PASSIVE smoking is even more harmful than previously thought, according to a series of studies released last week. Their publication coincided with the British government鈥檚 introduction of its watered-down and much-maligned Health Improvement Bill, which failed to commit to a complete ban on smoking in pubs, bars and restaurants in England.
The bill will see smoking banned in workplaces, including pubs and restaurants, in England by summer 2007, but not in private clubs and bars that don鈥檛 serve food. Northern Ireland, Scotland and Wales, by contrast, are planning to prohibit smoking in all public places.
鈥淭here is more and more evidence that there is a need for a ban,鈥� says Vivienne Nathanson, the British Medical Association鈥檚 head of science and ethics. It鈥檚 not just the 54 UK bar workers who die from the effects of second-hand smoke each year that we should bear in mind, she says. 鈥淭here鈥檚 a significant impact on a much larger group of people. It鈥檚 a lost opportunity.鈥�
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A study of adolescents in Massachusetts by Michael Siegel from Boston University School of Public Health and his colleagues found that those from towns with strict smoking regulations were only half as likely to become established smokers as those from towns with lax regulations. 鈥淭hey make a very reasonable case that total bans denormalise smoking as an adult behaviour,鈥� says Robert West, director of tobacco studies at Cancer Research UK.
Geoffrey Fong, a psychologist from the University of Waterloo in Ontario, Canada, and his team found that many of the arguments used against imposing a total ban were unfounded. They showed that compliance with the ban implemented in Ireland in March 2004 was high, support for it was also high, and that nearly half of smokers said it had made them more likely to quit.
One prominent critic of prohibition, UK secretary of state for defence John Reid, has argued that if people can鈥檛 smoke in pubs, they are more likely to smoke at home, and thus the impact on children will be greater. But West dismisses this view as 鈥渦tter rubbish鈥�. After the Ireland ban, fewer people were smoking at home, too, he says.
A surprising new finding is that second-hand smoke even has a detrimental effect on smokers. Using questionnaires to probe the respiratory health of nearly 10,000 members of the Hong Kong police force, including 4000 smokers, Lai-Ming Ho from the University of Hong Kong鈥檚 department of community medicine says his team 鈥渇ound very strong effects of passive smoking on the health of smokers. We found a dose-response effect, with respiratory symptoms such as cough, phlegm, wheezing and runny nose,鈥� he says. The studies appear in the journal Tobacco Control.
