awareness of the dangers of passive smoking.

5.11 Advertising needs to be supported and reinforced by an open public debate on the issues involved in passive smoking. As indicated in Chapter 1, our own commitment to a public debate specifically on issues around second-hand smoke is clear. We need to be prepared to hear all shades of opinions so that the issues can be surfaced and properly debated. We need to convince people not to smoke and convince people that if they do continue with the habit then they need to do so away from others so that they do not affect the health of those around them. This will be easier and more capable of being sustained if people can arrive at their own informed decisions rather than feeling as though this is being imposed upon them in some way.

5.12 Whilst smoking in the workplace remains a reserved area, we believe that there is a clear leadership role for the Executive. We must be prepared to take action to protect the health of our own staff and to ensure that help and advice is available for all those who wish to follow suit. The Health Improvement Challenge identified the workplace as one of the special focus areas for action and we will encourage employers across all sectors to review their health and safety arrangements with regard to tobacco smoke, and increase the number of employees that can enjoy the benefits of a smoke-free environment at work.

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