Is a smoking ban in UK parks and outdoor spaces a good idea?
BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h958 (Published 25 February 2015) Cite this as: BMJ 2015;350:h958
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In the pros and cons debate about banning smoking in London’s parks, Chapman accepted the role of Devil's advocate.(1) Did he compare the ban on smoking outdoors to North Korean policy simply to compete with Mayor Boris Johnson who dismissed Lord Darzi’s proposal as “bossy and nannying”? (2,3) Or was it merely a debating flourish, whereby an outstanding individual was speaking ‘tongue-in-cheek’ because everything which is exaggerated eventually becomes meaningless?
Chapman cannot seriously believe that exposing children to a behavior that uses an addictive product that kills 50% of its customers teaches them freedom. Free willed addiction is an oxymoron. As Chapman remains an officer in the Order of Australia, he presumably supports his own (non-dictatorship) country’s policy which bans smoking in “areas commonly used by children and young people”(Tobacco Amendment Bill 2014). Sadly, Chapman’s provocative point falls far behind the frightening reality: the US FDA is apparently now seriously considering a concern about the “lost pleasure” smokers experience when quitting smoking!(4)
Recent polls have shown 78% public approval for the 2007 public smoking bans.(2) The worldwide march of by-laws (and local regulations) indicates another ‘bottom-up’ democratic process for creating public policy when central governments fail to act to protect their citizenry from the vested interest of industries who have too much influence on national politicians.(5) For example, Los Angeles banned smoking in parks in 2007 (four years before New York City) and now more than 200 US municipalities prohibit smoking on beaches.(6) In Ireland, 80% of children’s playgrounds in parks are smoke free.(7) Paris’ Mayor Hidalgo banned smoking in Montsouris park from October 25, 2014 as an experiment (8) despite opposition from Paris council’s deputy for health, Dr Jomier, who declared he was “… not sure that smoking in a park is really a problem”. By-laws are unusual in France and Hidalgo was wisely testing public reaction. New York, Paris and London are the leading trio of smart, elegant, fashionable global capitals. Will London now lag behind both the other two, and also Nottingham City with its no-smoking policy in children’s playgrounds since 2011?
1 Darzi A, Keown OP, Chapman S. Is a smoking ban in UK parks and outdoor spaces a good idea? BMJ 2015;350:h958.
2 London Health Commission. Better Health for London. 15 October 2014. Available at http://www.londonhealthcommission.org.uk/wp-content/uploads/London-Healt...
3 http://www.telegraph.co.uk/health/11165930/Boris-Johnson-calls-ban-on-sm...
4 http://www.tobaccofreekids.org/press_releases/post/2014_08_06_fda
5 Braillon A, Dubois G. Tobacco control: up in smoke in Europe? Addiction 2012;107(5):1016-7.
6 http://www.no-smoke.org/pdf/SmokefreeBeaches.pdf
7 http://www.ash.ie/campaigns/smoke-free-playgrounds/
8 http://www.lefigaro.fr/actualite-france/2014/10/17/01016-20141017ARTFIG0...
Competing interests: No competing interests
I support a ban on smoking in public places and spaces, or at least the right of local authorities and institutions to impose and police a ban on any 'managed' outdoor space which is visited by the public. Now that the indoor ban is in place (a measure which also generated a lot of specious and dishonest opposition, with the constant invocation of 'personal freedom'), some public spaces, especially thresholds, have become almost no-go areas because of heavy contamination of breathable air, not to mention the appalling pollution of the physical environment by cigarette butts and packets. Bear in mind that the tobacco lobby remains immensely powerful, and has managed to largely overcome the advertising ban by 'soft' but potent measures, including the publication of photographs of smoking celebs, and the constant stream of period 'soaps' and dramas in which smoking takes place almost continuously; this is important because it is succeeding as perpetuating an image of smoking as 'normal', rather than a carefully nurtured addiction which remains our biggest mass killer.
