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Smoking in Public Places
A Consultation on Reducing Exposure to Second Hand Smoke

Towards a Smoke-free Environment:
Lessons from Home and Abroad - Report of a National Conference
9 September 2004

ANNEX A

Towards a smoke-free environment:
Lessons from home and abroad
Programme

ANNEX B

Biographies of Speakers

Peter Boyle FRSE FFPH FRCPS(glas)

Peter Boyle is from Glasgow in Scotland and he was also educated there. Following appointments at Ruchill Hospital and Harvard School of Public Health, Professor Boyle was Director of the Division of Epidemiology and Biostatistics at the European Institute of Oncology in Milan, Italy. He is Professor of Cancer Epidemiology at Birmingham University in the United Kingdom, Honorary professor of Cancer Prevention at Oxford University and Visiting professor at Glasgow University.

From 1 ^st January 2004, he has been the Director of the International Agency for Research on Cancer in Lyon, France.

His main research interests lie in disease prevention and he is particularly interested in the association between tobacco, nutrition, hormones and cancer risk and how this risk is affected by genetic susceptibility. Professor Boyle has published widely on a number of different types of cancer notably breast, colorectal, pancreas, prostate and oral cavity cancers as well as on benign urological conditions.

In 2000, he was honoured by the award of the Knight's Cross of Order of Merit of Republic of Poland (for contribution to Public Health in Poland) and by election to Fellowship of the Royal Society of Edinburgh.

Ron Borland PhD

Ron Borland PhD is the Nigel Gray Distinguished Fellow in Cancer Prevention, in the Cancer Control Research Institute at The Cancer Council Victoria. He was foundation Director of the VicHealth Centre for Tobacco Control at the Council. He has a PhD in psychology from the University of Melbourne and BSc and Masters degrees from Monash University. He is a Professorial Fellow in the Faculty of Health and Behavioural Sciences at Deakin University and also holds honorary appointments at the University of Melbourne and Monash University.

He has published over 120 papers in peer-reviewed journals, mostly related to aspects of tobacco control. He is on the editorial board of five international journals in the addiction, public health and behavioural medicine fields. He sits on the Research and Evaluation Committee of the National Tobacco Campaign, and is a member of the Australian Cancer Society's Tobacco Control Sub-Committee. He is one of the Principal Investigators of the International Tobacco Control Policy Evaluation Project: an international collaboration currently active in 7 countries: USA, UK, Canada, Australia, Ireland, Malaysia, and Thailand.

His current research interests are predominantly in tobacco control. They include studies on:

• the impact on smokers of tobacco control policies, especially health warnings and ETS controls,

• factors influencing successful quit attempts,

• developing more effective electronic smoking cessation interventions,

• strategies for disseminating effective cessation assistance,

• strategies for preventing uptake of smoking,

• the constituents of tobacco smoke and how these change as a function of type of cigarette and of how they are smoked,

• better systems for regulating tobacco,

• understanding what is needed for optimum community-wide tobacco control, and

• barriers to stronger governmental tobacco control initiatives.

David Molloy, Office of Tobacco Control, Ireland

Dave Molloy has been Chief Inspector in the Office of Tobacco Control since its establishment in 2000, and has been involved in the drafting of tobacco control legislation in Ireland, Europe and with the World Health Organisation.

He is responsible for the co-ordination of the Irish national tobacco control inspection programme under the Public Health (Tobacco) Acts, which includes the smokefree workplace law.

Prior to joining the Office of Tobacco Control Dave worked as a Principal Environmental Health Officer with the South Western Area Health Board. He holds a postgraduate Diploma in Environmental Engineering and a Masters Degree in Environmental Health Risk Management.

Mr Tadg O'Sullivan, Chief Executive, Vintners' Federation of Ireland

Tadg O'Sullivan, Chief Executive of the Vintners' Federation of Ireland (VFI) has been at the helm of Ireland's largest on trade association for almost two decades. The VFI represents over 6,000 publicans outside the Dublin area and he has been instrumental in overseeing and actively participating in bringing about many positive changes in the licensed trade in the last 20 years.

He was a member of the Liquor Licensing Commission with a prominent role in advising the Commission on recommendations from the publican's perspective. He was instrumental in the establishment of MEAS - Mature Enjoyment of Alcohol in Society - an organisation that promotes social responsibility among producers, marketers, distributors and retailers of alcohol in Ireland in order to reduce alcohol abuse and related harm.

