Introduction
On the 1st of July 2007, a ban on smoking in workplaces and enclosed public places took effect in England under the 2006 Health Act. The 2007 smoking ban was enacted with the aim of protecting non-smokers from the effects of passive or secondhand smoke (SHS). It aimed at reducing smoking frequency amongst adults in England from 15.5 percent to 12 percent or less. This ban was prompted by a long campaign that included studies that had been done in the 1950s. These studies revealed the connection between smoking and lung cancer. There was significant evidence of increased health risks associated with passive smoking and public opinion was supporting this ban. The ban was not universally accepted when it was brought in. MPs were offered a free vote on the Health Act 2006 bringing in the laws. Some campaigners proposed that the smoking ban was unreasonable and conservative, while the hospitality industry was worried about the possible economic impact. Although the smoking ban had some opposition from businesses and pro-smoking lobbying groups, it has been adopted and observed in the entire country. The United Kingdom currently has the most extensive tobacco control laws across the globe.
The problem
Smoking is the main cause of avoidable diseases and untimely deaths in the UK. Data from the World Health Organization (WHO) shows that tobacco is responsible for killing over 8 million people across the globe each year(World Health Organization, 2019). Over 7 million of these fatalities are caused by the direct consumption of tobacco. About one million of these deaths result from exposure of non-smokers to second-hand smoke. Although there has been a significant decrease in smoking frequency, about 13.9 percent of adults in England still smoke. According to the Office for National Statistics (2018), about 78,000 people in England pass on from smoking every year. A number of people also end up living with weakening smoking-associated diseases. According toPryce (2019), smoking was responsible for killing about 64,000 people in England in 2019 (pp.937). Pryce (2019) also asserts that about 506,100 hospital admissions that took place in England between 2019 and 2020 were smoking-related (pp.939). This is equivalent to nearly 1,400 each day.
Research shows that smoking is a prime culprit causing lung cancer among many smokers. However, the impact that passive smoking caused had proved challenging to quantify. In 2002, the International Agency for Research on Cancer published a report stating that frequent exposure to passive tobacco smoke can escalate the risk of lung cancer by 20 percent to 30 percent. In addition, the British Medical Association also suggested that passive smoke can escalate the risk of heart disease by between 25 percent to 35 percent. It also duplicates the risk of getting a stroke. By the mid-1990s, most public transport, shops, and workplaces, had prohibited or put restrictions on smoking. However, it was still legal for individuals to smoke in many licensed areas. In the years preceding the 2007 smoking ban, there was a rise in support for more limitations on smoking in public areas. While this partly showed the decrease in the number of smokers, it also illustrated the greater determination of non-smokers. The majority of them were prepared enough to permit smoking.
The United Kingdom Department of Health produced the public health white paper, ‘Choosing Health: Making healthy choices easier in November 2004 (Cornish et al., 2019). This paper stressed the burning need for protecting UK citizens from passive smoke. It argued that public view supported legislative intervention. More consultations were made resulting in the smoking ban being imposed based on the Health Act 2006. The main provisions of the smoking ban are in section 2 of the Health Act 2006 which covers smoke-free public places and workplaces (Cornish et al., 2019).
Smoking in public places like restaurants, cinemas, trains, theatres, buses, and workplaces was allowed in England in the 1960s and 1970s. notwithstanding the evidence that had begun showing the adverse health consequences of smoking from the 1950s onwards, the public as well many healthcare professionals greatly dismissed or disregarded the proof. The tobacco industry took it upon itself to deny and divert attention from the correlation between cigarettes and poor health. They did even though they knew the health risks caused by smoking. The demerits of smoking and SHS became more evident to the public and healthcare professionals throughout the 1970s and 80s. As a result, some offices and public places in the UK started to inflict partial and elective smoking bans. For instance, there was a rising number of “No Smoking” carriages and signages in trains. In mid-1987, there was a six-month smoking ban trial period in all Underground parts. Offices also began to confine places where people could smoke. Based on the International Agency for Research of 2002 and other reports proved that tobacco smoke has significant detrimental effects on health. These reports showed that tobacco smoke can cause lung cancer among non-smokers. In 2003, Dr. Liam Donaldson, the UK government’s chief medical officer, published his annual report declaring that elective agreements were not lowering the health risks posed by SHS as fast as possible (Chong et al., 2019). In 2005, scientists discovered that SHS can increase the threat of coronary heart disease by about 30% (Mazzonna & Salari, 2018, pp.1439). This impact is greater compared to what one would anticipate based on the dangers linked with active smoking and the comparative tobacco smoke doses distributed to both smokers and non-smokers.
