Select Committee on Health First Report

3  Dealing with the health effects of secondhand smoke

25. Two main ways of dealing with the health effects of secondhand smoke have been suggested: better ventilation and restrictions on smoking in public places.

The effects of ventilation

26. While recognising the health effects of exposure to SHS, representatives of the licensed trade argued that ventilation of licensed premises is a better and less prescriptive alternative to a prohibition on smoking in public places and workplaces. They have further argued that ventilation is a solution which other countries in the European Union have found satisfactory. Mr Nick Bish, Chief Executive of the Association of Licensed Multiple Retailers (ALMR), a trade association for companies operating licensed retail business with pubs, bars, restaurants and clubs, told us:

Mr Bish went on to concede that ventilation was no longer (as the hospitality industry had perhaps previously thought) the whole answer to the problem, and that smoking cessation had now become a major plank of Government policy. Nonetheless, he maintained that ventilation could provide both comfort and safety for workers in the hospitality industry: "There is a solution there. If we want to do it, there is a way. The ventilation industry can do it… That is just science. It works."[25]

27. One of the chief scientific exponents of the efficacy of ventilation in licensed premises has been Dr Andrew Geens, a Senior Lecturer at the University of Glamorgan's School of Technology Division of Built and Natural Environment.[26] In 2002, Dr Geens conducted a study of the ventilation system of the Airport Hotel, Manchester, measuring the carbon monoxide (CO), carbon dioxide (CO2) and particulate levels on four consecutive days (Monday to Thursday) in December. The ventilation system was switched on during the second and fourth days and switched off during the first and third days. Dr Geens found that the CO2 and CO levels were lower and rose less during the day on those days on which the ventilation system was operating, with CO levels reaching a maximum of 2-4 ppm when the ventilation was on compared to 10-14 ppm when it was switched off.

28. A further article by Dr Geens, co-authored by Dr Max Graham, also of the University of Glamorgan, appeared in the Building Services Journal of March 2005. This study focused on the Baker's Arms, a village pub in the Home Counties, in which particulate levels were measured over a period of time in October 2004. It concluded that "ventilation is effective in controlling the level of contamination", though it conceded that "ventilation can only dilute or partially displace contaminants and occupational exposure limits are based on the 'as low as reasonably practicable' principle".[27]

29. In contrast, the efficacy of ventilation is widely rejected by medical experts. Professor Dame Carol Black, President of the Royal College of Physicians, told the Committee that "The only thing you do by improving ventilation, however good your ventilation system is, is you make the air smell rather better, you just circulate the air around, you do nothing to take away the carcinogens in that environment".[28] Mr Bill Callaghan, the Chairman of the Health and Safety Commission (HSC), reinforced this view: "The evidence is that although ventilation can remove the smell, it cannot tackle the issue of removing the carcinogens."[29] This opinion was also shared by Mr Shaun Woodward MP, Under-Secretary of State for Northern Ireland. Announcing plans for a comprehensive ban on smoking in enclosed public places for Northern Ireland, he stated "Ventilation doesn't work".[30]

30. A study of nicotine levels and particulate levels in licensed premises was conducted in Manchester in 2005. Dr Edwards described a study in a public house in Cannock, Staffordshire, which had "state of the art filtration equipment".[31] The effect of this equipment, according to Dr Edwards, was unimpressive. When the system was switched off, the levels of PM2.5 (a particulate frequently monitored in such experiments) were between 800 and 900, which is approximately 16 or 18 times higher than those on a very busy road. The filtration equipment reduced levels to 500 or 600.

    You can say, yes, there is a reduction, maybe 30 per cent, 40 per cent, whatever the figure is, but a reduction to still a very high level is meaningless, and there is no evidence that ventilation reduces the level of carcinogens and the level of toxic components in secondhand smoke to levels which would protect health […] [the hospitality and tobacco industries] make no claim about health effects. None of them has ever done that, and that is because they cannot.[32]

31. Dr Edwards was particularly critical of Dr Geens's work. He questioned Dr Geens's methodology and presentation, pointing to the fact that the monitoring did not include evenings, when, he supposed, levels of SHS would be at their highest, and that Dr Geens presented percentage reductions, which, Dr Edwards alleged, were "meaningless" if they were simply "reducing from a very, very high level to a very high level".[33]

32. It has also been argued that proprietors and licensees would be reluctant to invest in expensive ventilation systems if, as the Government has strongly hinted, a comprehensive ban on smoking is only a few years away. Mr Woodward pointed out that this would be "a pretty unfair burden" to put on businesses.[34]

33. We are not convinced that ventilation offers a practical means of reducing SHS to safe levels. The scientific evidence is clear that there is no safe level of SHS. The expert evidence we have heard suggests that at best ventilation can only dilute or partially displace contaminates. Ventilation offers cosmetic improvements but does not represent a sufficient response to the health and safety risks inherent in SHS.

