Health Bill

My Lords, I speak today on only one aspect of the Bill—the subject of smoking. One important factor of the Bill is its timeliness. Perhaps it has even come a little late. When I stopped smoking, almost 30 years ago—I had gradually become a 40-a-day woman—I did so not because I was made ill by my addiction, but for social reasons and because, remarkably, I foresaw that at some time in the future—possibly many years, as turned out to be the case—smoking would become unacceptable and ultimately disappear from this country. I say ““remarkably”” because that is the only long-term prediction that I have ever made which looks like coming true. I remember saying to like-minded people that the time would come when only a few very old people would remain smokers. This no longer seems like a fantasy. The idea of a total ban on smoking no longer seems unreal; indeed, the media are already commenting on it as a fact, although the Bill has yet to pass through your Lordships’ House. Will a total ban discourage addicts from smoking? The Department of Health has estimated that almost 700,000 will give up. A British Medical Journal survey concluded that workplace smoking bans reduced numbers by 4 per cent as well as cutting the number of cigarettes that people smoked—by no more than 1.3 a day, it is true, so my 40-a-day would have been reduced to only 38.7. To reduce through price, the British Medical Journal has estimated that the cost of cigarettes would almost have to double. Most of us who have no use for cigarettes will have noticed that, generally speaking, it is only non-smokers who comment on the cost. Smokers grit their teeth and pay. Smoking bans work. It seems, too, that they work without much of an outcry. Scandinavia has always seemed to me as if it would be the last bastion of smoking in western Europe, yet the Norwegians banned it in 2004, their aim being to protect those non-smokers among their citizens from second-hand smoke. Last summer, Sweden banned it, while allowing smoking rooms. The bans happened in both countries with scarcely a ripple of fuss. Ireland’s ban, which the rest of Europe gloomily predicted would be unworkable, has been a distinct success. Since the 1960s, when I first began going to the United States, I have seen whole swathes of that vast country abandon smoking without fuss, so that it is possible to spend a week in a city there and neither see nor smell a single smoker. Bans were easy to enforce in New York and in California, and Montana saw a 40 per cent decline in the number of hospital admissions for heart attacks during a six-month smoke-free period. It is said by some that smoking should be left to people’s personal choice. Leaving aside the question of whether someone under the sway of an addiction has any choice, what of the non-smokers? Until now, people with respiratory conditions or allergies have been denied all choice. The good done by a total ban will not be against their will nor will they grouse and grumble about a nanny state. Four-fifths of the country’s 5 million asthma sufferers say that second-hand smoke makes their condition worse. Where are the civil liberties in compelling people to suffer others’ smoke? In restaurants and pubs and clubs it has been compulsion for those who wish to keep their jobs. Smoke is not simply in the atmosphere that non-smokers breathe. A friend of mine who is a doctor of medicine told me that while he was working in the Royal National Throat, Nose and Ear Hospital the children with asthma and other respiratory problems almost invariably had a parent or parents who smoked. He could smell the smoke on those children, the result of their being hugged by loving parents who had perhaps been careful not to smoke in their children’s company but whose hair and clothes still harboured the results of the smoke that they had absorbed. This is an aspect of passive smoking to which public attention has not previously been drawn. In one respect, the ban does not go far enough. When it comes, it will not, as we know, extend to royal palaces, prisons or residential care homes. Anyone who has been convinced of the reality of passive smoking will ask why not. Maybe those who live or work in the royal palaces—including this Palace—prisoners and elderly or incapacitated people approve of that exemption, but what of the staff? Choice is denied to them. Because of the relatively small spaces where smoking is allowed, one can be sure that there will be a concentration of smoke in the atmosphere. Librarians and catering staff in the case of your Lordships’ House, prison officers and nurses and carers in residential care homes will be affected by it and, as we now know, will have their health damaged by it, but they need their jobs. More than 600 people die each year in the United Kingdom from second-hand smoke. Long before passive smoking was recognised as dangerous, a friend of mine in New York died of lung cancer. She was in her 50s. She had never smoked a cigarette, but had spent every day of her working life in a newspaper office where most people smoked. The ban will one day, I am sure, extend to these exempted areas. Perhaps it should even extend to people’s homes if we remember asthmatic children, for whom normal breathing is difficult as a result of being hugged by their parents. We have been told that people’s right to smoke in private places should be respected, but the health of children who have to live there and have no choice should be respected more. It has been said that when the ban comes into force more people will smoke at home than at present. That presupposes that those who now smoke in pubs and clubs will stay at home more. But people do not go out in the evening to smoke; they go out in the evening because they like going out in the evening, largely to enjoy eating and drinking in a convivial atmosphere. It is hard to imagine them giving up that habit to remain in an environment where they can smoke. On my way here this afternoon, my taxi driver told me that he did not smoke, but that his wife smoked heavily, which is a cause of dissent in the household. I asked him whether he thought that a ban in pubs and clubs would encourage her to smoke more at home. He said that it would have rather the reverse effect because of the opposition in his house to her smoking anywhere but out of doors. On the question of passive smoking, the rights of children are perhaps even more important than those of workers. Most of us would agree that children should have some say in the environment in which they are brought up, though few do. They should at any rate be protected, as they are in other areas of life, from activities which are now known to cause them harm. An all-embracing ban including people’s homes is, however, a matter for the future, not the here and now. A ban with exceptions and exemptions, as we know, leads to abuses. Most of us know about pub licensees who, when licensing hours were heavily restricted, contrived ways of serving drinks to regular customers long into the night by establishing a ““lock-out””. So it might be with a partial prohibition on smoking, as those unwilling to give up their habit seek loopholes in the law. Moreover, ventilation is ineffective unless it is increased to gale levels, which would be unacceptable to most people. Scotland will go smoke-free at the end of this month, the National Assembly for Wales wants a comprehensive ban and comprehensive smoke-free legislation will be introduced in Northern Ireland. Medical opinion has for many years been in favour of the habit of smoking being abandoned and doctors will always tell patients that the most important step that they can take towards better health is to become non-smokers. Like the noble Baroness, Lady Masham, I ask my noble friend for some clarification on the exemptions to the ban.