Wednesday, February 15, 2006

Smoked out...

We now have a ban on smoking in all public places (including pubs, clubs and restaurants). And I disagree...

I'm not in favour of a blanket ban - I think it's illiberal. But, hey, when did this government do anything liberal. I recognise that bar staff being exposed to passive smoke is both unpleasant and dangerous. But I also believe that there should be venues where smokers can light-up.

So what are the alternatives?

LDYS (being semi-autonomous of the main Lib Dems) passed a policy to have 'smoking licences' like alcohol licences. To acquire a smoking licence, a venue would need to prove they had adequate ventilation. This would introduce more choice than a blanket ban but could penalise small venues. The venue would have to fill in an application for a smoking licence. Small venues have few staff and many struggle with increasing volumes of government legislation (The Culture Show discussed this problem with reference to to Punch & Judy operators and the end of the 'two in the bar' rule - a little known provision of the government's 24-hour licencing regime). Introducing smoking licences would only protect a very small number of bar staff whereas an alcohol licence is required because of the effects on a far larger number of people in the surrounding area. Smaller venues would probably end up being exclusively non-smoking - decent smoke extractors cost many thousands of pounds.

Someone suggested this morning on the LDYS forums that a solution may be to avoid proscriptive legislation entirely and incentivise providing adequate ventilation. But providing subsidised smoke extractors to any venues that wanted them would be incredibly expensive. An alternative may be to ease up existing legislation or give tax incentives to venues that provided adequate ventilation. They incentives could vary with venue size. This would protect bar staff, provide choice to patrons and prevent the burden falling disproportionately on smaller venues. Inspecting the venues could take place as part of ensuring compliance with existing legislation (e.g. during alcohol licence applications).



  • At 9:22 am , Blogger Jock Coats said...

    Bravo - I'm against this illiberal crap too! As a party we do, or at least used to, have policy to replace the national minimum wage which we say does not reflect regional variations in cost of living and so on, with negotiated industry based minimums in enforceable deals between trade associations and workers' representative bodies. We could, for example, use this to insist on paying a premium to people who are asked to work in smoking permitting places. Lots of people take jobs that have dangers, hidden and obvious, many do so because they pay better, though I suspect there are plenty of examples other than bar staff of people who get paid minimum wage yet take risks that make the job in reality worth more than other minimum wage jobs.

    Supposedly market research shows that 80% of people want to go out in a smoke free environment. This is a huge market incentive to provide such places yet the market has failed to do so in anything like those proportions. It seems to me to be a classic case of the industry deciding they don't want to be the first to innovate in case it doesn't pay off and waiting till their hands are tied by the state.

    Not a good thing for liberals to be involved in whatever the health arguments. Help the market, level the playing field in favour of the worker put at risk for no extra requard, but coersion? Illiberal and unnecessary.

  • At 9:24 am , Blogger Jock Coats said...

    Incidentally, anyone know what happens with hotel bedrooms?

    I've a mind to open a hotel with rent by the hour rooms and more settees than beds and have room service deliver booze...:)

  • At 10:56 am , Blogger Peter Black said...

    In Ireland hotel bedrooms are considered to be analogous with a home environment and so hotels are allowed to retain a percentage as smoking. On the ventilation issue the evidence given to the Welsh Assembly's Committee of enquiry on this was that it is ineffective in preventing passive smokers breathing in harmful particles. This should be evident by the fact that even in the most heavily ventilated bar you still leave smelling of smoke.

  • At 11:17 am , Blogger Femme de Resistance said...

    By ventilation I don't just mean opening a few windows (which was why I mentioned the expense). How about extractor fans? IIRC when this debate came up at the Oxford Union (attempting to make the bar the first non-smoking bar in Oxford) - certain extractor fans were suitable for removing particulates from smoking... but they cost £20,000 -50,000.

    Also - what about incentivising special smoking rooms (no separate bar/partitioned from the main area by a door)? This would be cheaper than extractor fans but would still be better than a blanket ban.

  • At 1:45 pm , Blogger Peter Black said...

    I was talking about extractor fans!! The only way you can create a safe environment with ventilation is to replicate an operating theatre environment - impossible in a pub or restaurant. Even the most expensive extractor fans do not remove carcinogenic particles and as I have said somewhere, they remove the smoke above your head so that it must pass over you on the way out. Special smoking rooms still have to be serviced by staff.

  • At 2:10 pm , Blogger Femme de Resistance said...

