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Smoking in Public Places
A Consultation on Reducing Exposure to Second Hand Smoke
Evidence Report
CHAPTER THREE - SUMMARIES OF REPORTS FROM CONSULTATION ACTIVITY
3.1 This chapter contains summaries of each of the consultation activities. These comprise:
Key Findings of Responses a Public Consultation, Sue Granville and Andrea Kinver, George Street Research
Key Findings from Focus Group Research, Kay Russell and Sue Granville, George Street Research
Report of Regional and Area Events, Scottish Civic Forum
Report of a Youth Consultation, Young Scot
Report of an Omnibus Survey, MRUK Research Ltd
Towards a Smoke-free Environment: Lessons from Home and Abroad: Report of a National Conference, Consultation Team and Centre for Tobacco Control at the University of Stirling.
SMOKING IN PUBLIC PLACES: A CONSULTATION ON REDUCING EXPOSURE TO SECOND HAND SMOKE: KEY FINDINGS OF RESPONSES TO A PUBLIC CONSULTATION
Sue Granville and Andrea Kinver, George Street Research
3.2 The full report is available
HERE
Background and Objectives
3.3 This report analyses the responses from organisations and the general public to the public consultation document that was launched on 7 June 2004, by the Scottish Executive Health Department.
3.4 The aim of the consultation was to obtain peoples' views on possible approaches to minimising the harm caused by second hand smoke. The consultation provided an open invitation to anyone who had an interest in this issue to give their views and the public consultation document was designed in a questionnaire format to enable the consultation to be as accessible as possible to a wide range of individuals who wished to make a response. The report aimed to reflect the range and depth of views provided.
Methodology
3.5 A total of around 600,000 consultation documents were distributed and 53,474 responses were submitted to the Scottish Executive. The consultation document set out the background to the consultation, highlighted the key topics for consideration and posed a series of questions to which respondents were invited to respond. The questions focused on 6 broad topic areas:
Whether further action needs to be taken to reduce people's exposure to second hand smoke
Whether individuals would support a law that would make enclosed public places smoke-free
Whether there should be any exemptions if a law is introduced
What could be done to encourage individual businesses to take voluntary action to become smoke-free or to provide more smoke-free provision
What else could be done to reduce people's exposure to second hand smoke
Details of any other views on smoking in public places.
3.6 Two very distinct types of response were submitted:
Free flowing responses were received primarily from organisations and professionals which were based on their experience and understanding of smoking in enclosed public places. These were entered into a bespoke database engineered specifically for this element of the public consultation paper as well as being analysed alongside the other responses. There were a total of 179 responses.
Responses using the Scottish Executive Consultation Document which were generally less extensive and were entered into a specific data processing package designed to deal with a large volume of responses. A total of 53,474 responses were received from the general public, groups and organisations and entered into this analysis package. The bulk of respondents were non-smokers and the majority of the responses came in via the questionnaire form.
3.7 Note that the views presented may be based on fact but may also be what respondents perceive to be accurate from their own perspective. This analysis reported on the range of views and perspectives and these have not been vetted for factual accuracy.
Key Findings
Taking Further Action
A large majority (82%) of respondents supported the view that further action needs to be taken to reduce people's exposure to second hand smoke.
94% of non-smokers were in favour of further action compared with only 43% of smokers.
However, there were varying views about what form this action should take.
Making enclosed public places smoke-free
A large majority of the general public (80%) supported a law to make enclosed public places smoke-free.
The majority of non-smokers supported this (92%), however only 30% of smokers said they would support a law.
Should there be exemptions from a law?
35% of respondents were in favour of exemptions and 56% were against. Of those in support of legislation, 24% were in favour of exemptions.
There were large differences of opinion amongst respondents based on smoking status with 78% of smokers in favour of exemptions compared with 26% of non-smokers.
More respondents under the age of 25 said that there should be exemptions than those aged 25 or more. 41% of under 16's and 45% of 16-24 year olds said there should be exemptions compared with 34% of 25-59 year olds and 35% of those aged 60 or over.
Respondents were most likely to suggest that exemptions could be applied in pubs and bars, or that alternatives (such as ventilation or segregation) could be introduced. This reflects the social aspect of smoking and its close association with drinking alcohol.
Those against exemptions tended to focus on needing a level playing field for all organisations and there were concerns that exemptions could cause confusion or grey areas.
Some comments related to specific places that are homes for some individuals whilst workplaces for others such as care homes or prisons. There were contradictory views about whether such places should be exempt.
What more could be done to encourage businesses to become smoke-free or provide more smoke-free provision?
A number of comments from respondents related to a need for legislation and identified the problems with schemes that rely on voluntary cooperation.
Many organisations submitting lengthier responses also emphasised the need for a law due to the ineffectiveness of voluntary schemes.