Prior to joining the VFI, Mr O'Sullivan held a variety of positions in the Public Service including posts at the Department of Justice and the Revenue Commissioners and in the Public Service Trade Union Movement.

John Douglas

John Douglas is the newly appointed General Secretary Designate of Mandate Trade Union, the Union of Retail, Bar and Administrative Workers in Ireland.

Educated at Trinity College, Dublin, John joined the Trade Union Movement in 1979, and on the formation of Mandate in 1994 became its first National Official with responsibility for Industrial Relations.

John is also a prominent member of the National Executive of the Irish Congress of Trade Unions. He was one of the main trade union leaders who fronted the campaign for an all out ban on smoking in enclosed workplaces in Ireland.

Thomas R. Frieden, MD, MPH

Thomas R. Frieden, MD, MPH, Commissioner of the New York City Department of Health and Mental Hygiene, was appointed by Mayor Michael R. Bloomberg in January 2002. The Department has a combined budget of $1.3 billion and a staff of 6,000 health professionals and allied employees.

Over the course of a distinguished 20-year career in public health, Dr. Frieden has worked as an epidemiologist, administrator, teacher, researcher, clinician, and community organizer. A considerable part of his public health career has been spent in New York. Dr. Frieden is dedicated to the mission of protecting and promoting the health of all New Yorkers. Foremost among his priorities is the strengthening of systems to accurately monitor each community's health status and provide information to enable the Department to work with communities to improve health status.

Dr. Frieden believes that certain public health problems require special attention. Because tobacco addiction is the leading cause of preventable illness and death in New York City, the Commissioner is a staunch advocate of expanded tobacco control activities. By reducing tobacco addiction, considerable progress will be made toward decreasing heart and lung diseases, cancer and other illnesses related to smoking.

Other basic health interventions high on Dr. Frieden's agenda include mental health care, prenatal care, cancer screening, and ensuring that more New Yorkers are treated effectively for hypertension and high cholesterol. With the HIV epidemic now more than 20 years old and with evidence of the increasing spread of the virus, Dr. Frieden views working closely with affected communities to develop more effective HIV prevention strategies as a top priority. He will also lead city efforts to address new and emerging disease threats, including those posed by biological terrorism.

He considers schools key partners in the prevention of tobacco use, HIV/AIDS, obesity, drug use, alcoholism, violence, and asthma. Dr. Frieden is also an advocate for high quality programs to serve persons with mental illness and those with developmental disabilities, and to free individuals from dependence on alcohol or other drugs.

A world-renowned expert in tuberculosis control, Dr. Frieden became Commissioner after working in India for five years assisting the government there in its efforts to control tuberculosis. As the Medical Officer for the World Health Organization on loan from the U.S. Centers for Disease Control and Prevention (CDC), he helped India develop one of the world's most effective tuberculosis control programs. With his assistance, the program has treated more than 3 million patients and has saved 600,000 lives.

Prior to his tenure in India, Dr. Frieden was instrumental in stopping the tuberculosis epidemic in New York City. He began his career at the New York City Department of Health in 1990 as a CDC Epidemiologic Intelligence Service (EIS) Officer working on a wide range of health issues. His success in documenting the spread of multidrug-resistant tuberculosis led to his appointment as Director of the Bureau of Tuberculosis Control and Assistant Commissioner. He served in this capacity from 1992-1996, during which time New York City cut cases of multidrug-resistant tuberculosis by 80%. The program Dr. Frieden built is still used to address tuberculosis in New York City and is considered an international model for tuberculosis control.

A graduate of Oberlin College, Dr. Frieden received degrees in Medicine and Public Health from Columbia University. He completed specialty training in Internal Medicine at Columbia and subspecialty training in Infectious Diseases at Yale University.

Combining a career of distinguished scholarship with public health action, Dr. Frieden is the author of more than 100 articles. The recipient of numerous awards, Dr. Frieden is fluent in English and Spanish and familiar with French and Hindi.

Nicola Holden, Senior Policy Analyst, Ministry of Health, New Zealand

Worked in both Occupational Health and Public Health over the past 10 years.

3 years working for Occupational Safety and Health - managing the occupational disease database and the medical panels which reviewed cases of asbestos related illness, chemical poisoning, solvent neurotoxicity and respiratory diseases.