An outdoor public places ban will build on the incredible success of the indoor ban in transforming our phyical environment, improving our health status as a nation, and starting to expose smoking for what it really is, an expensive way of killing yourself and others. A global national ban on all outdoor smoking probably is unreasonable and unenforceable, but remember that the same charge was levelled at the indoor ban - can that really have been only eight years ago? Seems like a different universe. The fact is that the tobacco lobby is currently winning the war on maintaining the 'glamour' of the smoking habit among young people, and it is important to win this particular battle in that war. The volume of the squeals of outrage from Forest and Co. is always a good indicator of the importance of any smoking-control proposal, so you can be sure that this measure, and related actions like Plain Packaging, are likely to be highly effective in continuing to improve our health and environment.
Plain Packaging has clearly been nobbled (temporarily) at the highest political level, and we must anticipate, and be prepared for, the same high-level interventions postponing any extension of smoking control into the external environment. We don't need an 'evidence base' for this - it is simply unpleasant and unhealthy to be walking our children in parks and gardens full of cigarette smoke, and sets a bad example to them. We need to deliver this, no whiffs or butts.
Competing interests: I'm not sure whether a lifetime spent trying to treat the appalling consequences of smoking counts as a competing interest. I was active in canvassing Ministers on the public places ban in 2007, and I believe that such interventions were critical in getting what was at the time a totally unexpected mass free-vote in favour of an indoor ban.
Professor Simon Chapman points out that, in Australia, daily smoking prevalence is now only 12.8% and is highly likely to keep falling. This, he says, has been achieved without the unethical coercion of smokers. I challenge this latter remark.
In Victoria, Australia, the limits on smoking are really draconian. No smoking (even in the street) within 200M of kindergartens and children's playgrounds, no smoking in pubs, restaurants, enclosed work areas, outdoor eateries, buses, trains, taxis, tramcars, many beaches and proposed legislation to stop smoking in private cars when children are present. There are many more restrictions under consideration and programs to help people quit. Our success is clearly largely due to these measures and plain package of smokes. I have no direct knowledge of the Sydney details but would be surprised if they were any less 'unethical and coercive'.
Best of luck with the UK assault on this dreadful product.
Competing interests: No competing interests
It is surprising that Simon Chapman finds it 'unethical' that society should be seeking to reduce the prevalence of smoking. Does it matter that arguments in favour of greater restrictions on where people can smoke 'go well beyond the direct health effects'?
'Outdoor bans based on communities' amenity preferences are not about public health but are akin to ordinances about playing music in parks or bans on public nudity and littering.' Surely this is a valid choice for society to make.
'Paternalistic, for-your-own-good laws about seatbelts and motorcycle helmets involve trivial restrictions on liberty.' I'm sure many would beg to differ in describing these restrictions as trivial. However, we accept that government is acting in our best interests. What about laws banning the personal use of heroin and other hard drugs? Are they trivial?
In fact it could be argued that banning smoking altogether would be a 'trivial restriction' as it would only affect a small proportion of the population for a single generation.
The most compelling policy suggestion is that of banning the sale of tobacco products to those born after 2000, as supported by the BMA. This would indeed represent a trivial intrusion into personal liberties as existing smokers would be untouched by the sinister paternalism of government and would be free to continue smoking right up to their early graves.
Given the current concerns regarding the safety or otherwise of e-cigarettes, perhaps the above policy could be extended to include these products also.
Smoking isn't purely a matter of personal choice and doesn't just affect current smokers: the continued tolerance of smoking in our society also exposes the next generation to the risk of addiction and its undisputed harms. That is a concern for us all. It is entirely legitimate for government to take steps to mitigate the problem on our behalf, and for public health practitioners to contribute to the debate. Unless we desire a state of anarchy it seems unnecessarily dramatic to describe any laws as 'coercive.'
Competing interests: No competing interests
Yes, because smoking is a public nuisance.
The assumption made in the article against banning smoking from parks is that it does not cause a health risk. The evidence is:
"
No studies looked at exposure in parks or on beaches—almost certainly because researchers with any knowledge of airborne exposures would appreciate that such exposures would be so small, dissipated, and transitory as to be of no concern.