Strategies established to deal with the problem
The ban on smoking in public places was a measure of reducing tobacco consumption in the UK. This ban was supported not only by the health care professionals and policymakers but also by the general public. The 2007 smoking ban was aimed at reducing passive smoking as it was found to be harmful. This ban incorporated legislative action by sanctioning the Health Act 2006 which covers smoke-free public places and workplaces. The government ban smoking in all enclosed and considerably enclosed workplaces and public places in the UK. Through these restrictions, the Health Act 2006 was protecting non-smokers from the adverse impacts of tobacco smoke. The secondary aim was to encourage active smokers to cease or reduce tobacco smoking (Chong et al., 2019). The UK government also raised the legal age for buying tobacco from 16 years to 18 years. The full ban on smoking in workplaces and public places is widely accepted in the UK and overall compliance is high.
Evaluation of the initiative
Results from various studies carried out in England indicate that the smoking ban has had notable benefits on health, changes in behavior and attitudes, and no apparent adverse effects on the hospitality sector. A myriad body of evidence exists now showing that smoke-free laws are beneficial in lowering secondhand smoke (SHS) exposure. Many studies have evaluated the exposure levels before and after the legislation in various settings such as pubs, restaurants, workplaces, at home, and other public places. Studies show that immediately after the smoking ban legislation, many people were trying to quit smoking. Research in the British Medical Journal showed that in the year following the ban regulation, there were about 1,200 fewer hospital admissions for heart attacks (Anyanwu et al., 2018). This is said to have been promoted by the improved air quality and reduction in the number of smokers. According to Office for National Statistics (2018), 22% of adults were active smokers in 2006. This rate had reduced to 18% by 2015. Windsor-Shellard et al., 2019 argue that air pollution caused by cigarette smoke in UK bars before the smoking ban was very high compared to the ‘unhealthy’ threshold for the quality of air outside. The air pollution in these bars was reduced by about 98% after the ban.
Three months after the smoking ban was imposed in England, there was a 6.3% decrease in the quantity of cigarettes sold. The proportion of active smokers in the UK in 2019 was about 14.1 percent; this was equivalent to about 6.9 million of the country’s population (Office for National Statistics, 2018). There has however been a significant increase in the proportion of adults who have never smoked tobacco over the last 30 years. This proportion ranges from 25 percent of men and 49 percent of women in 1974 to 56 percent of men and 63 percent of women in 2016 (Anyanwu et al., 2018). Increasing the minimum legal age for tobacco buying in England from 16 years to 18 years significantly reduced the rates of frequent smoking among youth in the region. Research showed that there was a major decrease in the number of individuals who were trying to quit smoking in 2007 following the ban. However, additional studies have shown that tobacco consumption in England has not been impacted by the smoking ban; this indicates that these individuals didn’t succeed in their attempt to quit (Rashiden et al., 2020, pp.29858).
The primary aim of the smoking ban was to protect the members of the public from SHS exposure and hence improve health. However, it is also now clear that this ban can change social norms on smoking. This in effect results in changes in smoking behavior. Studies have shown that there have been changes in attitudes from initial displeasure to the approval of the changes. There has been an increasing view of the personal, health, and environmental advantages of the ban. These studies have also shown that there has been a significant increase in compliance with the smoking ban legislation (Pryce, 2019, pp.939). There have only been a few reports of violation mainly at the boundaries between outdoor and public spaces. A study by Rashiden et al., 2020 showed that there hasn’t been significant proof of increased smoking at home after the ban (pp.29866). Comparatively, some individuals ventured into increasing restrictions on smoking at home. Pryce (2019) asserts that smoking influenced intentions and attempts to quit smoking among active smokers (pp.940).
