There is no evidence to support claims that smokefree legislation results in greater exposure to secondhand smoke in the home.
To the contrary, international evidence suggests that smokefree laws result in less exposure in the home, because they encourage smokers to give up and increase the proportion of smokefree homes/homes with smoking restrictions:
· Smokefree laws have been shown to encourage smokers to quit.[1] When fewer adults smoke, children’s exposure to second-hand smoke is reduced.[2]
· In Australia, the proportion of family homes with smoking restrictions more than doubled from 25 per cent to 59 per cent after smokefree workplaces were introduced.
In households where one adult smoked, the proportion with smoking restrictions rose from 17 per cent to 53 per cent. Among those where all adults smoked, it increased from 2 per cent to 32 per cent.[3]
· In California, the proportion of children and adolescents living in smokefree homes increased from 38 per cent in 1992 to 82.2 per cent in 1999.[4]
· Data from Australia shows that current and former smokers who work in smokefree environments are more likely to have smokefree homes.[5]
Trends in the percentage of adults reporting workplace smoking restrictions, and of adult smokers who report that they always smoke outside the home, in the State of Victoria, Australia, 1988 to 2001 (smoking restriction data interpolated for 1996 and 2000).
The reduction in smoking at home that would arise from smokefree public places would also help people with asthma. Adults exposed to secondhand smoke at home are 5 times more likely to develop asthma. Our panel data shows that people with asthma who are exposed to secondhand smoke at home:
· Are significantly more likely to suffer asthma attacks (episodes of coughing, wheezing or shortness of breath)
· Use reliever medication more
Giving oral evidence to the Health Select Committee on 23rd February 2005, Health Secretary Dr John Reid said:
“I am saying as an observation (it was not the primary reason why we did it) it is also my view that there will be a displacement if you allowed no smoking in any public place whatsoever. In our case we have got 90% of pubs and restaurants which will be non-smoking, but there will be some areas. So if you allow none whatsoever there will be a displacement (as in Ireland) from people who previously went to the pub who will take drink home.” [6]
However, a parliamentary answer from Health Minister Melanie Johnson to a series of questions from David Taylor MP reveals that the Government has no evidence for this assertion:
Smoking
David Taylor: To ask the Secretary of State for Health
1) if he will list the organisations and individuals from whom representations on the displacement of smoking from public places to homes as a result of legislation restricting smoking in public places were received during the preparation of the Public Health White Paper;
(2) what research his Department has collated on the possible displacement of smoking from public places to homes, as a result of legislation restricting smoking in public places;
(3) what research he has commissioned on the possible displacement of smoking from public places and workplaces as a result of legislation restricting smoking in such places;
(4) what assessment has been made of the effect of exempting from restrictions on smoking in public places/pubs which do not serve prepared food would have on displacing smoking from public places to homes.
Miss Melanie Johnson: The proposals for legislation set out in the White Paper "Choosing Health—Making Healthy choices easier" to shift the balance in favour of smoke-free enclosed public places and workplaces were based on the scientific evidence of harm from second hand smoke and the views from the public. In preparation of the proposals, we took full account of the latest scientific and medical evidence of the risk to health from exposure to second hand smoke, as set out in the report from the Scientific Committee on Tobacco and Health, which was published alongside the White Paper.
Many of the studies covered look at the effects on non-smokers of living with smokers. We took full account of the views of the public, as expressed in over 150,000 responses to the public consultation on public health, in preparing our proposals. While protecting the right of the majority to go out for a meal or a drink without damage, inconvenience or pollution from second hand smoke, the proposals also provide a degree of choice for the minority. We believe that this is a sensible solution that balances the protection of the majority with the personal freedom of the minority in England.
We have made an assessment of the impact that smoking in public places would have in a reduction in smoking prevalence, which would thereby have a beneficial impact of reducing smoke at home. We will continue to act on the issue of second hand smoke in the home and have already taken action through the hard hitting campaign launched last year depicting the dangers of smoking around babies and children. [7]
The introduction of smokefree workplaces should of course go hand in hand with comprehensive health promotion campaigns involving advertising and education. An unpublished study has found that there was a statistically significant decrease in the percentage of smokers in Ireland allowing smoking in their homes following the implementation of smokefree legislation in March 2004.
In England too, health promotion campaigns have been linked to behaviour change in adults. In summer 2003, the Department of Health ran a high profile media campaign to raise the general public’s awareness of the health risks of smoking around children. The aim was to encourage any adults who currently smoke around children to change their behaviour. The campaign was backed up by widely distributed education materials promoted by healthcare professionals including midwives, health visitors and smoking cessation counsellors to new parents and families. Prior to the campaign 28% of respondents stated spontaneously that secondhand smoke was a risk to children’s health. After the campaign this rose to 50%, with 3% of smokers claiming they had given up as a result of the advertising, and 19% of smokers claiming that they had stopped smoking around children.
However, evidence from elsewhere shows that a one-off campaign such as this is unlikely to have a long term impact and needs to be part of an overall long term strategy for reducing smoking in front of children. The most effective way to increase the proportion of smokefree homes would be to introduce comprehensive legislation to enforce smokefree workplaces and enclosed public places, without the exemptions currently envisaged by the Government.