A range of suggestions were made in favour of some form of financial incentives being offered to proprietors.
Respondents, especially organisations, commented on the need for education to raise awareness and the provision of smoking cessation services.
Themes
3.8 Throughout the consultation responses a range of themes and issues were raised and these are discussed below:
Health risks: there were discussions around the health risks of passive smoking. Respondents, especially health organisations, emphasised the need to protect the health of non-smokers. However, those not in favour of legislation argued that there were other environmental hazards (eg traffic fumes) that are also damaging to health.
Economic issues: a small proportion of respondents commented that a ban could have a negative impact on certain types of business, especially the hospitality industry.
Choice and rights: there were concerns about the removal of freedom of choice and interference of the "nanny state" although a small proportion of respondents mentioned that it is the Government's responsibility to ensure that public areas are smoke-free. The right to a smoke-free environment was mentioned as well as the right to smoke.
Practicalities: some respondents expressed concerns about the practicalities of introducing legislation and enforcing it effectively.
Education, support and help: the need for more education, public awareness campaigns and advertising about the dangers of passive smoking was emphasised. Respondents also felt that there needs to be increased smoking cessation support.
Alternatives
3.9 A range of alternatives or compromise suggestions were made such as the introduction of designated or segregated areas, smoking at certain times only, restrictions in specific places only, ventilation, a phased approach to the introduction of restrictions, and the use of incentives to encourage voluntary action. Nevertheless, there were also concerns about the effectiveness of such measures.
3.10 This strand of consultation activity is hereafter referred to as the "responses to the public consultation". Throughout the analysis we distinguish, where relevant, between "respondents to the public consultation" and "organisations providing lengthier responses to the public consultation" based on the different types of responses received.
SMOKING IN PUBLIC PLACES: A CONSULTATION ON REDUCING EXPOSURE TO SECOND HAND SMOKE: KEY FINDINGS FROM FOCUS GROUP RESEARCH
Kay Russell and Sue Granville, George Street Research
3.11 The full report is available
HERE
Background and objectives
3.12 Twelve focus groups were conducted in different locations across Scotland with targeted sections of the population. The main aim was to capture the breadth of opinions amongst members of the general public who might be particularly affected by the issue and who might not have contributed to the consultation through other methods employed in the exercise. These were:
Young people (aged 16-24)
Workers: private sector: licensed trade and hospitality sector i.e. pub and restaurant
Workers: private sector: manufacturing, engineering, construction or transport sectors
Workers: public sector: local authority
NHS workers
Pub customers.
3.13 The groups also covered a range of age groups, socio-economic groupings, both genders and included smokers, non-smokers and ex-smokers.
Methodology
3.14. The focus groups involved informal discussion with groups of eight to ten individuals about smoking in public places and the related themes.
Key Findings
Passive Smoking: Attitudes and Behaviour
There was generally less tolerance to smoking in public places than a number of years ago.
However, there was still support for the rights of smokers to smoke in public places (with some non-smokers also supporting this right).
The increase in smoking restrictions in recent years has left some smokers feeling that there are few provisions made for them.
Respondents perceived that clear distinctions tend to be made between places where smoking should be tolerated and those where it should be banned.
For many respondents, smoking was closely associated with drinking alcohol, relaxing and having fun, and smoking was widely considered to be acceptable in pubs and clubs.
Respondents indicated that the onus was often on the non-smoker to tolerate smoky places if they have friends who smoke with whom they wish to socialise, and many non-smokers accepted this.
Respondents revealed that socialising was sometimes affected by the desire to frequent less smoky environments, with a move towards selecting venues that are better ventilated where possible.
Health Issues
Although aware of significant health risks associated with
active smoking, the level of understanding of the
range of health risks varied.
Passive smoking was considered to be less risky than active smoking and some respondents denied that it is significantly damaging to health.
Some smokers denied or ignored the health information and statistics that identify a clear link between both active and passive smoking and terminal diseases and a small number of respondents held inaccurate information about the health implications of smoking.
Ventilation was widely perceived to reduce the amount of smoke in an enclosed public space and therefore reduce the impact of ETS on health. Some respondents regarded improvements in ventilation to be an adequate solution to the problem of passive smoking.
The majority of respondents recognised the importance of protecting children from smoky environments.
Smoking in the workplace
Participants perceived three main levels of smoking policy in different workplaces:
Work places with smoking policies restricting where smoking is permitted which are
respected and generally regarded as acceptable and desirable. These include offices, workplaces where food is prepared (kitchens; food and drink manufacturing companies) and local authority buildings.
Work places where smoking policies restricting smoking exist but are
violated. These include some manufacturing industries, factories, construction sites, transport companies and some hospitals.
Work places where smoking policies
do not exist. These include some licensed trade and hospitality industry premises, some manufacturing and industrial sites, some construction sites and some transport companies.
