Wednesday, 21 September 2011

How could a smoking ban review be acceptable to smokers and non-smokers?


A while ago the Freedom to Choose blog posted a 'loneliness' trilogy that reported on the experiences of smokers - especially elderly smokers - following the ban in public buildings. As one elderly woman concluded:

"I am now on anti depressants and wish that I had the courage to kill myself and join my dear husband.

Thank you politicians for making my life not worth living after working from age 14 until 68. I am now 74 and have lost my soul and will to live in this lonely place.”

While the ban has made pubs, restaurants and such like more pleasant places for us non-smokers, it has made for a lonely life for many smokers and especially women. So, when the Joseph Rowntree Trust began its examination of loneliness - partly in Denholme, a village up the hill from Cullingworth - I sent them the material from Freedom-to-choose and others about the negative impact of the smoking ban on loneliness and, indeed, on the mental health of elderly smokers.

So what should we do? Going back to few restrictions on smoking wouldn't be acceptable and would represent an imposition on non-smokers - including those who have conditions such as asthma that are exacerbated by passive smoking. But equally we need to allow a space for those who smoke within our public places - treating smokers as lepers is perhaps as damaging to health as the smoking itself. Depression and loneliness are big problems among the elderly contributing significantly to ill-health.

Loneliness is bad for your health. Researchers rate loneliness as a higher risk than lifelong smoking. Researchers also link lack of social interaction with the onset of degenerative diseases such as Alzheimer’s: an illness which costs us an estimated £20 billion a year and has an even higher human cost. One study reported a doubled risk of Alzheimer’s disease in lonely people compared with those who were not lonely.

It has been shown that loneliness makes it harder to regulate behaviour, rendering people more likely to drink excessively, have unhealthier diets or take less exercise. There is also evidence that loneliness adversely affects the immune and cardio-vascular systems.

So the efforts to reduce smoking - well-meant as they are - contribute to increases in something that is a higher risk - loneliness. We really cannot continue with the current 'denormalisation' approach - quite literally, it is killing people. So what could we do?

  • Promote and support the use of e-cigarettes - these are perhaps the most effective harm reduction system for smokers since they mimic the act and deliver only nicotine to the smoker rather than a cocktail of carcinogens from the burning tobacco. And e-cigarettes have no sidestream passive smoking risks - the 'smoke' we see is just water vapour
  • Allow premises above a certain size to have a separate, well-ventilated room for use by smokers - by using negative pressure and modern extraction technology (of the kind used to prevent odours and gases escaping from industrial processes) the negative impact for non-smokers can be more-or-less eliminated
  • Permit - perhaps on a trial basis - smaller premises to have times when smoking is permitted. This doesn't deal with the lingering smell but it avoids the sidestream/passive smoking risks

I'd welcome other suggestions as it must be within the wit of man to design a society that tolerates smoking (while being clear about its health risks) - the situation at present is both unfair and dangerous.



Pat Nurse MA said...

Simply choice of smoking or non-smoking venue would suffice. You must accept that some of us are cultural, lifelong smokers - in my own case I am a third generation smoker from childhood aged 8 to middle age. I can assure will never quit no matter what the Govt does to me.

I have contributed to society, I have paid taxes on my product for 44 years,I have never harmed anyone nor have I ever harmed my children - three are non-smokers. All are healthy. I have never had treatment for this so-called "Smoking related illness".

I was against the blanket ban not because I wanted "to smoke where ever I like" - or that I was against having places for those who don't like or fear smoke - but that it gave the wrong message to those with smokerphobia - which is like any other fear such as homophobia and based on a paranoid fear of people's lifestyle.

If you look at the passive smoking studies, you will find that only some 10% show that SHS has an irritant effect to a minority. None show that death is caused to others by SHS. To say it does is just a lie. The evidence does not support it.

I have not been out socially since 2007 unless I absolutely must like a family event.

Choice, and accepting that whether the Govt likes it or not people will smoke and they should not be discriminated against or bullied because they do, is the fairest and morally right way to approach this issue.

Funding one main competitor that supplies nicotine to the consumer - Big Pharma - over another - Big Tobacco - somehow feels very corrupt and wrong.

The fact that Govts plan to steal legal tobacco companies' own trademarks to be replaced with Big Pharma supported Tobacco Control graphic image trademark would be criminal if directed at any other legal business.

Anonymous said...

There is little doubt that Health Acts 2005/2006 have serious drawbacks, there is as you suggest a great deal of room for compromise between the smoking/non smoking communities. The contribution to the loss of venues where not only our senior citizens but every other adult social groups congregate is well documented, and should be of serious concern to our representatives in Parliament.

