British American Tobacco Australia - Response to the draft National Tobacco Strategy 2012-2018 - 25 June 2012
Reduce exceptions to smoke free workplaces, public places and other settings;
The following section outlines BATA’s views on the above priority area.
International experienceContrary to the argument that comprehensive indoor smoking bans are a common trend, in practice very few countries have implemented such bans.
Data compiled by the World Health Organisation in 201141 indicates that only 31 out of a total of 194 countries had adopted complete indoor bans, - about 16%. However, whilst there is strict legislation in these countries, the bans have proved problematic to enforce.
It is common for countries to allow designated smoking areas or rooms, or exemptions for certain establishments.
For example, as of May 2011 only 4 of the European Union member states, all 27 of which are signatories to the FCTC apart from the Czech Republic, had complete smoking bans with no designated smoking rooms allowed covering general workplaces, restaurants and bars42.
Indeed, the majority of EU member states (23) allow facilities for smokers at workplaces, such as designated smoking areas or rooms, including Denmark, Sweden, the Netherlands, and the Baltic countries.
Further, the majority of EU member states (20) have either allowed both restaurants and bars to have designated smoking rooms or areas, or have completely exempted bars below a certain size or those choosing to serve only alcohol and no food.
Business impact of smoking bans - international experienceThe tobacco control community argues that the implementation of comprehensive smoking bans covering restaurants, bars, cafes, hotels and clubs does not have an adverse economic impact on the industry.
This is not the case. Smoking bans can have severe economic impacts on the hospitality industry, including restaurants and bars, leading to multiple closures and staff redundancies.
Failure to pay attention to the pre-ban concerns of the industry and failure to properly assess impacts on establishments in the post-ban period, has led to the spread of such bans.
Business impact of smoking bans - Australian experienceSuch examples are evident here in Australia.
It was estimated that the introduction of indoor smoking bans in NSW in the 2000s cost pubs and clubs almost $1.7m a day in poker machine revenue.
It was reported at the time that this saw the loss of 2100 jobs at clubs in the first 12 months of the ban and club donations to organisation such as charities and professional sporting teams fell by $8.9 million.43
Lack of credible evidence on effect of outdoor smoking bansWhen it comes to outdoor spaces, there is no credible scientific evidence indicating risk to public health that would support smoking restrictions in outdoor spaces.
The FCTC guidelines for Article 8 (Guidelines on Protection from Exposure to Tobacco Smoke) state that, “In identifying those outdoor and quasi-outdoor public places where legislation is appropriate, Parties should consider the evidence as to the possible health hazards in various settings and should act to adopt the most effective protection against exposure wherever the evidence shows that a hazard exists.44”
Contrary to claims made by certain anti-smoking advocates and policymakers, the quick dispersal of tobacco smoke in outdoor settings means that non-smokers are not involuntarily exposed to levels of tobacco smoke that could constitute a risk to public health, particularly if these areas do not require employees to frequent them.
The need to ban diesel engine exhaust fumes in outdoor areas ?In its explanation of the need for even more regulations on smokers in public places the draft NTS cites FCTC Article 8 which requires Parties to recognise that “…scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability and to adopt and implement effective legislative, executive, administrative and/or other measures, providing for protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places.”45.
If the concern for public health was the priority, it should therefore follow that similar policies would be recommended to prevent exposure in outdoor areas to similar types of products.46
It is reported that the fumes affect pedestrians on the street, ship passengers and crew, railroad workers, truck drivers, mechanics, miners and people operating heavy machinery.
Commenting in the media, IARC Director Kurt Straif stated that “It’s on the same order of magnitude as passive smoking”. Should this indeed be the case, it would be fair to assume that DoHA would recommend measures to stop exposure to diesel engines, especially in the “workplace”, or in any other “public place”.
Obviously such measures would be unreasonable, as they would be for adult smokers. What is reasonable, however is for the draft NTS to recommend that appropriate areas be set aside for smokers in adult only venues.
Outdoor smoking bans – a regulatory step too far ?Rather than seen as a viable public health policy, there is a view in some tobacco control quarters that outdoor smoking bans are instead a step too far.