Different standards of policy for different types of workplaces are assumed to be the norm and therefore an inferior standard applies to some workers.
Discussions with employees from the construction and transport industries indicated that smoking is particularly likely to be permitted in these industries. Respondents suggested that where smoking policies exist, they are not taken seriously and frequently violated.
Employees in the licensed trade and hospitality sector are likely to work in smoky environments and this is considered part and parcel of the job.
Little regard was given to issues relating to health and safety in the workplace or an employee's right to a smoke-free workplace.
Smoking in restaurants and pubs
Banning smoking in restaurants was regarded as particularly desirable.
There was tacit acknowledgement from some smokers that they may need to accept restrictions on smoking in some public places if they are to avoid an outright ban everywhere. To many, bans or restrictions in restaurants and other places serving food were considered to be a more acceptable compromise than a ban in pubs.
There was a deeply engrained assumption that the pub is one of the few places where smoking should be freely allowed.
Smoking in other public places
The restrictions that currently apply in other public places (public transport, shops, aeroplanes, malls, offices etc) were generally accepted by the majority of respondents. This could suggest that public opinion may follow existing norms as with seat belt and drink driving legislation.
There was some debate over whether or not smoking should be banned in certain places such as hospitals, prisons and care homes that are effectively people's homes as well as falling into the category of enclosed public places and workplaces for other people operating within them.
Making all public places smoke-free
There were varied levels of support for legislation to make all public places smoke-free.
There was consensus amongst some respondents, regardless of their smoking status, that the time has come for
some restrictions to be enforced on smoking in enclosed public places. There was also a view that a range of alternative measures could be introduced in place of a complete ban.
Some respondents were clearly in favour of a complete ban, primarily because of a personal dislike of smoking and a concern for personal health. They also perceived there to be a number of positive consequences resulting from the introduction of a ban and these include:
More pleasant smoke-free social environments
Non-smokers more likely to go out more often
Improved health for both smokers and non-smokers
Help smokers smoke less or give up
Improve image of Scottish Executive, in taking an assertive stance on an issue of public concern.
However, some respondents had reservations about the introduction of a complete ban for a number of reasons:
Negative economic impact on the licensed trade and hospitality sector
Infringement on individual rights
Health argument is not sufficient reason
Reduction in tax revenue
Government is only concerned to avoid litigation in future
Difficult to enforce such legislation
Negative impact on community fabric.
These individuals would prefer partial measures such as:
The introduction of designated or separated smoking areas
A staged approach to the introduction of a ban
Restrictions on smoking at the bar service areas only
Restrictions on smoking in areas where food is served only
Allowing proprietors to choose for themselves to offer a smoking or non-smoking environment.
3.15 This strand of consultation activity is hereafter referred to as "the focus groups". SMOKING IN PUBLIC PLACES: A CONSULTATION ON REDUCING EXPOSURE TO SECOND HAND SMOKE:
SMOKING IN PUBLIC PLACES: A CONSULTATION ON REDUCING EXPOSURE TO SECOND HAND SMOKE:REPORT OF REGIONAL AND AREA EVENTS
Scottish Civic Forum (SCF)
3.16 The full report is available
HERE
Background and objectives
3.17. The Scottish Civic Forum conducted a number of public consultation and discussion events at locations throughout Scotland consisting of national and local events.
Methodology
National Events
3.18. Four national events were held in Dundee, Aberdeen, Inverness and Glasgow.
3.19 At each event Tom McCabe MSP, the then Deputy Minister for Health and Community Care gave an introductory presentation. Each event hosted a panel including health professionals or researchers, representatives from ASH Scotland and representatives of the licensed trade and hospitality sector to answer questions from the floor.
3.20 Each national event started with a plenary session, followed by break out sessions when participants were divided into smaller groups to enable further discussion.
Local Events
3.21 A series of 13 local events were held throughout Scotland in rural or suburban locations between July and September 2004. These aimed to provide people with less easy access to national events with the opportunity to participate. Meetings were held in Aberfoyle, Glenrothes, Granton (Edinburgh), Kilmarnock, Stranraer, Falkirk, Livingston, Dalkeith, Ardrossan, Greenock, Bellshill. Additional events were held following specific requests at St Stephen's High School, and in Galashiels.
3.22 The local events were chaired by a SCF coordinator who introduced the main issues and took the participants through the main areas covered by the consultation materials. At some events participants were divided into groups to enable greater discussion and the opportunity for input from all those who wished to speak.
3.23 In general, both the local and the national events were attended by members of the public, as well as health professionals and representatives from the licensed trade and hospitality sector.
Key findings
3.24. Similar themes emerged at both the national and local events and these are summarised below.
Level of support for legislation
3.25 At each local event, the SCF coordinators attempted to quantify where possible the extent of support for legislative changes. In some cases this was done by a show of hands. At all events there appeared to be broad support
for action to be taken to reduce exposure to second hand smoke. However, there was some disagreement as to what type of action should be implemented.