    I guess this is detail and it's something of a moot point - you could always incentivise smoke-free pubs. It seems odd that whilst 80% of the UK population (I think) are non-smokers, smoke-free pubs, etc. are few and far between.

    Bar staff-wise - bar staff who smoke are unlikely to object (in fact, may positively choose) to work in smoking pubs and once there was a choice of work places - smoking pubs may find it harder to recruit staff (raising wages). Or this could be dealt with as Jock suggests.

    I just feel that if you ban smoking in pubs because of the inherent danger of collecting glasses in a smoking room, then you also need to ban extreme sports because of the (far greater and more immediate) dangers that instructors place themselves under everyday.

  • At 5:38 pm , Blogger Peter Black said...

    I am not proposing banning smoking in pubs but in workplaces. And how do you incentivise a smoke-free pub? Who pays?

  • At 5:24 am , Blogger Femme de Resistance said...

    I am not proposing banning smoking in pubs but in workplaces.

    I guess I see smoking as intrinsic to the experience of an entertainment venue in a way it's not intrinsic to being, say, an accountant.

    This may be a reactionary way of looking at things born of people being able to smoke in pubs now. But I think sufficient people see it that way that it would be better to incentivise being smoke-free (and more liberal) than just banning it.

    If I viewed it as being incidental to the *purpose* of an evening out for smokers then, yes, you would be entirely justified.

    And how do you incentivise a smoke-free pub? Who pays?

    Well, Jock's suggestion for example. If the minimum wage is higher in smoking pubs then it's an incentive to make a pub non-smoking. Or how about reducing some taxes or legislation on venues/businesses if they become non-smoking?

  • At 5:38 am , Blogger Femme de Resistance said...

    I am not proposing banning smoking in pubs but in workplaces.

    No one is in disagreement here that smoking in pubs endangers workers and that it would be better for the staff (and non-smoking patrons) if pubs were non-smoking.

    There are two issues:

    a) Is smoking in pubs different to smoking in an accountant's office? I would argue that smoking in pubs is viewed as intrinsic to a chilled evening in a pub by smokers in a way that smoking is not intrinsic to being an accountant. This may be a reactionary way of looking at this due to seeing smokers in pubs so smokers = pubs... but I think sufficient people see it that way that it's worth making a non-compulsive changeover and encouraging the industry to come into line on its own (after all 80% of the population are non-smokers but finding a non-smoking pub is hard... which seems like a market failure to me).

    Leading onto:

    b) Is banning the most liberal way of dealing with this problem? To which I'd say the answer was 'no'.

    And how do you incentivise a smoke-free pub? Who pays?

    Well, Jock's suggestion for example. If the minimum wage is higher in smoking pubs then it's an incentive to make a pub non-smoking. Or how about reducing some taxes or legislation on venues/businesses if they become non-smoking?

  • At 1:29 pm , Blogger Peter Black said...

    Apologies for the length of this comment but I thought it was right to reply in full.

    The difference between us seems to be that I do not believe in applying the employment methods of a 19th century mill-owner to the 21st Century. This is not about the great liberals of the past but about how Liberalism operates in the present. Yes a lot of people do risky jobs but the whole point of employment law. health and safety, measures and good practice is to reduce the risk. A work-place smoking ban falls into that category. That is why it is a liberal measure because it has regards to the rights of those least able to resist harm.

    At the end of the day you cannot use market forces to either compensate for risk in this field or to mitigate against it. The market reacts completely different in the entertainment and hospitality industry than it does in a north sea oil field. In the latter you have a limited, highly skilled workforce, in the former you have a plentiful supply of largely unskilled people who can quickly be trained up. The only outcome of applying a risk-based minimum wage to bar staff will be to bankrupt businesses. If you expect them to do it voluntarily they will not because they will lose money. The other outcome is that many people who struggle to find other jobs will find that they have to choose between compromising their health or not working. That is not a liberal choice.

    Where smoke-free bars have set up they have struggled to compete because non-smokers have chosen to accompany their smoking friends, even though they would prefer to go elsewhere. That is why there is no level playing field. This legislation will enable all businesses to operate on an equal basis.

    The point is that this is about balance. I would not propose a total ban because that would outlaw a legal activity that can be carried out in a way that it does not cause a detriment to others. I do however support a workplace ban because I believe that the rights and health of workers who have no real alternative choice need to be protected. I am backing my convictions.

    Let us also be clear, this is not about the smell of cigarette smoke, it is about the very harmful carcinogens and toxins that cannot be removed from an atmosphere by ventilation. Do not think that just because the smell of smoke has been minmimised that it is now safe, it is not.

