Dani Garavelli: Five years on, just what has the smoking ban really achieved and are we seeing a backlash?

Published on Friday 11 March 2011 17:41

WHEN the idea of a smoking ban in public places was first mooted in Scotland there were apocalyptic warnings from the tobacco industry: it was claimed the move - an assault on personal freedom - would lead to widespread civil unrest. Not only would the legislation be unworkable, there would be no reduction in the number of smokers. Instead, many people would choose stay at home puffing away under their children's noses.

Litter would mount up outside offices, pubs would close and there would be a rise in the level of domestic violence.

Yet despite all the scaremongering, when the Smoking, Health and Social Care (Scotland) Act finally came into force five years ago in March 2006, there was little in the way of fall-out. Not for Scotland the high-profile martyrs later seen in England - such as Hamish Howitt, of the Happy Scots Bar in Blackpool, whose determination to defy the law forced him out of business. A virtual political consensus north of the Border, combined with a commitment to enforcement, meant that - from the very beginning - there was a 97 per cent compliance rate.

Now, only five years after the ban was introduced, the extraordinary thing is that it is not regarded as out of the ordinary - in fact it is pretty much taken for granted. Scotland's example has been followed across Europe, with even hard-smoking countries such as Italy falling into line.

Indeed it is, for most of us, so difficult to remember what it was like to come home with our hair and clothes stinking of smoke, that it comes as a shock when we stumble across smoking in public places abroad.

Kate Moss may have been in tune with a growing Gallic rebellion when she strutted up a Parisian catwalk, cigarette held to her lips on national No Smoking Day last week. In France, a failure to enforce penalties has led to a widespread flouting of the rules, with people frequently lighting up at work, in the Metro and in bars. But in Scotland, the majority of people not only abide by the law, but appear to endorse it.

With a succession of reports showing that the population is already reaping health benefits, polls carried out by YouGov suggest that around 66 per cent of us now approve of the law. Consequently, campaign groups such as smokers rights lobby group Forest's Save Our Pubs and Clubs, which is active in England - have failed to get a foothold north of the Border.

It's not all good news, though.According to one report, pub closures - already increasing before the smoking ban came into force - have accelerated since, damaging the social fabric of some communities.

And the hard fact is that while there was a brief surge in the number of people buying over-the-counter nicotine replacement therapies and contacting smoking cessation services in the months immediately after the ban was introduced, the numbers of people actually smoking has barely changed - almost 25 per cent of adults in Scotland still smoke, with the figure rising as high as 40 per cent in areas of severe deprivation.

At the same time, with health campaigners now pushing for the ban to be extended further, it is feared a joint conference between anti-smoking and anti-drinking groups in Scotland later this week could cause a French-style backlash amongst those who suspect the smoking ban was merely the launching pad for an attack on all lifestyle choices the government disapproves of.

So - five years on - how much impact has the ban on smoking in public places really had on our long-term health and our attitudes to smoking? Has there really been a fundamental change in our lifestyle as a result? Or is more legislation needed to help make Scotland a smoke-free zone?

Far from being the product of a modern, sanitised society, smoking bans go back more than 400 years. In 1575, the Mexican ecclesiastical council prohibited the use of tobacco in any church in Mexico and in Spanish colonies in the Caribbean. Popes Urban VII and VIII also banned smoking, with Pope Urban VII threatening to excommunicate anyone who "took tobacco in the porchway of, or inside, a church, whether it be by chewing it, smoking it with a pipe or sniffing it in powdered form through the nose". It was, however, the Nazi Party which imposed the first modern, nationwide tobacco ban, prohibiting it in every German university, post office and military hospital,

In the early 2000s - as awareness of the dangers of passive smoking grew - the issue raised its head again. New York extended its anti-smoking laws to include all restaurants and bars, including those in private clubs in 2003, and the following year, Ireland became the first country in the world to introduce a complete workplace ban.

Since Scotland followed suit, researchers have carried out a series of studies, most of which have pointed to significant health benefits for non-smokers. Scientists at the University of Dundee found significant improvements in bar workers' lung function as a result of the smoking ban, with the benefits particularly pronounced for bar workers with asthma.

One investigation co-ordinated by NHS Scotland found a 39 per cent reduction in second-hand smoke exposure in 11-year-olds and in adult non-smokers, while a study of nine hospitals showed a 17 per cent reduction in the number of heart attack admissions.