3.26 Although in some cases there was
strong support for a complete ban, it was also clear that many felt that the ban should not be all encompassing and that there should be exemptions of some sort. Those from the licensed trade were largely against a ban, and favoured continued voluntary activity or ventilation as alternative measures.
Places that should be exempt
3.27 In the majority of local events there was some discussion about which public places should be exempt from the legislation. Many agreed that special provisions would be necessary in specific locations that are a "home" for some individuals, and therefore a place where an individual has the right to smoke if they wish, whilst also being a workplace for others. These included residential care homes, private homes where health staff such as health visitors or district nurses are required to work and prisons.
3.28 However, it was recognised that by making these places exempt, employees working within them would continue to be subject to health hazards associated with ETS and so provisions should be made to limit their exposure to it.
3.29 Some participants felt that some sort of smoking provision should continue to be available for smokers in pubs and other leisure venues. A number of participants felt that whilst restaurants should be smoke-free, pubs should continue to allow smoking.
Perceived benefits of legislation
3.30 The principal reasons in support of legislation that emerged during the discussions included:
The failure of the current voluntary charter: there was scepticism about the success of the current voluntary charter, and it was recognised that voluntary measures may not be able to bring about the level of change required. The main problems identified were the fact that few pubs have signed up to the charter, and that, where separated zones have been introduced, smoke can drift across from the smoking area. However, representatives of the licensed trade and hospitality sector claimed that the voluntary charter was having a positive impact and expressed preference for continued support for this course of action.
Health benefits: the evidence about the implications of second hand smoke for health was considered for the most part to be strong rationale for the introduction of measures to limit exposure to second hand smoke. That said, a small minority of participants were sceptical of the health significance of passive smoking. There were also views that restrictions would result in a reduction in smoking overall, and would also help smokers to give up.
Protection of children: there were specific concerns to protect children from the harmful effects of second hand smoking.
Employee protection: the importance of protecting the public when they are at work was also identified as a key reason for legislation to be introduced. Some participants drew attention to employee litigation in the future by those who suffer smoking related illnesses due to passive smoking. This was considered to further support the argument for the introduction of some measure of control or restriction.
Level playing field: the importance of a "level playing field" was also considered to be a factor promoting a full ban rather than a partial one, to ensure that small businesses which cannot offer alternatives, such as separate smoking rooms, would not suffer in a competitive market place.
Perceived disadvantages of legislation
3.31 Negative implications were also identified as reasons against a complete ban. The representatives from the licensed trade and hospitality were amongst those who presented the arguments against the introduction of legislation.
Economic concerns: some members of the general public were concerned about potential problems for businesses as smokers might stop frequenting pubs and clubs and stay at home. The view was of greatest concern to the representatives from the licensed trade and hospitality sector.
Rights and choices issues: equal rights and choices for all members of the public, both smokers and non-smokers, was a subject of debate. Some participants argued that smokers have the right to smoke and that non-smokers could choose to avoid smoky environments. In response, others argued that non-smokers have the right to a smoke-free environment.
Government interference: some participants expressed concern at what they considered to be excessive interference in personal affairs and choices. There was a feeling amongst some participants that this would be the start of oppressive legislation in many aspects of social activity that the government will now try to ban or restrict. Others, in contrast, felt that the government was justified in taking a legislative course of action because smoking (both active and passive) has the potential to be so damaging to public health.
Enforcement and implementation: in many of the local events concern was voiced about how any new legislation would be enforced and who would be responsible for enforcing it. There was also a feeling that enforcement in rural areas would be particularly difficult.
Other harmful substances: in response to the health arguments, the point was made that there were many other harmful substances.
Biased consultation: some representatives from the licensed trade sector were concerned that the consultation was not valid because they believed that the Scottish Executive had already decided on their course of action prior to the start of the consultation. They also felt that the forums were biased because a larger number of panel members were in favour of the smoking legislation.
Hypocritical government: some participants described the government as being hypocritical in their approach as they will continue to receive tax from cigarettes.
Proposed alternatives to a complete ban
3.32 Some participants who did not wish to see a complete ban suggested a range of alternative courses of action. These included:
Ventilation: the effectiveness of ventilation to remove harmful particles from the air was discussed at some length in several of the public forums. Health professionals argued that the harmful carcinogens were not removed effectively by ventilation. However, this was queried by those from the licensed trade and hospitality, some of whom would like ventilation to be considered as an alternative measure.
Staged approach: a more gradual approach was requested by members of the licensed trade and hospitality sector in particular, although some members of the public also suggested this was a route that would help publicans prepare themselves for the new proposals. Others also suggested that the proposal could be piloted in the first instance, prior to the legislation being introduced, to establish what the impact would be.