Then moved with husband to London. Worked for the Health and Safety Executive on their Occupational Health Strategy between 1998 and 2001.

Returned to New Zealand in 2001 and has since been working in the Public Health Directorate of Ministry of Health. Part of the National Drug Policy Team, working predominantly on Tobacco Control. In particular has been involved in supporting the Smoke-free Environments Amendment Bill 2003 through the Health Select Committee and then through Parliament. Focus is now on implementing these changes as smoothly as possible for 10 December 2004.

Melodie Tilson

Melodie Tilson has twenty years of experience in public policy advocacy and policy analysis. For the past fourteen years, Melodie has focused on tobacco control, first as Director of Public Issues with the Heart and Stroke Foundation of Canada and subsequently as an independent consultant. Melodie provides strategic advice, conducts policy analyses, and develops and facilitates workshops for clients at the national, provincial, and local levels. Among Melodie's many clients are Health Canada, the Canadian Cancer Society, the Non-Smokers' Rights Association, and the Saskatchewan Coalition for Tobacco Reduction.

Melodie has researched and written a comprehensive guidebook on how to lobby for local laws banning smoking in public places and workplaces and a tobacco advocacy guide for youth called The Power of Many. Melodie has participated in numerous advocacy campaigns, playing a leadership role in successful campaigns for regulations to mandate world-precedent-setting tobacco package warnings; for federal legislation to prohibit tobacco sales to minors; for increases in federal tobacco taxes; and for the City of Ottawa's smoke-free bylaw.

Melodie lives in Ottawa, Ontario, Canada with her husband and three sons.

Janice Forsythe

Principal Consultant, Cypress Consulting

In 1992, Janice Forsythe became involved in tobacco control at an organizational level when she became the Executive Director of the Canadian Council for Tobacco Control. During her tenure at the Council, what she learned about the tobacco industry's tactics to hook youth on their products to ensure their future markets only served to increase her innate passion about the issue. From 1992-1997, she worked on key advocacy and public health promotion campaigns to help promote a smoke-free society across Canada.

In 1998, after having left the national Council, Janice opened her own home-based consulting business. Her main area of work is tobacco control, as well as general governance and administrative issues for non-governmental organizations.

Janice's knowledge is extensive on several different tobacco control issues. She has recently worked on projects related to youth and young adults, the tobacco industry's marketing tactics, smoking cessation, and secondhand smoke.

Janice chaired the Ottawa Council on Smoking and Health's Public Issues Committee, which led the fight for smoke-free public places and workplaces in Ottawa, Canada's capital city. This was a volunteer position from 2000-2001. Janice also researched and wrote four fact sheets on environmental tobacco smoke for the City of Ottawa's health department on a contract basis.

Anne Ludbrook, Senior Research Fellow, Health Economics Research Unit, University of Aberdeen

Anne is Programme Director of the Evaluation of Health Improvement Programme in HERU. She is a graduate of the University of York, with an MSc in Health Economics. Following an appointment as Economic Adviser at Grampian Health Board, she joined HERU in 1983. Since then she has been involved in a range of research activities, consultancy work for the NHS and the World Health Organisation, and advisory work for various health related organisation. Her current research interests relate to developing the evidence base for health improvement and recent work has included lifestyle issues, such as tobacco and alcohol, and wider policy issues, such as the impact of income support on health.

Stuart Ross

The holder of a law degree and a member of ICAS, Stuart took up his current position in 1989 and subsequently led the MBO in 1993 and the flotation of Belhaven in 1996. He has spent almost all his working life in the leisure sector and has held a variety of senior positions in the brewing industry and licensed trade in Scotland. He is currently Chairman of the Scottish Licensed Trade Association and is the immediate past-President of Scottish Beer and Pub Association. Today he is representing the Scottish Voluntary Charter Group and he is a member of Tom McCabe's Tobacco Action Plan working group.

Paul Ballard, Consultant in Health Promotion, NHS Tayside

Since joining NHS Scotland in 1980, Paul has held Health Promotion Director posts, in Sunderland and Cambridge, before returning to Scotland in 1993 to work with NHS Tayside. During 1997-1999 he worked on secondment to the Scottish Executive Health Department, providing specialist advice on all aspects of health promotion and health inequalities.

