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Prof Nicholas Hopkinson, Professor of Respiratory Medicine at the National Heart and Lung Institute, Imperial College London, said:
“Following the success of the indoor smoking ban and the ban on smoking in cars with children, it’s a sensible policy to ban smoking in some outdoor areas.
“This will reduce the exposure of customers and especially of bar staff to passive smoke. There’s no safe level of smoking, and the policy will also help to encourage occasional, ‘social’ smokers to quit.
“Evidence from the 2007 ban suggests that increased awareness of the harm from passive smoke is likely to make smokers more likely to smoke outdoors rather than in their own homes, improving the health of family members. Of note, child hospitalisations from respiratory disease fell after the ban on smoking in 2007.”
Prof Sean Semple, expert on tobacco control and the health effects of indoor air pollution at the University of Stirling, said:
What’s the evidence on the risk of passive smoking in beer gardens?
“A recent large study across Europe measured levels of nicotine in the air in outdoor terraces of over 200 bars and cafes, including 20 venues in the UK. Nicotine was present in the air in over 90% of terraces sampled. Higher concentrations were found in outdoor settings during evening and night-time, where two or more smokers were observed at the time of measurement and where the terraces had some walls or roof coverings. While these outdoor concentrations are much lower than the levels that would have been present inside bars prior to the smoke-free legislation of 2006/7, the World Health Organization state that there is no safe level of exposure to second-hand tobacco smoke and that the risks of heart and lung diseases increase with increasing exposure.”
Might banning it drive people into their homes where it could pose a bigger risk?
“This is a valid concern. Smoking in the home and the exposure of non-smokers and children to extremely high second-hand smoke concentrations is arguably the greater population health risk compared to second-hand smoke exposure in outdoor settings. The UK has made substantial progress in reducing the number of smokers who smoke at home and most recent estimates suggest that between 2-5% of children continue to be exposed to second-hand smoke at home. It will be important to ensure that this progress continues. We would hope that banning smoking in selected outdoor settings sends a further message about the harms of tobacco smoke and encourages smokers and non-smokers to recognise that smoking in the home, particularly where children are present, should not take place.
“It is worth noting that exactly the same ‘displacement’ argument was made in 2006/7 when smoking was banned inside pubs and restaurants. Detailed research of over 2500 children found no evidence that children experienced increased second hand smoke exposure associated with any displacement of parental smoking from hospitality venues to the home, indeed the amount of nicotine measured in children’s bodies reduced after the 2006/7 smoke-free spaces legislation across the UK.”
To what extent could a beer garden smoking ban have a positive public health impact?
“The measures proposed are part of a wider approach to the UK moving towards a smoke-free generation including a rising age of sale that will mean that those born after 2009 would no longer be allowed to purchase tobacco products. Banning smoking in highly visible places like outdoor beer gardens and restaurant terraces will help to stop young people seeing smoking as a ‘social norm’.
“The public health benefits of restricting the outdoor locations where smoking can take place are likely to be substantial: reducing exposure of non-smokers (and smokers) to second-hand smoke; reducing smoking uptake by the next generation; and reducing consumption of cigarettes by smokers. All of these outcomes will help reduce the substantial burden that smoking-related diseases cause to our NHS.”
Additional comments
“The TACKSHS project also measured nicotine in air concentrations in over 200 children’s playgrounds and at 220 primary school entrances across 11 countries in Europe (including the UK). Overall, nicotine was detected in the air of nearly half of outdoor entrance areas of schools and in about 2 out of 5 of playgrounds. Smoking in these locations is likely to expose children both to the harms of second-hand smoke and to the ‘social norm’ of adult and parental smoking activity. Levels of nicotine tended to be lowest in playgrounds covered by local or national legislation banning smoking and were highest in playgrounds in poorer areas.”
https://www.bbc.co.uk/news/articles/cg79ym5mrzyo
Declared interests
Sean Semple: no conflicts of interest to declare.
Prof Nicholas Hopkinson is Chair of Action on Smoking and Health (ASH).