Incentives: it was suggested that a system of incentives for landlords offering smoke-free provision could be developed to increase the number of smoke-free venues. Similarly, some suggested the provision of grants to install ventilation equipment. The licensed trade and hospitality representatives also requested compensation to be offered to publicans if they lose money in the event of a ban being introduced.
Smoking licences: some participants suggested that pubs that wished to allow smoking could apply for a smoking license enabling them to offer smoking facilities for those customers that require them.
Local authority decision making: whilst some suggested that local authorities could be empowered to enact this type of legislation, it was recognised by some that this would result in uneven provision across the country which it was felt would be undesirable.
Legislation for restrictions in certain places only: some suggested that restrictions should be imposed only in places where food is served and where children are present.
Taking things forward
3.33 A number of themes related to taking things forward in the most effective way were also discussed:
Need for education and cessation support: the need for ongoing support and resources for education and cessation were identified as critical by many respondents as part of a comprehensive range of activities working towards improved public health in addition to a smoking ban.
Need for clear information: there were mixed views about the impact of legislation in New York and Ireland with some arguing that the law has been effectively implemented with minimal consequences for businesses whilst others claim that the opposite has been the case. Some participants felt that this indicated a need for clear evidence of the implications in other countries and for this evidence to be promoted widely to foster greater support and counter fears of the negative consequences.
The need to address social deprivation: the fact that smoking continues to be concentrated in areas of socio-economic deprivation was mentioned as a serious problem and was considered by some participants to be an area requiring focused attention by the government as part of the larger policy on tackling smoking.
Clear definition of enclosed public places: this was requested by participants at some events who felt that there was scope for ambiguity as there were some places that were neither clearly public nor enclosed, but to which they would like the law to apply. Examples cited were bus shelters and doorways, both of which are felt by some to result in ETS being inflicted on other people in much the same way as in an enclosed public place.
3.34 This strand of consultation activity is hereafter referred to as the "regional public seminars". SMOKING IN PUBLIC PLACES: A REPORT OF A YOUTH CONSULTATION
SMOKING IN PUBLIC PLACES: A REPORT OF A YOUTH CONSULTATIONYoung Scot
3.35 The full report is available
HERE
Background and objectives
3.36 Young Scot conducted a youth consultation programme on behalf of NHS Scotland as an aspect of the larger consultation process to target the views and opinions of children and young people. Young Scot collected the views of over 4,000 young people across Scotland through a variety of avenues.
3.37 The main aim of their activities was to involve as many young people as possible in different parts of Scotland. The programme aimed to inform children and young people of the key issue at hand and the related debates, and to offer them an opportunity to express their views. The programme also aimed to establish the extent of support amongst young people for making enclosed public places smoke-free.
3.38 The youth consultation ran from 15 June 2004 to 30 September 2004.
Methodology
3.39 The Young Scot programme consisted of a number of events at national and local level.
National Level
3.40 At national level the consultation was conducted primarily through the Young Scot website where youngsters were able to complete the consultation questionnaire exploring views on smoking in enclosed public places. A total of 770 completed consultation responses were obtained and these covered a range of respondents in terms of gender, age, and geographic location.
Local Level
3.41 Four local authority areas, Dundee, Highland, North Ayrshire and Dumfries and Galloway, were selected for additional awareness raising and consultation activities. Questionnaires were made available in each local authority area to youngsters aged 12-18 through a variety of means such as post-card ballots, email, through libraries, schools and community centres and by distributing them at events. Across the four local areas a further 1,121 consultation responses were obtained. In the four local areas additional surveys were also conducted.
3.42 Additional insights into the views of young people were obtained through a range of activities and events that were arranged in each of the four local authority area. These included local festivals, workshops, meetings, publicity days, school visits, outreach street work, focus groups, display boards in public places, email alerts, and online discussion forums where the key issues were explored.
Key Findings
3.43 The findings, based on a total of
1,891 completed surveys obtained during national and local activities, indicated that:
64% of young people believe that smoking in public places should be banned.
66% believe that there should be some places where smoking is allowed.
75% believe that more needs to be done to reduce the effects of second hand smoke.
Many young people in Scotland have strong views on the issue of smoking and the negative effects on their health.
Many believe that more information and support should be provided to highlight the dangers of smoking and help people to quit.
3.44 The same issues that emerged in other parts of the consultation were reflected in the views and opinions of children and young people. There were differing views with some in favour of a complete ban and others expressing a preference for some exemptions.
In support of a ban
Health: the concern for the potential health implications of passive smoking was considered to be a good reason for introducing legislation or a complete ban.
Dislike of the habit: young people expressed their dislike of the smell and the litter caused by cigarettes.
The right to a smoke-free environment: some youngsters expressed the opinion that the public has a right to a smoke-free environment in all public places.
