Smoke signals: How the rest of the world is adopting the smoking ban

• A sign at the entrance to Bryant Park in New York notifies visitors of a new smoking ban. Picture: Getty Images Editorial

IT has been blamed for the closure of scores of pubs – but has cut children's exposure to second-hand smoke almost in half. Love it or hate it, the smoking ban, introduced in Scotland in 2006 and followed by the rest of the UK soon after, is likely to be here to stay.

But, as governments across the world adopt a variety of versions of the ban, others are watching with bated breath to see what measures will be successful and what should be consigned to the legal scrapheap.

Some countries have already taken the ban a step further than the stringent rules currently in place in Scotland – adding more public places to the list of areas where people cannot smoke and some even prohibiting smoking in private cars.

The Scottish Government insists it has "no plans" to extend the law in the near future, but admits that passive smoking for children travelling in cars is a major concern for ministers. "The successful implementation of the smoke-free legislation has undoubtedly reduced exposure to second-hand smoke among children in Scotland, partly as a result of the greater awareness among their parents and those close to them about the risks of second-hand smoke," said a spokeswoman for the Scottish Government. "While we have no plans to extend the smoke-free laws to parks or private cars, the Scottish Government is conscious that private cars are now one of the main places for exposure of children to second-hand smoke. In conjunction with our health improvement partners, we are continuing to do all we can to highlight the risks posed by second-hand smoke."

Pro smoking campaigners have accused the Scottish Government of using the smoking ban as a "politicial issue" and say they believe any repeal of the law would be almost impossible to achieve north of the border.

"The Scottish Government liked to think it was leading the way in introducing the ban first in the UK – as it could change this law when it perhaps felt it had few powers to change others," said Simon Clark, director of Forest. "It has turned into a political issue and I think we are resigned to the fact that we are unlikely to make much headway in getting the ban reverted in Scotland."

But, despite a few dissenting voices, the ban in Scotland was widely met with little more than a grumble – turning overnight from a nation that loved nothing more than a fag and a pint to one that could happily enjoy the two, separately.

In other regions, however, a well-intentioned ban implemented by optimistic governments met with severe opposition from angry smokers and publicans.

Smokers in other countries openly flaunt the ban, lighting up in public places and even workplaces without a care. In some cases – such as that of the Netherlands – eventually forcing governments to backtrack on the original ruling. Just this month in Nepal, a local newspaper reported that a ban of a similar kind to Scotland's was being ignored not only by members of the public, but by lawmakers themselves, who were openly lighting up in the government building where the new law had been decided.

However, although generally law abiding, not all of Scotland's citizens are in favour of extending the ban.

Critics claim that the anti-smoking lobby's final aim is to outlaw cigarettes entirely – and believe any further legislation would pave the way for an eventual total ban. We take a look at the development of the anti-smoking legislation throughout the world and consider the options for how far Scotland's ban could go.

RELAX THE BAN

'This would be a backwards step'

IN liberal Holland, the initial smoking ban of 2007 met with major opposition. Priding itself as the relaxed, free-for-all country of Europe – in Amsterdam at any rate – many bar owners opted to ignore the ban, eventually launching a fully-fledged civil disobedience campaign.

The amended law now allows smokers to light up in small, owner-operated pubs with less than 753.5sq ft and staffed by only one person. The reversal applied to more than 2,000 bars and some claim has saved the pub trade in the Netherlands.

In many other European countries, the smoking ban is less stringent than in the UK. In Germany and Austria, for example, restaurants and pubs must have separate areas for smoking and non-smoking – in many cases separate rooms – but do not have to ban it entirely.

"This would be a backwards step," claimed Sheila Duffy, chief executive of Ash Scotland, which lobbies for tobacco legislation. "We knew before the existing law was passed that partial restrictions are ineffective, and only a blanket ban offers complete protection from second- hand smoke."

Limited opposition to the ban in Scotland, makes this option unlikely, though it would be a welcome move for disgruntled publicans who say people are staying at home to drink while smoking. It is estimated that more than 450 pubs have shut down in Scotland since the ban was introduced five years ago.

Pro-smoking lobby group Forest sees this option as its ideal solution. "We would like to see a world where smokers and non-smokers can socialise together," said director Simon Clark.

BAN DRIVERS FROM SMOKING IN VEHICLES

'Volunteer to make your car smoke-free'

CAR cigarette lighters could soon be a thing of the past if campaigners get their way. In March, a report by the Royal College of Physicians recommended that smoking should be banned in cars – in a bid to reduce second-hand smoke exposure for the children of heavy smokers. Road safety experts have also supported such a ban, believing that the distraction of smoking a cigarette can be as dangerous as talking on a mobile phone, or eating fast food while driving.

Similar bans have already been established in certain areas of Australia, Canada and the USA, while an announcement last month that the Irish Minister for Health was also considering an anti-tobacco ruling for cars carrying children sparked fury from campaigners claiming that the move would be an infringement of human rights.

"I'd like to see people in Scotland turn their knowledge of the harms of second-hand smoke to action and voluntarily implement smoke-free homes and cars," said Sheila Duffy, chief executive of Ash Scotland, which has called for a consultation on introducing further regulations to limit smoking in vehicles.

