Scotsman declares smoking ban in cars 'a step too far'.

Read here.

The recommendation to ban smoking in cars is made on the basis of research by Aberdeen scientists (as the Evening Express declares proudly), at the Scottish Centre for Indoor Air, which found that:

levels of harmful pollutants were 11 times higher in “smoking” cars when compared with “non-smoking” cars.

It seems odd, to say the least, to generalise about smoking cars, as if they all contained equal amounts of smoke, were all of the same size and all subject to the same variable conditions (same number of windows open, vents open to the same degree, and so on).

And although I agree with the Scotsman's leader position on this, their report tells us,

Some experts claim smoking in cars exposes non-smokers to high levels of second-hand smoke which has 23 times more toxins than a busy smoke-filled room. Previous studies have revealed at least three in ten smokers light up in their cars when there are other people present.

The same critique can be applied here. There is no standard exposure in a room, which can vary in size, occupancy, air insulation and all other factors pertinent to exposure to contaminants. More significantly this reporting shows no awareness that the British Medical Journal apologised around a year ago for claiming that  cars were 23 times more toxic than a bar. They issued an alternative statement: 'the concentration of toxins in a smoke-filled vehicle could be up to 11 times greater [yes, 11 times greater] than that of a smoky bar' (see this link). Quelle coincidence!

The background to the story popping up last year was an announcement of a study carried out by SCIA (link above), which announced the dangers of smoking in cars, where concentrations of toxins were higher than the 'safe level' of outdoor air exposure recommended by the WHO. This is discussed here in some detail (thanks to Michael J. McFadden for assistance), but this part, concerning the relevance of outdoor exposure levels to measuring secondary smoke in cars, is the most damning:

While it is true that according to agencies such as the US EPA that urban, automotive, and industrial air pollution has been shown to be unhealthy or even dangerous when it reaches higher levels for periods of 24 hours or more, it is also true that the EPA doesn’t set standards for FPM 2.5 for shorter periods because there is no sound medical reason to believe that shorter episodes of such exposures actually pose a threat to health.  When the SCIA takes readings during car journeys that typically last less than several hours and tries to apply the EPA’s 24 hour standards to those readings, it is explicitly violating the very guidelines of the EPA itself. [These guidelines outlined in the linked post above]

The Scottish Indoor Air Centre's aims are somewhat distressingly focussed on SHS levels, declaring that its priority is:

1. Increasing our understanding of exposure to secondhand smoke in homes and cars (particularly with respect to children’s exposure) and its health effects; exploring possible interventions to reduce exposure in these microenvironments. We believe that the provision of real-time exposure data to smokers is likely to be a very effective mechanism of behavioural modification. [Emphasis added]

It is fully involved in the National Lottery-funded project Refresh and ASH Scotland in their bid to encourage smoke-free homes. Hence its emphasis on behavioural change.

The Scotsman is to be applauded for not supporting this move. There is no reason to support it.

LATE EDIT
I've just come across an account that contains a direct link to the SCIA study (pdf), with some interesting extracts.

Table 2 presents the descriptive statistics of the mean and maximum PM2.5 found during smoking and non-smoking journeys, while Figure 1 shows the time-weighted average (TWA) PM2.5 for each journey, by participant. PM2.5 concentrations in 3 of the non-smoking journeys exceeded the 25 μg/m3 WHO guidance level for indoor air [16], while this occurred in all smoking journeys for between 11 and 100% of the journey time (53% of the time, on average). [emphasis added]

That was one result they didn't shout about. Even with a short car journey the levels of non-smoke contaminants can exceed the EPA 24-hour standard (but this time duration is, according to the standard, is too short to have health implications).

The study also indulges in reinventing the EPA standards:

We have used the WHO PM2.5 guidance level as a comparison as this as the WHO has recently stated that the value can be applied both to indoor and outdoor exposures [16]. The comparison to this guidance should be done with some caution as this health-based value is based on a 24 hour time-weighted average. Clearly the exposures during car journeys we have measured are all much shorter than a 24-h averaging period but given recent work suggesting that there may be no safe level of exposure to SHS [18] we think that the use of the WHO indoor air standards for PM2.5 is a reasonable health-based method of comparison. [emphasis added]

Since the guideline explains carefully (para 28) how to calculate whether the EPA standard is valid for periods shorter than 24 hours this seems to be taking a liberty!

(Read on also about the SCIA's finding about 23, or 11, times as toxic as a smoky bar claim: 'our data do not support this claim nor the BMA's retraction'.)

No comment from ASH Scotland on PE 01451?

After the Scotsman article on Friday detailing our petition I have been waiting all weekend for Sheila Duffy's response. She can usually be relied upon to make a robust rebuttal of anyone who challenges the wisdom of tobacco control in the pages of the Scotsman.