Ineffectiveness of designated areas: some young people who were aware that designated areas currently existed in some public places felt that these did not work effectively as smoke does not respect boundaries.
Against a ban
The right to smoke: there was quite a strong view that smokers have rights, and should be given a place to smoke. Whilst smoking could be banned in most public places, some young people felt that some places should be exempt.
Exemptions: pubs and clubs were mentioned as they key areas that should be exempt. Young people suggested that there could be some "smoking bars" or there could be designated areas within pubs for smokers.
Alternatives measures suggested by children and young people
3.45 Young people suggested a number of alternative courses of action that they felt would help work towards a smoke-free Scotland:
Provide incentives to businesses that enact non-smoking policies or fines to those who take no action.
Increase the price of cigarettes.
Ban cigarettes.
Increase the age limit for buying tobacco.
Introduce regulations or incentives to improve ventilation.
Introduce special measures to protect children.
Increase education and provide information to children from a young age about dangers of smoking.
Use national campaigns to inform the public, again targeting people when they are young. One suggestion was for a national celebrity campaign using young people's idols describing the consequences and dangers of smoking.
3.46 This strand of consultation activity is hereafter referred to as "the youth consultation".
SMOKING IN PUBLIC PLACES: REPORT OF AN OMNIBUS SURVEY
MRUK Research LTD
3.47 The full report is available
HERE
Background and objectives
3.48 MRUK research were commissioned by the Scottish Executive to undertake a research exercise with a representative sample of the Scottish population, regarding smoking in public places and addressing aspects of the smoking in public places consultation exercise itself. Specific issues to be addressed included:
Smoking status
Smoking policy within the workplace
Support for changes to the law to make enclosed public places smoke-free
Awareness of recent advertising about health risks of passive smoking
Awareness of the Scottish Executive's public consultation exercise in relation to smoking.
Methodology
3.49 A quantitative research exercise was used. A total of 1,026 in-home interviews were undertaken with a representative sample of the Scottish population using MRUK's in-home Scottish omnibus. Interviews were conducted across 52 constituency based sampling points selected to be geographically representative of the Scottish population. Interviews were conducted on a "random route" basis within sampling points to ensure that a random sample was achieved
19. Quotas were established for age, gender and socio-economic group with only one interview per household being undertaken.
3.50 The achieved sample was split evenly across genders. A spread of ages was achieved in line with the Scottish population. Around 4 in 10 interviews were undertaken with ABC1's, with the remainder (59%) being from C2DE socio-economic groupings.
3.51 Overall, almost half of this sample claimed to be current smokers (47%) with a smaller proportion (just over a third - 36%) indicating that they had never smoked. Around a fifth claimed that they had smoked in the past but had since stopped. This differs from national adult prevalence smoking rates, which stand at about 31%.
3.52 Amongst those who were currently employed, around a third were employed in workplaces which had designated areas on the premises where people could smoke. Just over a quarter were employed in workplaces that allowed people to smoke in designated areas outside the premises. A similar proportion (26%) stated that smoking was not allowed anywhere within their place of work.
Key findings
Just over half of all respondents were in support of further action to reduce exposure to passive smoking and second hand smoke, with strength of opinion being strongest amongst those who have never smoked. Current smokers were more likely to be of the view that no further action needs to be taken (55% of current smokers).
Views were mixed with respect to the level of support for a law that would make enclosed public places smoke-free, with just over half expressing support for such a law and around a third indicating that they were unsupportive. Although support for such a law was most prominent amongst those who have never smoked (77%), around a third of current smokers indicated that they too would support the introduction of such a law. In addition, those respondents where the workplace policy was for no smoking anywhere within their place of work were also more likely to be in support of such a law (63%).
Overall, two thirds of those who would support such a law were also of the opinion that, should such a law be introduced, exemptions should be considered, with pubs and clubs forming the basis of such exemptions (57% and 21% respectively).
Principal reasons for being against a law that would make enclosed public places smoke-free centred around the belief that smokers have the right to smoke in public places (48%) and that non-smokers can choose to avoid smoky places. Around a fifth of those not supporting such a law were of the opinion that enough was already being done to restrict smoking in public places.
Awareness levels of recent advertising about health risks of passive smoking were strong, with almost three quarters claiming to have seen or heard recent advertising on the matter.
Specifically, just over a third claimed to have seen or heard something in the media with respect to the Scottish Executive's public consultation exercise on smoking in public places, with this being particularly true amongst those from the AB socio economc group (47%).
Amongst those who had previously seen or heard something in the media with respect to the public consultation, a high proportion (59%) indicated that they did consider responding to the Scottish Executive's consultation in smoking but decided not to.