"
The fallacy here is to treat an absence of evidence as evidence.
There are alternative reasons why the damage from smoking in open spaces has not been studied. There are two:
- The difficulty of controlling the environment
- The fact that it has been important to study the more damaging effects in enclosed, or partially enclosed spaces
It speaks of very special pleading to wish to continue to subject people in the open air to cigarette smoke because the absence of studies is evidence that they suffer no health problems.
It is a matter of simple observation to any non-smoker (who has, consequently, sense of smell), that the stink of cigarettes in parks and other open spaces is just as noxious as it is in a restaurant or other internal space. Smokers, who do not have a sense of smell as a result of their addiction, appear to think that they do not cause offence by their nauseating stink when people are five or six metres away. This is not the case. A non-smoker can be in discomfort from coughing, with streaming eyes and the unpleasant taste of tobacco in his mouth eight metres away from a smoker if the breeze is going in the right direction.
Apart from the proven health risk of such exposure (having a coughing fit does indicate that your lungs have been affected), it is a public nuisance to subject other people to such discomfort.
Competing interests: Non-smoker
A little "draconian attack on basic freedoms" shall definitely prevent so many smoking relayed preventable morbidity.
Competing interests: No competing interests
Is smoking ban is a ban or boon to society is like double edged weapon that cannot be answered in a very simple answer. Even with pro- and anti stand on this issue substantiated by scientific studies will never provide a clear cut guideline. This is a social issue which has to be dealt by the individual in a community. The individual has to be trained and taught to develop a mindset that will guide him or her to take a stand on a particular issue. Smoking is one such issue that an individual must decide depending upon the facts and figures available in the publications put out by the public health system. The decision taken on this habit forming issue has to be voluntary and spontaneous. There will be many more such issues like alcoholism , sexual abuse, environmental pollution and adverse social actions that affect our natural environment.
Such issues need social responsibility inculcated by societal members to save our health and even our planet from our own doings. So a ban on smoking in public places is a social responsibility of every citizen that a citizen or community must decide. Such decisions need to be voluntary and not forced by law or regulation.
Competing interests: No competing interests
Any argument which uses the NHS costs of smoking to justify increasing the ban is on very poor ground. The £2.7 billion quoted must be measured alongside the £12.3 billion estimated revenue from tobacco . This is the 2012-3 figures and one of the highest in recent years. Financial arguments should also take into account additional pension savings from the earlier mortality. Are non-smokers prepared to see a rise in general taxation to make up this deficit? There are of course negative health implications if this very large net income deficit is to result in further reductions in Benefits and Social Services. Interestingly , this net balance just about covers the overall costs of obesity and its complications. Perhaps we need to re-focus on our health priorities ? Designating tobacco income to the NHS might be a solution but would presumably be unacceptable to both the anti-smokers and exchequer . I have never smoked and have been pretty intolerant of smokers ,, but feel we need a compromise between intolerance and persecution. It is a pity no mention is made of the significant environmental pollution of parks (and beaches) with cigarette butts.
Competing interests: No competing interests
Basically no. It would be better to ban fattening foods
Competing interests: No competing interests
Re: Is a smoking ban in UK parks and outdoor spaces a good idea?
A smoking ban in parks and outdoor spaces is definitely a great idea on account of various benefits of high probability. This should not be perceived as an attack on individual rights. A ban on smoking in public parks would deny only a small pleasure to smokers. Smokers will feel happy that banning will result in significant decline in exposure to second-hand smoke (SHS). We need to encourage a campaign that highlights the contribution of everyone including smokers. I believe that this is going to change the way we look at the current issue. According to a recent study, (1) SHS exposure was significantly reduced in public places after the smoke-free legislation came into force. Moreover, children play in parks and the ban on smoking will prevent the sight of smokers and it may prevent undue attraction to smoking. Therefore, we may save the future generation from the danger of smoking. A little sacrifice here may save us from falling prey to the spiralling dangerous habit of smoking.
1. Indian J Community Med. 2015 Jan-Mar;40(1):27-32
Competing interests: No competing interests