When it comes to such policies, to quote Simon Chapman “to me, ‘going too far” in SHS policy means efforts premised on reducing harm to others, which ban smoking in outdoor setting such as ships’ decks, parks, golf courses, beaches, outdoor parking lots, hospital gardens and streets”.47
Further, Mr Chapman states that “…arguments for zero tolerance of any tobacco smoke in outdoor public settings requires interrogation of the assumptions and values driving such demands. In my experience, these are nakedly paternalistic, with heroic rearguard efforts being made to appropriate science in justification.”48
Moves to ban smoking in the home becomes the logical next step to outdoor bans, and it is concerning that the draft NTS signals its intention to go down this path.
Smoking in the homeIt is disappointing that the draft NTS has seen fit to go beyond the FCTC and looks to ban smoking in the home. Smoking bans in residential dwellings are not required by the FCTC, and are not the subject of national or provincial legislation anywhere in the world.
Neither the FCTC’s Article 8 (Exposure to Tobacco Smoke) nor the accompanying guidelines on Article 8, state that smoking should be prohibited in residential dwellings, whether public, rented or privately owned; multi-unit housing or single family homes.
Dangerous precedent setMoves towards banning smoking in the home could potentially lead to the need for warrants to be issued to allow police to come into your home and, in effect, arrest a person for smoking.
The question becomes one therefore of legal precedent. Once the police are allowed to come into your home to see if you are smoking, would it then logically follow that they be granted powers to come into a person’s home if there were suspicions of a parent feeding their children too much sugar, or of an adult drinking too much alcohol, etc ?
Once the government is allowed to come into your home to see if you are smoking or not, the precedent has been set for any government to legislate entry into your home on whatever policy issue they decide.
Effective education campaigns - reducing exposure to ETS in the homeEducational campaigns, either looking generally at the harms of secondhand smoke, or specifically related to smoking in the home, are by far the preferred method of governments to address exposure (particularly children’s exposure) to passive smoking in the home. Evidence shows that educational campaigns have proven effective.
In 2002, the NSW Health Department launched the ‘‘Car and home: smoke free zone’’ campaign, which was aimed at limiting the exposure of children aged 0–6 to environmental tobacco smoke in these environments. The campaign, which lasted 3 years, resulted in a 55.7% increase in the number of reported smoke-free homes occupied by smokers with children aged under 6, together with a 41.8% increase in the number of reported smoke-free cars49.
Significantly, educational campaigns were also found to be effective within immigrant communities in Australia, typically considered hard to reach and often with high levels of smoking in the home. A survey undertaken in New South Wales measured the effect of the National Tobacco Campaign and supplementary local campaigns on smokefree homes. Compared with surveys undertaken in 1997, the proportion of smoke-free homes significantly increased by almost 10% (absolute increase) in the 2001 survey50.51” Looking at survey data from 1989 – 1997, the researchers discovered a “clear and continuing trend towards reduction of ETS exposure around the home”, which they said was, “extremely reassuring and suggests that more progress is likely to be made without the need for intensive interventions.” An advertising campaign on protecting children from ETS conducted in 1992, was highlighted as particularly effective.
In the United Kingdom, it was announced in 2008 that, “The Government has no plans for smokefree legislation to be extended to private dwellings52,” the UK’s Department of Health said in 2010 that, “By increasing the level of awareness of the harms of secondhand smoke, particularly to children, we will encourage people to voluntarily make their homes and private cars completely smokefree.53”
The UK Government’s focus on a campaign to reduce smoking in the home was supported by one of the UK’s most influential public health groups the Royal College of Physicians, who recommended that, “Mass media campaigns promoting the importance of smoke-free homes, supported by behavioural interventions for individual families, are likely to represent the most suitable approach” to reduce children’s environmental tobacco smoke exposure to children.54”
In a recent study, sponsored by the UK Department of Health, secondhand smoke related media campaigns (running “frequently” between December 2003 and April 2007) were found to substantially decrease levels of smoking in homes, especially with children present: “Knowledge was associated with smoke-free homes and abstinence from smoking when in a room with others even once potential confounders had been adjusted for. The odds of smokers having a smoke-free home increased by 9% with each unit increase in knowledge. Similarly, with each additional unit increase in knowledge, the odds of smoking abstinence increased by 11% when with children and 6% when with adults.55”
In addition, an ongoing project by ASH Scotland is currently undertaking field work to develop, pilot, and evaluate a new intervention to encourage smokefree homes, with the organisation saying that, “Social marketing campaigns have an important role to play in promoting smoke-free homes. They should raise awareness of the risks and encourage adults to make practical and appropriate choices. Key stakeholders in Scotland agree that a tiered media campaign should be implemented, and that social marketing in consultation with local work should be encouraged.56” Commenting on the project, ASH Scotland Chief Executive Sheila Duffy reiterated that, “This will give [smokers] the freedom to manage their own smoking and choose effective ways to protect their families’ health.57”
In Canada, a “Secondhand Smoke in the Home and Car” mass media campaign undertaken from January – March 2005 sought to reduce exposure of children to secondhand smoke. Following the campaign, 25% of survey respondents reported that they had taken some action related to stopping smoking or reducing secondhand smoke in their homes as a result of seeing or hearing the campaign materials, with an additional 21% indicating intent to do so in future58. Following the second wave of the campaign, (December 2006 – February 2007) 56% of people surveyed reported that they had either taken action or planned to take action as a result of seeing/hearing the campaign materials (compared to 46% in 2005). Following both campaigns, 56% of survey respondents indicated that their homes were completely smoke-free, compared to the 2005 level of 43%.