One solution I feel would be venues run and staffed by smokers for smokers. There is more than enough information regarding the alleged risks of smoking to ensure that any person smoker or non smoker can excercise free choice as to which type of venue they wish to patronise.

This would leave free the majority of venues for families and those who wish to spend their leisure time in smoke free environments while allowing smoking and non smoking adults who choose a smoking environment to socialise with their peers.

Given that at least one fifth of the country's adults smoke it is reasonable that one in five venues could be smoking and that rural areas like villages should have at least one smoking venue.

While this will not fully solve the problems that loneliness bring it will in part relieve them, by giving preference to smoking staff and being run by smokers themselves would not put non smoking staff at alleged risk unless by their own informed choice.

The Health Acts were originally enabled to protect staff, not make them unemployed. By employing smoking staff in smoking venues they are not at any greater alleged risk than they already are.

John Watson

Anonymous said...

I am a lady of 62 and have not been out to socialise since June 30th 2007.

In my younger days I was told that only 'ladies of the night' and 'loose women' stood around on the street smoking and it is hard to dispel these ingrained ideas.

I do not want to stand outside a pub, club etc. and feel embarrassed and 'on display'. It cannot be safe to be standing outside on a dark night or healthy to be standing out in freezing cold and rainy weather.

I certainly do not want to take my drink out on the street nor would I want to leave it inside.

Surely the politicians can see what they are doing to the health and well being of older smokers.

I am now indoors every evening and have had no social contact outside my home for over 4 years.

Anonymous said...

"So what should we do? Going back to few restrictions on smoking wouldn't be acceptable and would represent an imposition on non-smokers -"

The whole question is beginning to look a little academic.

"Based on the evidence, "there is no level of alcohol consumption for which cancer risk is null."

"On the whole, alcohol is considered an avoidable risk factor for cancer incidence and, more generally, for the global burden of disease,"


"However, internationally, the term is also used to encompass efforts challenging notions that smoking ought to be regarded as routine or normal, particularly in public settings.

Hammond et al state that “social denormalisation” strategies seek “to change the broad social norms around using tobacco—to push tobacco use out of the charmed circle of normal, desirable practice to being an abnormal practice”.

Which appears to be what the smoking ban was really all about, a social denormalisation strategy.

Last time they started with alcohol but we know how that turned out.

“Dr Vivienne Nathanson, head of science and ethics for the British Medical Association, said: “We have to start de-normalising alcohol – it is not like other types of food and drink.”

Public 'must be protected from passive drinking'

WHO gets nod to tackle harmful use of alcohol

"The blueprint, to be presented in two years, should include a set of recommended national measures for states. These could cover guidance on the marketing, pricing, and distribution of alcoholic drinks and public awareness campaigns.

In 2003, WHO clinched the first global public health treaty which targeted tobacco through stronger warnings on cigarette packages and limits on advertising and sponsorship"

Rate alcohol and tobacco like illegal drugs, says top scientist

"Professor Horn told the Government's drug advisors in London that many people believe alcohol is more harmful than heroin or cocaine.
He told the Advisory Council on the Misuse of Drugs: 'It's been recognised that [alcohol] is the most harmful recreational drug you could use. The risks are very similar to illegal substances."

Doctors urge total ban on alcohol adverts

"She added: "Over the centuries, alcohol has become established as the country's favourite drug."

"Given adolescents often dislike the taste of alcohol, new products like alcopops and toffee vodka are developed and promoted as they have greater appeal to youmg people.

"All these promotional activities serve to normalise alcohol as an essential part of everyday life."

As someone who doesn't drink, I have no fears that someone breathing alcohol on me will kill me.
But you can easily see how these things start.


Mr A said...

At the end of the day the things that annoy me about the smoking ban are 1) The deliberate denormalisation of millions of people by the State, at the behest of a heavily-funded few; 2) The bastardisation of science to promote their goals and 3) The removal of private property rights so that the owner of a property cannot decide on whether to allow a legal activity to occur there.

As such, while "minimum size" policies etc would undoubtedly make things a lot better than they are now, I just can't accept anything that doesn't restore the rights of the owner of the property, which means repealing it completely and relying on market forces to help property owners decide whether it is in their best interest or not to allow smoking there.

That said, there is a good argument for making good ventilation a legal requirement, so that by default those places that are not willing to make the outlay would of course be non-smoking (as well as those venues that choose to remain non-smoking, of course).