"This was a particularly robust piece of research and it makes sense because even 30 minutes in a smoky room creates harmful changes in the lining of blood vessels and so forth and makes you more vulnerable to heart attacks," says Sheila Duffy, the chief executive of anti-smoking organisation Ash Scotland. According to a Glasgow University report, the number of young people admitted to hospital with asthma has fallen by around 18 per cent a year since 2006, compared with a 5 per cent rise in the year before the ban, suggesting publicity around the new legislation has led people to think twice about lighting up in front of their own children.

"I'd say the ban really helped to make smoking look like a less normal thing to do. In some of the poorest communities in Scotland, smoking rates are similar to what they were in the Seventies in Scotland as a whole," says Duffy. "For the first time in some of those communities, smoke-free public places created an experience of not seeing everyone smoking all the time, so I think it's been really valuable for that as a secondary benefit."

On the other hand, fears about the decline of pubs may have been well-founded. A report commissioned by Save Our Pubs and Clubs that Scotland lost 700 pubs between 2006 and 2010, and that the rate of loss in Scotland, Wales and England sped up by almost exactly the same amount in the year after they introduced their respective bans.

"There is still a great deal of anger in some quarters," says Simon Clark, director of Forest and the Save Our Pubs and Clubs campaign. "It is certainly true that the majority of smokers have adapted to the ban, but it's one thing to have a high compliance rate, and quite another to claim it's hugely popular. The reason for the high compliance rate is that the penalties for flouting the ban are quite severe, not so much if you're a smoker, but if you're a landlord who turns a blind eye to smoking. Not only can you be fined several thousands of pounds, but you could potentially lose your licence."

Clark accepts that, having got used to smoke-free pubs and bars, non-smokers are unlikely to support a change in the law, but he wants to see it reviewed. "What we want is a small amendment that would allow those pubs and clubs that have the capability of offering a separate well-ventilated smoking room," he says. "You would keep the smokers well away from the non-smokers, so they would never need to be exposed. The bar staff wouldn't have to go in for at least an hour afterwards." Clark says most European countries allow such rooms, but Ash Scotland thinks the suggestion is laughable. "We say what we've always said. A no-smoking zone in a pub is like a no-urinating zone in a swimming pool. Smoke will always drift through," says Duffy.

Far from seeking a compromise, anti-smoking groups in Scotland and the rest of the UK are gearing up for the next battle.

Spurred on by the likes of Moss (and Lily Allen and Lady Gaga, who have also flaunted their cigarettes as a badge of rebellion), they claim there is still a lot of work to be done, particularly in areas of deprivation and amongst young girls who buy into the 'smoking keeps you thin' myth.

Last week, as England followed Scotland's lead in forcing shopkeepers to keep cigarettes under the counter, Westminster said it would also consider forcing tobacco companies to sell their product in plain packaging. And other countries are taking things even further.

In New York, it is now an offence to light up in any of the city's 1,700 parks and along 14 miles of coastline. And last month in the Big Apple, Harry Lysons, who was sued by his neighbours for filling their apartment with "foul and noxious odours", agreed to pay them $2,000 every time smoke from his cigar ended up in their apartment, with an extra charge of $1,500 if he failed to pay in 15 days.

Back at home, the conference jointly hosted by Alcohol Focus Scotland and Ash Scotland, - expected to see health experts recommending the zero tolerance approach to smoking be extended to drink, has already raised hackles.

So could pushing too far with legislation cause a backlash? Clark says that while, until now, Forest has fought its corner alone, Westminster's apparent support for plain packaging has provoked a chorus of disapproval from a coalition of disparate groups. "More people are beginning to speak out and say the tobacco control policies are going too far," he insists. "In terms of public smoking, people are going to say: 'If we're not allowed to smoke in pubs and bars, if the smoking ban gets extended to outdoor areas such as parks and beaches and cars, then where on earth can we smoke?'

"At the end of the day, people will say: 'This is ridiculous. This is a legal product - you have got to allow people to use it somewhere.'?"

In numbers

Almost 13,500people die from smoking-related diseases every year

25% of the Scottish population still smoke

700 pubs have closed since 2006

The number of heart attack admissions to nine hospitals fell by 17% in the year after the ban.

Those who flout the legislation face a fixed penalty of 50.

The manager or person in control of any no-smoking premises can be fined a fixed penalty of

for either allowing others to smoke there, or failing to display warning notices. Refusal or failure to pay the fine may result in prosecution and a fine of up to 2,500

Smoking costs NHS Scotland 409m annually - and the Scottish economy as a whole 837m a year