Amongst those who were unaware of having seen or heard any media coverage with respect to the public consultation exercise on smoking in public places, around one in seven indicated that had they known more they would have considered responding. Nonetheless, almost half of those who were unaware of any media coverage stated that they would not have considered responding even if they knew more about it, with strength of opinion here being highest amongst those aged 65+ (59%), DE's (54%), males (50%) and those living in the East (56%).
3.53 This strand of consultation activity is hereafter referred to as "the omnibus survey".
TOWARDS A SMOKE-FREEE ENVIRONMENT: LESSONS FROM HOME AND ABROAD: REPORT OF A NATIONAL CONFERENCE
Smoking in Public Places Consultation Team, Scottish Executive and Centre for Tobacco Control Research, University of Stirling
3.54 The full report is available
HERE
Background and objectives
3.55 A national conference on the issue of smoking in public places was held at the International Conference Centre in Edinburgh on 9 September 2004.
3.56 The aims of the conference were to:
Present an overview of the research on harm caused by second hand smoke
Look at ways that other countries have reduced exposure and the impact of controls on health and business
Assess the practicalities of a range of approaches in Scotland.
3.57 The conference was intended for national and local level policy makers, health practitioners, trade unionists, the voluntary sector and business people, including those from the licensed trade and hospitality sector.
3.58 Attendance consisted of:
Business representatives, mainly from the licensed trade (14%)
NHS Boards and health professionals (30%)
Local authorities including COSLA
20 (17%)
The voluntary sector (13%)
Universities, environmental health, trade unions, Health and Safety Executive, the Scottish Executive and other government departments.
3.59 The national conference report outlines summaries of each of the presentations at the conference. Here, we provide a summary of the main themes and debates that emerged.
3.60 The following papers were delivered:
Session One: Scene Setting
Opening Address: Jack McConnell MSP, First Minister and Tom McCabe MSP, Deputy Minister for Health and Community Care
Overview of the Health Risks Associated with Second hand Smoke: Dr Peter Boyle, Director, International Agency for Research on Cancer (IARC)
Setting Controls on ETS: What the Research Tells Us: Dr Ron Borland, Cancer Control Research Institute, Victoria, Australia
Session Two: The Irish Experience
Going Smoke-free: The Irish Experience: Dave Molloy, Chief Inspector, Office of Tobacco Control, Ireland
The Impact of Controls on the Hospitality Sector in Ireland: Tadg O'Sullivan, Chief Executive, Vintners Federation of Ireland (VFI)
The View from Behind the Bar: John Douglas, General Secretary Designate, MANDATE Trade Union, The Union of Retail, Bar and Administrative Workers in Ireland
Session Three: Worldwide Experience
Making New York Smoke-free: Thomas Frieden, Commissioner of Department of Health and Mental Hygiene
Bringing in Nation-Wide Controls in New Zealand: Nicola Holden, Ministry of Health
Provincial Smoke-Free Provisions Across Canada: Melodie Tilson and Janice Forsyth, Ottawa
Session Four: The Way Forward for Scotland
International Evidence: Health and Economic Consequences of Controls on ETS and Potential Impact on Scotland: Anne Ludbrook. Health Economics Research Unit, University of Aberdeen.
A Statutory Approach: Creating A Level Playing Field: Stuart Ross, Scottish Licensed Trade Association (SLTA)
Smoke-free Tayside: Not just a pipe dream: Paul Ballard, NHS Tayside, Public Health Directorate
3.61 Discussion sessions were held throughout the proceedings.
Key Themes Emerging
Health Issues
3.62 Robust scientific evidence was presented to demonstrate the significant health risks associated with second hand smoke both at home and in the workplace.
3.63 Dr Boyle of the International Agency for Research on Cancer drew attention to the following key findings:
Involuntary smoking is carcinogenic to humans (2004 IARC Monograph).
Studies have proved that health risks are associated with passive smoking, and that risks increase with increased exposure. These include links to lung cancer, cardiovascular disease and acute stroke.
There are specific risks for children such as childhood respiratory diseases, Sudden Infant Death Syndrome, middle ear disease, asthma in children, eye and nasal irritation.
Non-smokers exposed to second hand smoke in the workplace have a 16-19% increased risk of lung cancer.
Health risks are also greatest amongst the most deprived communities where smoking levels have remained high.
3.64 Researchers modelling the health impacts of ETS for Scotland found that of 439 lung cancer and ischaemic heart disease deaths due to passive smoking, 71 resulted from non domestic exposure. These are expected to
rise over the next 30 years to 233 out of a total of 500.
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Findings from other countries
3.65 The implications of the introduction of legislation in the Scottish context were informed by international comparison. The conference included evidence from different countries or regions where legislation to restrict or ban smoking has recently been introduced. There were representatives from Ireland, Australia, the USA (New York), Canada (Ottawa) and New Zealand. In addition, two of the papers modelled the impact of legislation in other countries in the Scottish context (Ron Borland and Anne Ludbrook).