Smoking Restrictions in Private VehiclesWhilst BATA does not oppose moves to ban smoking in cars with children, it is worth noting that very few jurisdictions are moving to legislate on the issue and media and public attitudes often criticising such proposals as a clear and unjustified infringement on personal liberty.
Such measures are also not required under the FCTC.
41.WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco (MPOWER Report) Available at: World Health Organisation website.
42. DG SANCO. May 2011. Overview of smoke-free legislation in the EU. Available at: European Commission website.
43. Smoke ban costs clubs $1.7m a day, Sydney Morning Herald, 10 December 2008
44. WHO FCTC guidelines for Article 8 (Guidelines on Protection from Exposure to Tobacco Smoke). For more information please visit World Health Organisation website.
45. Draft NTS, pg 39
46. WHO press release, IARC, Diesel Engine Exhaust Carcinogenic, 12 June 2012.
47. (Simon Chapman; Going too far? Exploring the Limits of Smoking Regulations.)
48. (Simon Chapman; Going too far? Exploring the Limits of Smoking Regulations.)
49. Yiow, L.’ Australia: campaign gets smoking parents to cut down’. Tob Control 2005;14:363. Available at: Tobacco Control website.
50. Wen, LM et al. Changes in smoke-free home status in an immigrant Lebanese community in Sydney, Australia. Australian and New Zealand Journal of Public Health 2002 volume 26:1. Available at: Wiley Online Library website.
51. Borland, R et al. ’ Trends in environmental tobacco smoke restrictions in the home in Victoria, Australia’. Tob Control 1999;8:266-271. Available at Tobacco Control website.
52. UK Department of Health ‘Consultation on the Future of Tobacco Control’ 17 August 2008 Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_085651.pdf (This website link was valid at the time of submission)
53. UK Department of Health. ‘A Smokefree Future: A comprehensive tobacco control strategy for England’ p 54. February 2010 Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_111789.pdf (This website link was valid at the time of submission)
54. Royal College of Physicians ‘Passive Smoking and Children’ p187. March 2010. Available at: Royal College of Physicians website.
55. Evans et al. ‘Assessing the knowledge of the potential harm to others caused by second-hand smoke and its impact on protective behaviours at home’. December 2011; Journal of Public Health (Advance Access). Available at: Oxford Journals website.
56. ASH Scotland (webpage) ‘Reducing exposure to second-hand smoke’. Available at: http://www.ashscotland.org.uk/policy/beyond-smoke-free/reducing-exposureto-second-hand-smoke (This website link was valid at the time of submission) (accessed 22 February 2012)
57. Duffy, S. ‘Clearing the Air on Secondhand Smoke’ Smoked Out: Monthly musings on tackling tobacco. 1 December 2011 Available at: Ash Scotland website.
58. American Cancer Society, ‘Lessons Learned Globally: Secondhand Smoke Mass Media Campaigns’ February 2010 Available at: http://www.stopsmokingcampaigns.org/uploads/File/FINAL%20SHS%20camp%20rev_Case%20Studies_Feb%202010.pdf (This website link was valid at the time of submission)