BMA Cymru Wales calls a ban on smoking in public places in Wales

Main Category: Cancer / Oncology
Article Date: 09 Nov 2004 - 10:00 PDT

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In a stark BMA report, 'The Human Cost of Tobacco', published today, doctors chronicle individual stories behind the statistics to show how second-hand smoke destroys lives and health.

Every year at least 1000 people die from the effects of passive smoking. The BMA believes the biggest single step governments can take to improve the health of the public is to take action at national level to stop smoking in enclosed workplaces.

BMA Cymru Wales is appealing to Secretary of State for Wales and Leader of the House Peter Hain to put his weight behind the National Assembly's wish to have a Welsh bill to ban smoking in public places in Wales.

Welsh Secretary Dr Richard Lewis said: "The people of Wales are in favour of improving their health, and the National Assembly - the voice of Wales - has declared its wish to introduce a ban. Whilst the UK parliament prevaricates, Wales should have its own powers to forge ahead with this major public health issue.

In his foreword to the report, Dr Tony Calland, Chairman of BMA Welsh Council says: "Over thirty years of medical practice has shown me the devastating effects of illness on individual patients. Some of these illnesses come for no known reason, but many come because of the choices patients make through their lives. No choice has a more devastating effect on health than the choice to smoke tobacco.

"I have seen it cause bronchial cancer, throat cancer, mouth cancer, lip cancer and bladder cancer. I have seen the victims of these cancers die an uncomfortable, premature and often undignified death.

"I have seen it cause coronary heart disease, stroke, peripheral vascular disease, blindness, deafness, miscarriage, respiratory disease, bowel disease and many more conditions.

"Smoke free public places can help the 70% of smokers who want to give up. In Ireland, nearly 7,000 smokers have quit since legislation was introduced earlier this year.

"There must be even greater publicity of the dangers of tobacco smoke, an even greater effort to help people to give up smoking, but a government that fails to ban smoking in all public places is a disgraceful failure in protecting the health of the very population it claims to serve.

BMA UK Chairman, Mr James Johnson, offered the UK Health Secretary, John Reid, the same advice as smokers get: "There is no doubt that giving up smoking can be extremely difficult ? like any addiction kicking the habit is no easy task. When smokers decide to quit they are often advised to set a date, bin the fags and then just do it. Support from a doctor or health professional during this time can be invaluable. I am going to give the same advice to John Reid.

"In the forthcoming White Paper for England, he should set a date for banning smoking in all enclosed public places, this will give the bars and restaurants time to bin their ash-trays and then these workplaces will just have to abide by the law. John Reid already has the support of the medical profession."

The report lists cases throughout the United Kingdom of doctors' experiences of dealing with patients who are exposed to second-hand smoke.

For example:

LUNG CANCER

"I have had three confirmed cases of inoperable primary lung cancer in life-long non-smokers in the last two years. The biopsies showed the type of lung cancer only seen in smokers, and all three worked in public places where they were heavily exposed to secondary cigarette smoke. All three died within weeks of diagnosis."

RESPIRATORY DISEASE

"I also work in an regional respiratory centre that (as with many in South Wales) was initially established to care for men working in heavy industry - especially mining. The emphasis has now shifted and we care for many people who suffer daily with Chronic Obstructive Pulmonary Disease and serious asthma as a direct result of smoking. In my experience and increasing number of these are women.

"My own father died at the age of 54 as a direct result of heart disease brought about by years of smoking and heavy drinking. I believe that much of this resulted from the years of health neglect he experienced due to the culture of smoking and heavy drinking in the forces (RAF), and then working in local bars and clubs. I am ashamed to say he also continued to smoke as a health care professional whilst working in the Ambulance Service before he had to retire prematurely with ill-health.

"Whilst I am fully aware of the effects of obesity and alcohol excesses on society, I believe smoking in public places to be a special case. For example, overeating in a restaurant affects only the health of that individual - but lighting up affects the health of everyone around them (including children). Could this be considered an infringement of the non-smoker's human rights? There are also issues with inequalities as smokers will take more unofficial "fag breaks" lowering their productivity and meaning more time away from work (often out in the cold) than non-smokers - is this fair?

"The burden of passive smoking falls most heavily on the poor and vulnerable. Bar workers are exposed to levels of second-hand smoke that are six times higher than those of office workers, such as doctors or politicians. Smokefree public places protect non-smokers. They encourage smokers to stop, and help them to succeed. When fewer adults smoke, children's exposure to second-hand smoke is reduced. Smokefree places reduce the risk of young people taking up smoking, helping to break the cycle of tobacco dependence in deprived communities.

"We need to enforce this change of culture, to alter peoples mindset against smoking in the presence of non-smokers. IT CAN BE DONE - as with the general social taboo of drink driving, so too by using health care professionals to get your message across we can do the same for smoking in public places."

CHILDREN

"A considerable part of my job involves working with vulnerable and neglected children who are often unhappy and miserable in homes where parents are pre occupied with their own problems and invariably smoke heavily in front of them - their children are often unkempt, chesty and smell of stale smoke leading to further problems when they turn up in school or play group like this. Accidental ( or otherwise) cigarette burns occur frequently, which are painful and heal messily with secondary infection."

"I saw a young boy on a number of occasions suffering from severe asthma attacks. His mother said she could not think of anything that brought on the attack but the young boy said 'I always get sick after seeing grandad'. Apparently his grandfather owns a small and usually smoke filled restaurant."

"The most serious effects are on the smallest children. Premature babies whose mothers smoked have smaller lungs and worse respiratory difficulty. Young babies are admitted to our paediatric ward with wheezing which improves away from cigarette smoke and worsens again as soon as they go home."

PREGNANCY

"In my current post in obstetrics I see numerous cases of low-birthweight babies and difficult pregnancies exacerbated by passive smoking"

GENERAL ISSUES

A Welsh doctor makes his impassioned plea: "I am a proud member of the Labour party and you must be aware that the burden of passive smoking falls most heavily on the poor and vulnerable. Bar workers are exposed to levels of second-hand smoke that are six times higher than those of office workers, such as doctors or politicians. Smokefree public places protect non-smokers. They encourage smokers to stop, and help them to succeed. When fewer adults smoke, children's exposure to second-hand smoke is reduced. Smokefree places reduce the risk of young people taking up smoking, helping to break the cycle of tobacco dependence in deprived communities."

PUBLIC HEALTH

"As a public health doctor, I am acutely aware of the impact of smoking on the health of my community. I have worked in South Wales for over 20 years and smoking remains the main cause of preventable illness and death in our communities.It is the major contributor to inequalities in health within the community. Working in partnership with communities and local government, a lot of local action has been taken place, particularly targeted at most disadvantaged communities, through health promotion schemes, health living centres- The smoking cessation programmes have had considerable success for those engaged. However, the rates of reduction in smoking in the most disadvantaged groups remain depressingly very difficult to reduce, despite best efforts. Without renewed action to cut smoking rates ? which remain worryingly stagnant among the most disadvantaged - targets on reducing cardiovascular disease, cancer and health inequalities will not be achieved."

The BMA has been calling for legislation to ban smoking in enclosed public places since 1986.

For more information please contact:

John Jenkins
Tel: 029 2047 4611
mobile 07788 565216
pager 04325 638059
Fax: 029 2047 4621
Email: jjenkins@bma.org.uk

BMA Cymru Wales
Fifth floor
2 Caspian Point
Caspian Way
Cardiff Bay
Cardiff
CF10 4DQ

Telephone: (029) 2047 4646
Fax: (029) 2047 4600
email: info.cardiff@bma.org.uk