    As for the claims that there is no proven causal relationship between second hand smoke and ill-health/death, only the tobacco industry is saying this now. This is (a rather lengthy) extract from the report of the Welsh Assembly Committee set up to look at this issue:

    "The Health Risks of Environmental Tobacco Smoke (ETS)

    3.2 Most of the evidence cited to show that ETS is detrimental to health centred on six key documents. The authors of the documents have used evidence from numerous studies that have been peer reviewed and have carried out empirical analyses to show causal evidence of the health impacts. These five studies were produced over a period of six years and their findings each replicate those of the other reports.

    3.3 The 1997 report of the California Environmental Protection Agency concluded that there was sufficient weight of evidence of a causal relationship between ETS exposure and developmental problems in babies; sudden infant death syndrome; some respiratory illnesses; lung and nasal sinus cancer; and cardiovascular disease. The report also found suggestive evidence of a causal link with spontaneous abortion, cervical cancer and further respiratory related problems.

    3.4 In 1998 the Scientific Committee on Tobacco and Health (SCOTH) published a report commissioned by the four UK Health Departments. This concluded that ETS exposure:

    • is a cause of lung cancer and, in those with long term exposure, the increased risk is in the order of 20-30%;
    • is a cause of ischaemic heart diseases, and if current published estimates of magnitude of relative risk were validated, such exposure would represent a substantial public health hazard;
    • is a cause of serious respiratory illness and asthmatic attacks in infants and children when parents smoke in their presence;
    • is associated with sudden infant death syndrome, the main cause of post-neonatal death in the first year of life. The association is judged to be one of cause and effect;
    • is likely to be a causal association with middle ear disease in children, linked with parental smoking.

    3.5 SCOTH issued an update report on 16 November 2004 reviewing evidence since its report of 1998.5 It concluded that knowledge of the hazardous nature of second-hand smoke has consolidated over the previous five years, and that this evidence confirms that second-hand smoke is a serious public health risk.

    3.6 In 1999 the World Health Organisation published its conclusions following consultation on environmental tobacco smoke and child health. It found that:

    ETS is a real and substantial threat to child health, causing death and suffering throughout the world. ETS exposure causes a wide variety of adverse health effects in children, including lower respiratory tract infections such as pneumonia and bronchitis, coughing and wheezing, worsening of asthma, and middle ear disease. Children’s exposure to environmental tobacco smoke may also contribute to cardiovascular disease in adulthood and to neurobehavioural impairment.

    3.7 The report also concluded that maternal smoking during pregnancy is a major cause of sudden infant death syndrome (SIDS) and other well-documented health effects, including reduced birth weight and decreased lung function. In addition, the consultation noted that ETS exposure among non-smoking pregnant women can cause a decrease in birth weight and that infant exposure to ETS may contribute to the risk of SIDS.

    3.8 In his report for 2002 the Chief Medical Officer for England included a section on ETS.7 His introduction to the section stated:
    Exposure to other people's cigarette smoke (second-hand smoke, passive smoking, environmental tobacco smoke) can: increase the risk of contracting smoking related diseases such as cancer and heart disease; place extra stress on the heart and affect the body's ability to take in and use oxygen; trigger asthma attacks; increase the chances of sudden infant death syndrome (SIDS); and harm children and babies even more than adults.
    3.9 In 2002 the British Medical Association’s (BMA) Board of Science and Education published a report in collaboration with the Tobacco Control Resource Centre.8 The report summarised the scientific and medical knowledge on the nature and scale of the health effects of passive smoking:
    • in adults, second-hand smoke increases the risk of lung cancer by some 20-30 per cent and the risk of coronary heart disease by 25-35 per cent. In children, exposure to second-hand smoke increases the risk of lower respiratory tract illnesses, asthma, middle-ear infection and sudden infant death syndrome.
    • Certain population groups are particularly vulnerable: children, pregnant women, people with existing cardiovascular or cerebrovascular disease, and those with asthma and other respiratory disorders. Moreover, those in lower socioeconomic groups are at greater risk of exposure than those in better-off groups.
    • There is no safe level of exposure to tobacco smoke, and adverse effects can be seen at low levels of exposure.

    3.10 Ash Wales and the paper from the University of Aberdeen referred to the report of the International Agency for Research on Cancer, produced in 2002 and published in 2004 by the World Health Organisation, which reviewed links between passive smoking and cancer and concluded that tobacco smoke is carcinogenic to humans. This report presents international scientific concensus.