There is even, taking a leaf from the nudge philosophy, perhaps a case for licensing, so that non-smoking venues are "encouraged" but not compelled (it would be very important that such a license be reasonable, however). That way, from a mercenary Government perspective, they can even make money out of such a policy rather than watching 15% of an industry disappear in 4 years and pay the dole to 100,000 ex hospitality workers.

However, anything less than a total repeal is just ignoring the root problem - the non-evidence-based dictats of a tiny minority against the wishes of the market. Smoking isn't the issue - it's social engineering and unchallenged denormalisation. As such, the whole ban has to go.

Anonymous said...

Anon 19:28

"It cannot be safe to be standing outside on a dark night or healthy to be standing out in freezing cold and rainy weather."

I so agree and living in West Yorkshire, I have not forgotten those terrifying years.

"Day or night, they were scared to walk alone - hardly surprising when the formal advice from police was: "Do not go out at night unless absolutely necessary and only if accompanied by a man you know."

And yet for the purposes of denormalisation we were being set up as sitting ducks and those of evil intent would know that from July 1st 2007, at all times of the day or night there would be women alone, forced outside by the law.

"The controversial "zero tolerance" plans are part of a new Bill, which will make all hospitals smoke-free by the end of 2006. In London, the deadline will be a year earlier, health officials announced last week.

Patients too frail to endure low temperatures outside will be offered "nicotine replacement therapy" in the form of gum and patches.

Other measures will include putting up "older person" signs around hospitals for patients crossing busy roads to smoke.

"A nurse was stabbed to death yesterday in a frenzied attack after leaving her hospital for a cigarette break."

"St George's Hospital, run by Havering Primary Care Trust, recently introduced a strict no-smoking policy anywhere in its precincts."

24. "No exemptions are justified on the basis of health or law arguments"

The Government takes more notice of scare stories than of evidence, a Lords committee has said

"The report said: “It may be that the unstated objective of policy is to encourage a reduction in active smoking by indirect means. This may well be a desirable policy objective, but if it is the objective it should have been clearly stated.”

Perhaps they thought that fear would make us comply.


George Speller said...

Your support is welcome, but your knowledge of science is woeful. There is no scientific basis for the smoking ban - no "study" has ever shown significant "sidestream/passive smoking risks" - some show a benefit - in all cases results are so small as to be statistically irrelevant. As for "third hand smoke" at which you hint in the term "lingering smell" - the "science" was so poor the "facts" were established by a telephone poll. There is no need for "negative pressure and modern extraction technology " - all that's needed is a sensible level of ventilation now so sadly absent in non-smoking pubs that they are untenable by anyone with a sensitive nose.
The solution is, of course, to allow the owner of a private property (a pub) to decide whether smoking is allowed or not. That way an appropriate compromise could be reached. Unfortunately the smokerphobe know that, despite their claims that everybody loves the ban (including smokers) they secretky fear that most pubs would revert to pro-smoking or at least to some degree of choice, offering non-smoking rooms for those that prefer them. It is, of course, perfectly legal for the owner to hire only smokers to work in such places.

Curmudgeon said...

"While the ban has made pubs, restaurants and such like more pleasant places for us non-smokers"

In a narrow sense, maybe, but in a wider sense many of them have closed, so you can't go there at all, and it has been widely observed that much of the craic and sense of companionship has gone from local pubs.

david said...

'the ban has made pubs, restaurants and such like more pleasant places for us non-smokers'

The same argument could be applied to uncrowded trains and buses. Who would prefer not to be forced to sit next to a stranger, particularly one that makes the atmosphere less 'pleasant'? The difference is, of course, that underused trains and buses are often subsidised at the expense of the authorities and/or more utilised services, whereas pubs are not. That's precisely why 1000s have closed since they have become more 'pleasant*'

*at least according to some, but not to the majority it would seem.

Anonymous said...

The problem with having some pubs smoking and some not (by law and not choice that is), is you are screwing around with the competitiveness of the pubs.

I used to have 5 pubs in my area before the ban, I now have 2 pubs, and they have seen sever cuts in trade.

If 1 of them could allow smokers, the other one may as well close. Whilst this would not be true universally, there are enough instances where this would happen and demonstrate it as unfair.

And the same applies to requiring strict levels of ventilation control in a smoking room, this is not a cheap option, again causing unfair price competition.

Simply let pubs have smoking rooms, and ensure they are properly closed of or separated from the rest, and not by the traditional line on a floor.

Keep it simple, keep it fair.

The whole point of this is that you are accepting a policy were you accept people will be doing something *by choice* that is not good for them.

Start talking about "controlled levels of strict ventilation" etc. and you may as well not bother, because you are not accepting the basic principle of what the change is about, freedom.