Studies also have found out that tobacco consumption patterns and cessation rates vary significantly between occupational groups. These studies have shown that there is a notebale relationship between smoking and occupation. Individuals in manual and routine jobs are twice likely to smoke compared to those in managerial jobs (Mazzonna & Salari, 2018, pp.1440). The smoking ban resulted in a 93% decrease in air pollution in UK bars. However, there have been concerns of people who are unable to go to the pub and smoke doing so at home. In that case, they end up smoking near their children which can increase their exposure to SHS. This is true, especially for households that allow smoking inside. This occurs mostly in households where the head is currently unemployed or from a lower social class. A significant limitation here is that it is impossible to tell the impact or do a long-term follow-up of people after the introduction of the ban. Although research has shown that the smoking ban was effective in lowering SHS exposure among children and adults, there is no adequate proof that the introduction of smoke-free regulations in public places displaced smoking at home.
The introduction of the smoking ban legislation involved major changes for many businesses and employers in England, especially those in the hospitality industry. Though a majority of workplaces had already introduced restrictions on smoking before July 2007, others had not, e.g., most restaurants, hotels, and bars (Mazzonna & Salari, 2018, pp.1445). Some employers in this industry were worried that this ban would contribute to a loss of customers; this is because most smokers chose to avoid venues where they couldn’t smoke. These concerns were worsened by news from the tobacco sector which claimed that the introduction of the smoking ban would result in business closures as well as job losses.
Summary
It has been more than a decade since the smoking ban was introduced in England. The findings discussed above show that the smoking ban has had major consequences. Studies have shown that the ban has had a notable impact on health and changes in behavior and attitudes. There has not been proof of any detrimental effects of the ban on the hospitality industry. Studies have shown that the smoking ban reduced people’s exposure to SHS in the workplace and public areas. This has in turn improved their respiratory health. SHS exposure to children also fell as a result of the ban. Other studies have shown that a large number of smokers in England tried to quit smoking as a result of the smoking ban legislation. However, additional research is needed to determine whether changes in smoking behavior were experienced in the longer term. Although the ban has succeeded to some extent in reducing the health risks of SHS exposure, a lot needs to be done. Smoking is still the prime cause of preventable deaths. The view of health inequalities is alarming, therefore more should be done to reduce the notoriously high rates among manual and routine workers as well as individuals with mental health conditions.
References
Anyanwu, P.E., Craig, P., Katikireddi, S.V. and Green, M.J., 2018. Impacts of smoke-free public places legislation on inequalities in youth smoking uptake: study protocol for a secondary analysis of UK survey data. BMJ open, 8(3), p.e022490.
Chong, C., Rahman, A., Loonat, K., Sagar, R.C. and Selinger, C.P., 2019. Current smoking habits in British IBD patients in the age of e-cigarettes. BMJ open gastroenterology, 6(1), p.e000309.
Cornish, D., Brookman, A., Horton, M. and Scanlon, S., 2019. Adult smoking habits in the UK: 2018. Office For National Statistics: Office For National Statistics.
Mazzonna, F., & Salari, P. (2018). Can a smoking ban save your heart?. Health economics, 27(10), 1435-1449.
Pryce, R., 2019. The effect of the United Kingdom smoking ban on alcohol spending: Evidence from the Living Costs and Food Survey. Health Policy, 123(10), pp.936-940.
Rashiden, I., Tajuddin, A., Amani, N., Yee, A., Zhen, S.T.E. and bin Amir Nordin, A.S., 2020. The efficacy of smoking ban policy at the workplace on secondhand smoking: systematic review and meta-analysis. Environmental Science and Pollution Research, 27(24), pp.29856-29866.
Windsor-Shellard, B., Horton, M., Scanlon, S. and Manders, B., 2019. Adult smoking habits in the UK. Cigarette Smoking among Adults Including the Proportion of People Who Smoke Including Demographic Breakdowns, Changes over Time, and e-Cigarettes.
World Health Organization, 2019. WHO global report on trends in prevalence of tobacco use 2000-2025. World Health Organization.
write