In many of the countries where a ban is in place, the legislation applies only to cars where children are being carried as passengers – although it has been argued that such a rule would be too difficult to implement in practice, making an outright ban a favoured option.

"It would be impossible," claimed Simon Clark, director of Forest. "It would be difficult to see if a driver who was smoking was carrying a child in the back of his car. It would mean friends would have to shop each other. It's a step towards a Stasi-like society."

Italy is one of a few countries to unveil plans to introduce an outright ban on smoking while driving – a move which Kevin Clinton, head of road safety for Accident prevention group RoSPA, says he would back.

"Our view is that drivers should not smoke while driving because it impairs the driver's ability to drive safely and increases the chances of crashing," he said.

"It is a mental distraction because at least part of the driver's attention is on finding and lighting a cigarette – and research clearly shows that driving is impaired when a driver's attention is divided) and a physical distraction because the driver has to use at least one hand to deal with the cigarette."MAINTAIN THE STATUS QUO

Now a way of life for most Scots, who are still likely to notice the difference when they enter a pub or club – Scotland's ban technically prohibits people from smoking in enclosed places where anyone might work.

Pubs, restaurants and offices are all subject to the legislation, which was implemented in March 2006 – but the ban also extends to offices, the inside of hospitals and schools.

In fact, any public building which is said to be "wholly or substantially enclosed" – that is, anything with a roof and solid walls that enclose more than half the structure.

Most bus shelters were also deemed to be included in the ban, although it was argued that some models were not more than half enclosed, and therefore exempt.

Many councils opted to slap an outright ban on smoking in all bus shelters, no matter how many sides they had, to avoid having ongoing arguments with passengers keen to light up undercover in rainy weather.

"Scotland's public places going smoke-free brought health benefits to employees and customers," said Sheila Duffy of Ash Scotland, which campaigned hard to have the ban implemented.

But while Scotland's legislation, which was cutting-edge in March 2006, paved the way for a UK-wide ban a year later – it is now less stringent than in many other parts of the world.

Although the Scottish Government insists it has no current plans to change the legislation, it is unlikely it will remain as it is forever.

Watch this space.

BAN SMOKING IN OUTDOOR PLACES WHERE CHILDREN PLAY

'It could be counterproductive'

CUTTING smoking in areas where children could be present is one option for those reticent to introduce a full public ban, but keen to ensure that youngsters do not suffer from the second-hand smoke of those around them. This option has been taken up by the Spanish government, which created one of Europe's toughest anti-smoking policies when it launched the ban as part of a raft of anti-smoking measures in January.

"I'd encourage health and education services to move towards adopting smoke-free grounds and communicate this clearly so the public and users of services understand the rationale behind the policy," says Sheila Duffy, chief executive of Ash Scotland.

"The NHS expends a lot of resources on treating diseases caused by smoking, and smoking slows recovery from a range of conditions. But we need to recognise that many people who have to stop abruptly – for example, if they are admitted for surgery – can find it difficult."

She added that keeping cigarettes away from school grounds would reinforce the anti-smoking message to children.

"Trying to protect children from anything that is not good for them is counterproductive," said Simon Clark, director of pro-smoking group Forest. "When I was a child growing up in St Andrews, there was a law that said people shouldn't drink outside of pubs. Of course, as soon as I could, I was desperate to see what went on inside pubs.

"If you follow this argument through, parents would not be able to drink at home, or eat food that is not good for them in front of their children."

BAN SMOKING IN ALL PUBLIC PLACES, INCLUDING PARKS, STREETS AND PUBLIC SQUARES

'The risks of outdoor exposure are small'

IN June it emerged that the market town of Stony Stratford, near Milton Keynes, Buckinghamshire, had unveiled proposals to ban smoking entirely on its streets.

The town, which now looks unlikely to take the plans any further after being met with limited support, was following in the footsteps of New York, where members of the public are no longer allowed to light up in many public places – including parks, coastline, some streets and public squares.

Across the Atlantic, swaths of outdoor public places, have become tobacco-free since the new rules were introduced earlier this year.

But while the move may seem to be an obvious step forward for anti-smoking campaigners, some believe it would actually be detrimental – claiming it could force smokers indoors, where the effects of passive smoking are far higher.

"Our priority must be reducing the known health risks associated with second-hand smoke exposure," explained Sheila Duffy of Ash Scotland. "These risks are at their highest in enclosed indoor spaces and while some find smoke exposure outdoors unpleasant, the health risks of outdoor exposure are likely to be small in comparison.

"Prohibiting smoking in large areas like whole towns or city centres could displace smoking to areas like cars and homes where the risks are higher or more vulnerable groups like children can be exposed."

She added: "We'd encourage smokers to smoke outside when they can, to reduce the risks to others."

For once, Duffy and Forest director Simon Clark are in agreement. "The issue here has moved away from one of public health ," said

Clark. "This is now about the fact that people do not like the smell of smoke outside – the amount of actual smoke that people can inhale when others are smoking outside is minimal."

Although the New York ban has been largely successful so far, it is unlikely that there would be an appetite for such an extreme move in Scotland.