I've had to wait until today for the daily ASH Scotland news bulletin (not posted online yet), only to find that neither Friday's coverage at the Scotsman, nor Sunday's at the Scottish Sunday Express (which was not online, but they cover reports regularly that are not online) even made it to the daily news bulletin!

I wouldn't even mention this had I not found their coverage in the past to be pretty reflective of what's out there in the mainstream press: not all of it favourable to their cause.

Can it be that Sheila and her crew are lost for words?

Scotsman reports on petition

Having submitted two previous petitions (both listed in the side bar) on the smoking ban, press attention was something I did not particularly expect. However the Scotsman has given this account, and it is a fair one:

A group called Freedom to Choose Scotland, which has previously lobbied for an end to the ban, says that new European Air Quality standards on indoor areas, published since the smoking ban, backs up its case.

The group says these guidelines do not suggest good practice involves a ban on smoking. It is recognised as a pollutant, along with others, but ventilation requirements are set out to deal with these.

The Petition states: “Ventilation, or clean air technology is a developing science and ventilation includes extraction and other methods of air cleaning,

It adds: “Any effective air cleaning system removes toxins regardless of their source.”

The EC document that first prompted us to submit Petition 01451 is called EN 13779 – Ventilation for non-residential buildings. As the petition says, its section on 'good practice' does not call for a general smoking ban. but concerns the quality of air brought in from outside and the way exhaust air is released. I would be lying if I claimed to understand it all. But the point is that the rules are the same for tobacco smoke as for everything else. Indeed if you look at Table 3 (p. 17) you will see that, while smoking is treated differently from non-smoking, even smoking is described only as a 'moderate' level of pollution.

The article also picks out another important point: removing toxins 'regardless of their source'. Why single out a single source of (relatively mild) pollutants when our whole environment is stuffed with regulation-breaking levels of them? It really doesn't make sense.

It makes no more sense than to say the doctrinaire solution of preventing smoking in public places will always prevail, when we have the collective will and the understanding required to obviate the need for a comprehensive ban.

So a huge thanks to Scott MacNab for the write-up in the Scotsman. It comes shortly after stories in the media about pub closures prompted by a report: 'Local pub, local hub? The future of the Scottish community pub', which you can download from here. The report does not flinch from the impact of the smoking ban on pubs, but its main concern is the duty escalator on beer, which has made it much more expensive for consumers in recent years. It describes Scottish pub closures in stark terms: 703 community closed in Scotland since 2007 (nearly one-fifth of the total). This cannot be doing Scottish social and community life any favours.

More soon.

Petition link here: please keep sharing, the closing date is 22 October!

Duffy in print

Sheila Duffy has excelled herself today by producing a leader column in the Scotsman entitled 'Restricting tobacco industry will improve health' (this was not published online), and another in the Herald: 'Health levy will bring huge benefits to public health and the economy'.

Does tobacco control have some special status for our national media that ASH Scotland's opinion gets placed next to the editorials at the centre of the Scotsman?

In her column, Duffy applauds the Australian effort to bring in plain packaging and makes her support for this legislation very clear. She refers to the recent UN summit on non-communicable diseases and the 'fundamental conflict between the tobacco industry and public health. She promotes plain packaging as a global strategy endorsed by the Framework Convention on Tobacco Control – an undemocratic measure that seeks to over-ride national democratic processes.

In the Herald she writes about the proposed health levy on major supermarkets, in reference to a previous article in which the Scottish Retail Consortium warned that the levy could fall on an increasing number of retailers with time. She huffs, 'well, they would say that, wouldn't they?' because they are 'keen to protect their members' interests'. Well – it takes one to know one.  This is the old story –  there is a dispute and both sides lobby. One does it out of sheer altruism and the other out of sheer self-interest. Sheila wants this levy because it is destined for 'preventive work': in more prosaic terms, to sustain the health promotion business.

The 'denormalisation' process is also at work here. Duffy echoes the words of Margaret Chan of the World Health Organisation who criticises the tobacco industry's efforts to gain support against plain packaging legislation, especially for the effrontery of employing lawsuits to challenge tobacco control legislation. God forbid that tobacco companies, having been marginalised from the policy-making process, should be allowed to make the public aware of their view of the situation.

Sheila clearly has a vested interest in the health levy. No doubt she will point to all the benefits of smokeless pubs such as a 17 per cent drop in heart attacks, a 13 per cent drop in childhood asthma admissions, better respiratory health in bar staff (based on a comparison of their health between February and June) and other fantasies. Her stock figures are 13,500 – the annual Scottish death rate from tobacco – and one in four, which is the proportion of Scots that are killed by tobacco. These figures are used in 2009,  but if we go back to 2005 we see very little change (in fact the rate for smoking-related deaths is only 13,000, but they have probably changed their method of counting). It rather looks as if the money spent on ASH Scotland has got very little result over the last six years.