Restrictions on smoking

34. Given the wide acceptance of the scientific evidence that SHS is harmful to the health of non-smokers and that ventilation is not an adequate solution to the problem, governments in many parts of the world have introduced restrictions and controls on smoking in public places and workplaces. Comprehensive smoke-free legislation, whereby smoking is prohibited in almost all public places and workplaces (with very limited exceptions), has now been introduced in Ireland, Norway, New Zealand, Australia, Italy and South Africa, as well as several states of the USA including New York, California and Delaware. Norway implemented its comprehensive ban on smoking in public after a partial ban was found to be unworkable.[35]Table 1: Smoke-free legislation around the world
Country or state Extent of smoking ban Date of introduction
California, USAAll workplaces January 1998
South AfricaAll public places and workplaces (ventilated rooms allowed) October 2000
Delaware, USAAll public buildings including workplaces November 2002
ThailandAll air-conditioned buildings November 2002
Florida, USAAll workplaces except stand-alone bars July 2003
IrelandAll enclosed public places and workplaces March 2004
Connecticut, USABars, restaurants and workplaces with more than 5 employees April 2004
IndiaAll public places; smoking areas required in bars and restaurants May 2004
NorwayBars, restaurants and clubs June 2004
New ZealandAll enclosed public places and workplaces December 2004
ItalyAll public places; ventilated smoking areas allowed January 2005
VietnamAll public places January 2005
AustraliaAll enclosed public places and workplaces Various (state-by-state legislation)

Data from

35. A comprehensive ban on smoking in public places will be introduced in Scotland on 26 March 2006. A similar smoke-free policy has been announced for Northern Ireland (although, because of the current suspension of the Northern Ireland Assembly, it will have to be enacted by Parliament); this is due to be implemented in April 2007. The decision in principle to ban smoking in public places has also been taken by the National Assembly for Wales.

36. Commonly, the most contentious part of a smoke-free policy has been banning smoking where it is most prevalent—in the hospitality sector, and particularly in bars and pubs. Some countries have introduced concessions in this area; for example, the law in Italy provides for separate smoking areas with illuminated signs, automatic doors and an approved ventilation system. However, because of practical difficulties in creating such an environment in many premises, it is estimated that 97% of outlets in Italy have in fact introduced a complete ban on smoking.[36] Similarly, in New York state provision was made for registered "cigar bars": these are required to have been in operation since before 31 December 2001 (thereby preventing new establishments from opening in the wake of the smoking ban); they must derive at least 10% of their gross annual sales from tobacco products; and the sale of food must be incidental to the sale of alcoholic beverages and account for no more than 40% of the gross annual sales.[37]

37. Another feature of smoke-free legislation has been the issue of exemptions for certain categories of workplace, mainly those which are also in some way a person's dwelling place. Prisons, psychiatric institutions and residential care homes have fallen into this category. The residents of these institutions have a higher prevalence of smoking than the general population, and may face physical, mental and emotional difficulties in being prevented from smoking. We discuss this further in Chapter 6.

38. Comprehensive smoking bans have generally proved effective and popular with the public once they have been implemented. In the Republic of Ireland, studies have shown that levels of exposure to SHS among workers have been significantly reduced. The evidence from Ireland also suggests that levels of support increase as time goes by after the introduction of a ban. A survey one year after the ban came into force showed that 93% of respondents (including 80% of smokers) thought that it was a good idea, and 96% thought it had been a success. The introduction of the comprehensive smoking ban was also voted the 'high' of 2004 in a national poll by RTÉ (Radio Telefís Éireann, Ireland's public service broadcaster).[38]

39. Recent surveys carried out by the Office of National Statistics (ONS) suggested that 80% of the population in England supported a ban on smoking in workplaces, including restaurants, although less than 50% supported a complete ban on smoking in pubs and bars. However, the situation is changing rapidly. Ms Deborah Arnott, Director of ASH, told the Committee that in July 2005 UK respondents, when asked the same question as used in Ireland prior to the introduction of the comprehensive smoking ban there, showed higher levels of support in the UK (73%) than had existed in the Republic of Ireland before the smoking ban was introduced there (67%).[39]

40. The only solution to the problem of SHS exposure is to prohibit smoking in public places and workplaces, including licensed premises. This approach has found increasing favour with governments around the world, and public opinion in the UK is moving very quickly in its favour. Moreover, the experience of the Republic of Ireland shows that smoke-free legislation becomes even more popular once it has been introduced.

24   Q 316; for the view of the Gallaher Group, see Q 158. Back

25   Q 318 Back

26   Ev 19, Volume II. Back

27   Andrew Geens and Max Graham, No ifs or butts, Building Services Journal, March 2005. Back

28   Q 73 [Dame Carol Black] Back

29   Q 418 Back

30   Smoking ban in all public places and workplaces, 17 October 2005, The Federal Occupational Safety and Health Administration (OSHA) in the US and the American Conference of Government Industrial Hygienists (ASGIH) have concluded that even proposed new technologies, such as displacement ventilation systems, which may reduce secondhand smoke exposure levels by 90% still leave exposure levels which are 1,500 to 2,500 times the acceptable risk level for hazardous air pollutants (see HC Deb, 14 December 2005, col 2104W). Back

31   Q 73 [Dr Edwards] Back

32   ibid. Back

33   Qq 73 [Dr Edwards], 75, 83 [Dr Edwards]; for Dr Geens' response, see Ev 89, Volume III. Back

34   Q 510 Back

35   Q 454 Back

36   Smoking ban forced on Italy's cafes, 10 January 2005, Back

37   Cigar friendly New York, 21 April 2003, Back

38   Marie Killeen, Acting Director of Communications, Office of Tobacco Control, meeting with the Committee. Back

39   Q 429 and see Annex 2. Back

previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2005
Prepared 19 December 2005