3.66 The UK is currently lagging behind in the level of legislative controls on smoking in public places, although there are only a small minority of workplaces that do not have a smoking policy at all.
3.67 The situation in other countries suggests that where legislation has been introduced there has been:
High levels of compliance
An increase in public awareness and support for the legislation
Increased acceptance of the smoke-free areas by smokers
Consumer preference for smoke-free areas
Reductions in smoking
No apparent adverse economic effects although some individual businesses affected (however hard to ascribe this to smoking legislation as there is high turnover in business openings and closures)
Domino effect with legislation introduced in one area, region or country encouraging others nearby to introduce legislation.
Economic issues: the situation in Ireland
3.68 There was some debate over the economic implications of legislation banning smoking in public places. The licensed trade and hospitality sector stated their concern that such legislation could be detrimental for Scottish businesses. Economic evidence from different countries was presented to help assess the economic risks.
3.69 Some degree of controversy surrounded the situation in Ireland. Independent economists commissioned by The Office of Tobacco Control (OTC) in Ireland predicted little or no aggregate economic effect. The OTC presented figures for the first six months following the ban in March 2003, which indicated that compliance levels were high, tourism numbers were up and bar sales were down by 1.3% (continuing a downward trend over the past few years).
3.70 John Douglas of MANDATE noted that the impact on jobs had been marginal and noted additional factors affecting business such as increased price competition, changes in lifestyle and high levels of excise duty. However, the data covers the summer months and it was argued that the onset of winter in Ireland will have more serious economic implications for businesses. The Vintners' Federation disputed the economic evidence, claiming that their members have seen a drop in bar sales of 15-25%. No evidence was presented to support this.
Economic issues: other international evidence
3.71 Speakers from countries / areas where legislation has recently been introduced noted that similar fears about economic implications existed prior to the legislation. However, the economic evidence produced for each country or area represented indicated that there has not been a negative impact. These findings have taken account of prevailing economic conditions, and the fact that the sector is subject to some level of turnover.
3.72 However, this data was also disputed by Tadg O'Sullivan from the Vintners Federation of Ireland who argued that in New York and British Columbia in Canada there had been serious economic consequences for the licensed trade and hospitality sector. No evidence was presented to support this.
Workers' Rights
3.73 The
right of workers to a healthy workplace has been the main rationale behind the introduction of legislation in other countries. The importance of ensuring that all workers have
equal protection regardless of the industry in which they are employed was emphasised in several papers
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3.74 In Scotland, any controls would be introduced through public health legislation rather than workplace health and safety which remains Westminster's responsibility.
Business issues
The importance of a
level playing field was emphasised. This would most effectively be achieved by a total ban given that some businesses lack the resources and facilities to introduce ventilation or designated areas.
The business opportunities that going smoke-free can offer were also highlighted and the licensed trade and hospitality sector were urged to consider these.
Suggested alternatives
3.75 The licensed trade and hospitality sector representatives presented alternatives to a complete ban.
Air Quality Standards: some consideration was given to introducing air quality standards as a compromise solution through the introduction of ventilation systems. However, speakers referred to the weight of international evidence that demonstrates that ventilation systems are not powerful enough to remove harmful carcinogens from the air.
A staged approach: the Scottish Voluntary Charter Signatory Group (SVCSG) consisting of the Scottish Licensed Trade Association, the Scottish Beer and Pub Association, the British Hospitality Association and the Scottish Tourism Forum proposed a five point plan over a three year period which would then be reviewed. This consisted of:
No smoking at the bar
No smoking where and when food is being served
All licensed premises to make 30% of floor space non-smoking, rising to 40% in the second year, and 50% in the third year
All licensed premises to have a smoking policy exhibited at the entrance
Smoking should not be permitted back of house.
Summing up
3.76 Professor Hastings, Chair of the Conference, summed up the day's proceedings from a personal point of view. He acknowledged that although there is debate concerning the level of harm, there was no disagreement that passive smoking has a detrimental impact on health; and there was a consensus that the ultimate aim was for a smoke-free Scotland. The disagreement and debate surrounded how and when this aim could most effectively be reached.
3.77 He gave consideration to the three available options for Scotland:
Ventilation: this was rejected as an option based on international evidence showing that ventilation does not protect people from the effects of ETS. If anything it worsens things by creating a false sense of security.
Partial Bans: there were doubts about the practicalities of introducing legislation to impose partial bans such as those suggested in the five point plan put forward by the SVCSG.
Complete ban: this was identified as the most effective approach. Whilst recognising the need to consider the impact on jobs and businesses, the hard evidence presented at the conference did not suggest that there would be a negative impact. However, the impact of controls in Ireland should continue to be monitored.
3.78 This strand of consultation activity is hereafter referred to as "the national conference".
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