Edit: Scotsman piece now online.

Scotsman: World is adopting the smoking ban: denying the wisdom of ages

Surely the message from this piece by Scotsman consumer affairs correspondent Jane Bradley is that the rest of the world isn't adopting the smoking ban – at least not with the 'zero tolerance' approach adopted throughout the United Kingdom.

Bradley claims that the smoking ban has halved children's exposure to smoke (this seems a bit unlikely to me but no doubt she has studied the 'correct' sources) and that the smoking ban was 'likely' to be here to stay. She speaks of other 'countries' going further than the UK (referring to individual US states and possibly states in Australia), but also refers to countries, like the Netherlands, where the ban has not gained popular support.

Simon Clark of Forest is quoted as having pretty much given up on Scotland as a lost cause ('I think we are resigned to the fact that we are unlikely to make much headway in getting the ban reverted in Scotland'). Never say die, Simon. Bradley does however acknowledge the unpopularity of the ban with publicans:

Limited opposition to the ban in Scotland, makes this option unlikely, though it would be a welcome move for disgruntled publicans who say people are staying at home to drink while smoking. It is estimated that more than 450 pubs have shut down in Scotland since the ban was introduced five years ago.

The ever present Sheila Duffy of ASH Scotland deplores the suggestion of amending the ban declaring that 'only a blanket ban offers complete protection from second-hand smoke'. She then urges people to ban smoking in their own cars in order to achieve even more protection from second-hand smoke – she's nothing if not thorough.

The article finishes with the nonsense that smoking while driving is not safe – typical of the tunnel vision adopted by people from every walk of life who wish to discourage smoking. The number of journeys completed safely on a daily basis is testament to the nonsense of this statement. The only things that make driving unsafe are inattention, faulty mechanics, alcohol and certain other medications, and bad luck/other drivers. (You can see road casualties from this link here: Table ras:10001 for numbers of accidents and Table ras:30002 for numbers of casualties. Clearly it would be better if we didn't have so many, but I don't see how you can come out with smoking as a factor on the basis of anything better than supposition.)

Bradley claims that the smoking ban is likely to stay, and even Forest despairs of removing it. But no smoking ban is needed. And while the ban hasn't brought demonstrators to the streets in Scotland as it has in the Netherlands or Spain, there is no doubt that smokers would increase their attendance in public venues if there were no ban. It is simply normal behaviour to congregate, whether over tea and coffee or over a drink.

No smoking ban is needed, because smoke is only one of a number of pollutants that were discussed in an air quality standard that was drawn up in 2007 for the whole of Europe. Table A1 shows levels of pollutants in indoor air (four levels, of which smoking takes place in levels 2, 3 and 4), and there are detailed descriptions of how to dispel the pollutants. Technically beyond my comprehension, but it certainly doesn't say: 'Don't even try and get rid of tobacco smoke. Can't be done – but here's how to deal with kitchen and garage exhausts, paints and solvents.'

All this technology exists because somebody has identified a need to extract pollutants from air. The need is there, followed by the application of science to meet the need. The wisdom of 'anti-smoking' seeks to overturn the wisdom of centuries in the words of Rollo Tommasi (comment 15). 'No air management system can protect people in a room from smoke produced in that room.' We can make aeroplanes, rockets, perform surgery, make bridges that can carry formidable amounts of traffic – design all manner of hardware, software, learn languages, apply computer languages to make virtual reality. But we can't move smoke? ever?

Try this, Rollo.

Champix and the heart

A number of media stories concern reports that Champix may be responsible for an elevated risk of heart attacks. The Mail, the Express, the Independent, Medical News Today and others including the Scotsman all carry the story. The increased risk is said to be 72 per cent, which while being around three times greater than the alleged risk of secondary smoke exposure causing lung cancer or heart disease is still not conclusive.

Alone among these stories, the Scotsman makes no mention of the injuries associated with Champix. Not everyone is affected by them, but many disturbing after-effects have been reported, some of which have led to suicide – enough to make many users and their friends call for the drug to be banned.  There are also reports that adverse incidents were reported through 'improper channels' (and here) in order to cover them up.

Study author Singh said: "I think our new research shifts the risk–benefit profile of varenicline. People should be concerned. They don't need Chantix to quit and this is another reason to consider avoiding Chantix altogether." Champix's history has been enough to get the drug withdrawn in France. It didn't need an inconclusive study on heart troubles to conclude that Champix could well be more trouble than it's worth.

Interestingly Medical News Today also states this:

Varenicline has been shown to modestly increase the chances of a successful quit attempt, compared to unassisted smoking cessation attempts. But overall, the majority of smokers who quit do so without any pharmaceutical assistance at all.

Surely this is a cue for a stop to ridiculous claims like this? and thousands of pounds of public money poured into smoking cessation aids, when most quitters don't need them.