    3.11 The following studies are also significant.

    3.12 A study in Helena, Montana USA, looked at whether there was change in hospital admissions for myocardial infarction (heart attack) while a local law banning smoking in public and in workplaces was in effect.10 This found that during the six months in which the ban was in place the number of admissions of people from Helena fell significantly, while those admitted to the same hospital from outside Helena rose. When the ban was removed, the number of admissions from Helena increased. A commentary on the study suggested that although the study was small it focussed attention on a subset of literature on secondhand smoke and its consequences. The literature seems to indicate that relatively small exposures to toxins in tobacco smoke seem to cause unexpectedly large increases in the risk of acute cardiovascular disease.11

    3.13 The Scottish MONICA study showed the effects of non-smokers exposed to ETS mainly at work having a significant reduction in pulmonary function.

    3.14 A study showing that workers in premises permitting customer smoking reported a higher prevalence of respiratory and irritation symptoms than workers in smoke-free workplaces. Concentrations of salivary cotinine found in exposed workers in this study have been associated with substantial involuntary risks for cancer and heart disease.

    3.15 Professor David Cohen of the University of Glamorgan, has undertaken a study modelling the economic and health impact of a ban on smoking in public places. The model predicts:

    The estimated effect of eliminating exposure to environmental tobacco smoke (ETS) in public places in Wales is an annual reduction in deaths from lung cancer and coronary heart disease of 253 with a possible additional reduction in deaths from stroke and respiratory diseases of 153.

    There may be an additional annual reduction in deaths of between 60 and 180 if active smoking is reduced as a result of the smoking ban.

    3.16 The report of the Office of Tobacco Control, Ireland, on the first year of smoke-free workplaces says:
    • that in a study of pubs in Dublin where exposure levels in 24 pubs before and after the ban have been analysed, there has been a significant reduction in particulate levels – Ave PM10 by 53 per cent and Ave PM2.5 by 87.6 per cent;

    • a study of 81 bar workers before the introduction of the smoke-free law and a year later indicates a reduction in breath carbon monoxide levels. The results show that for the 56 workers whose tests have been completed and analysed there has been a 45 per cent reduction in non-smokers and a 36 per cent reduction in ex-smokers.15

    3.17 A study undertaken for Smokefree London, published in the British Medical Journal estimated deaths from passive smoking in the UK. It found that passive smoking at work was likely to be responsible for 617 deaths a year, including 54 in the hospitality industry. This would equate to one-fifth of all deaths from passive smoking in the general population aged between 20 and 64 years and up to half of such deaths of employees in the hospitality industry.16

    3.18 Of those organisations which gave evidence to the Committee, only FOREST,17 the Tobacco Manufacturers’ Association,18 and the National Association of Cigarette Machine Operators19 contended that there is no evidence that ETS could be significantly detrimental to the health of non-smokers.

    3.19 Four scientific studies were cited in support of this view. The Committee noted that three of these were produced in the early 1990s before much of the evidence of harm had been established. However, one longitudinal study which followed a large cohort was published in 2003 by the British Medical Journal.20 The cohort comprised over 188,000 adults who were followed from late 1959 until 1998, with particular focus on 35,500 who had never smoked but had spouses with smoking habits. The report concluded that:

    The results [of the study] do not support a causal relation between environmental tobacco smoke and tobacco related mortality, although they do not rule out a small effect. The association between exposure to environmental tobacco smoke and coronary heart disease and lung cancer may be considerably weaker than generally believed."

    Finally, on the issue of ventilation the Committee reported:

    "The British Medical Association (BMA) claimed that ventilation cannot protect against the health risk of passive smoking. They advised the Committee that ventilation does not remove the fine particulate matter that is breathed most deeply into the lungs and into the thorax and that filtered tobacco smoke has the same potential to ncause cancer in a cell system as unfiltered tobacco smoke. Their view was supported by, among others, the Chartered Institute of Environmental Health, the Public HealthAssociation Cymru and Ash Wales. Ash Wales and Professor Gerard Hastings contended that it would take an air flow comparable to a wind tunnel or tornado to be in any way effective."

  • At 1:30 pm , Blogger Joe Otten said...

    What would the practicalities be of providing breathing equipment - oxygen cylinders - to bar staff? Perhaps just supplying the nose and not the mouth so that they could still speak and be heard.

  • At 1:52 pm , Blogger Peter Black said...

    Sorry to abuse your comments in this way. I have now posted my very lengthy comment as an entry on my own blog.

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