As Consultant in Health Promotion with NHS Tayside's Public Health Directorate, Paul plays a lead role in the strategic planning of health improvement. He also leads and directs the input of the Public Health Directorate, (including Specialist Health Promotion Service), in the joint health improvement agenda for NHS Tayside and the Community Planning Health Partnerships.

Paul is particularly committed to tackling health inequalities and this underpins his approach to smoking cessation and prevention. He played a leading role in drawing up NHS Tayside's Smoking Policy and is involved in a wide range of other multi-agency smoking prevention and cessation initiatives.

He represents the Scottish Health Promotion Managers Group on both the Scottish Ministerial Working Group in Tobacco Control and the Partnership Action on Tobacco and Health Group.

Originally natives of Edinburgh, Paul and his wife Morag now live in Carnoustie, (but neither play golf). They have a daughter, Emma, studying at Robert Gordon's University, Aberdeen.

ANNEX C

CONFERENCE EVALUATION

40 conference evaluation forms were returned. The following is an analysis of the responses.

1. How useful did you find the conference as a whole?

2. Do you feel that the aims of the conference were met?

3. Which presentation did you find most useful? Top three outlined below, based on votes for three presentations.

4. What further advice or assistance on the issues dealt with at the conference would you have benefited from? Flavour of responses provided below.

"Would have welcomed enhanced evidence from the hospitality sector."

"Further discussion on practicalities of a range of approaches for Scotland."

"Clarity on what evidence will be used by the Executive."

"Need for more data from Ireland on economic effects."

"The day had a biased debate. The Executive has already made up its mind."

"Guidance on introducing a ban, where smoking restrictions are already in place."

"Having the conference earlier in the consultation process."

"To see much greater clarity about the nature of the consultation."

"More on smoking cessation support."

"More time for questions."

"Plans for implementation in caring professions - or debate."

"A speaker who has suffered directly as a result of passive smoking."

"Comparative risks of ETS and other health risks."

5. Do you feel that you are going away from the conference having benefited from other countries' experiences?

6. From your perspective, what would you say are the key things from this conference that need to be considered in planning future action in Scotland on this issue?

"Strength of scientific evidence - for effects of passive smoking and lack of effect of ventilation"

"Clarity around the evidence; it works, now need to begin planning for implementation; inform the public"

"Continued and extended investment of other tobacco control initiatives, including cessation services"

"Need for continuing research and monitoring of data, before and after, if a ban is introduced"

"Not taking a softly, softly approach - all or nothing; not hanging about; focussing on workplace employees"

"Views of breweries/licensed trade - need to get them on board"

"Learning from other countries how a ban has worked"

"This is a health, not an economic issue"

"Implications for enforcement - need for SE to liaise with Health and Safety Executive and local authorities"

"Highlight the activities of the tobacco industry in trying to prevent change"

"Inconsistency by speakers"

"Need for clarity of definitions - workplaces or public places"

"Commerce - impact of ban on tourism and hospitality industry"

"Action to engage with people in deprived communities"

"Implementation to all workplaces, so that there is a level playing field"

"Research on dealing with mental health patients"

"Possible review of SHAW awards"

"The need for watertight legislation"

"Developing consultations to become a further part of Scottish devolution"

7. Please rate the conference organisation:

8. Delegates who responded were mainly from the central belt of Scotland.

9. Any other comments. A flavour below.

"We have to bring in a ban, but we must support the smoker."

"Need to tackle smoking in lower socio-economic groups more effectively."

"Well organised and stimulating. Well done."

"Start too early for commuting; programme too crowded, leading to overtiming."

"Need to publicise evidence more fully."

"No evidence provided by licensed trade speakers."

"We need the Executive to show real leadership on this matter."

"Conference not widely advertised. Members of the public should have been there"

"Confirmation of place had to be asked for. But very interesting and well organised day."

"Excellent conference - packed programme and powerful messages."

"Deputy Minister should have been at the conference all day; poorly chaired; did not run to time; too much replication of information/data"

"Some speakers spoke for too long. Perhaps trying to cram too much in."

"Excellent presentations and discussion."

"Good to have handouts for further use."

"Excellent day."

"Anti-ban speakers did not provide any evidence in support of their case."

"The balance of the agenda was iniquitous, given the polarised views."

"Should have been a two-day course."

"A lot of evidence on licensed trade, rather than public places in general"

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