Big Lottery money pays for smoking cessation

A recent motion in the Scottish Parliament

 *S4M-04716 Dennis Robertson: Congratulations to CVS Aberdeenshire Central and South—That the Parliament congratulates CVS Aberdeenshire Central  and South on receiving an Awards for All grant of £4,400 from the Big Lottery Fund; understands that the grant will be used to support an existing smoking cessation pilot project by training volunteer ex-smokers to befriend smokers and encourage them to participate in local alternative activities groups; considers that CVS Aberdeenshire Central and South received this award as it will help people to have better life chances and make communities healthier, and thanks it for the work that it does.

Smoking cessation would seem (officially) to be a national obsession, but do we see a return on increasing levels of resources committed to smoking cessation?

I have recently put a FOI request to the Scottish Government on the amount of money spent since 1999 on smoking cessation. The response is due by next Friday. I'll report it here.

Minimum pricing shelved

As reported by the new-look Freedom2Choose.info website.

Since there is a legal dispute as to the competence of the Scottish Parliament on minimum pricing that will take years to sort out, the Scottish Licensed Trade Association would do well to focus its efforts in supporting our call for a review of the smoking ban. Paul Waterson and the Association clearly recognise the impact of the smoking ban on the hospitality trade.

Reviewing, and amending, the smoking ban is clearly within the competence of the Scottish Parliament.

Controlling air quality is the route to reforming smoking bans

Controlling air quality is the route to reforming smoking bans first published by ThinkScotland

A DAY DOES NOT PASS when we are not asked to believe that a substance that most people were breathing since the beginning of time – smoke from ordinary plant materials – cannot be dealt with using modern air cleaning technology. For all the literature produced about it, there have been no medical cases where causation of medical conditions has been categorically proven to be due to low levels of exposure to tobacco smoke – a fact that has made many people question the need for any smoking ban, never mind one as comprehensive as the one found in Scotland.

Recently I proposed, on behalf of Freedom to Choose (Scotland)¹, Scottish Parliament petition 01451 (Review of smoking ban) in order to challenge the assumptions of the health lobby, whose underlying motivation is to discourage smoking, that smoke is a toxin that no air cleaning technology can now or will ever be able to deal with safely, that there is no safe level of tobacco smoke, and, most definitely, that ventilation doesn't work.

Declaring that never will technology be able to clear the emissions from smoking seems to be the product of a mindset that does not want to enable smokers to be catered for either in the workplace or in recreational venues. The position of Freedom to Choose (Scotland) is that society's interests should be met rather than resisted. A blanket prohibition on smoking makes it harder for people to get together socially, and this affects people more in districts where concentrations of smokers are higher, aggravating inequalities in many ways.

It is generally true that in workplaces there is a principle that exposure to toxins is best avoided if at all possible, however it has also always been recognised that different workplaces involve different sorts of exposures to different levels of risks from different sources that are difficult to avoid without fundamentally challenging the nature of that workplace.

Asking schoolteachers and children to put up with classrooms that had tanning lamps installed and running in the ceilings would be unacceptable, yet we allow restaurants to install patio dining and drinking facilities where their workers are "forced" to expose themselves on a daily basis to the risk of malignant melanoma from solar radiation. Just as with any Class A carcinogen, there is, theoretically, no safe level of exposure to sunlight, yet we do not ban patio dining: we accept that workers can reduce the risk through partial protection provided by clothing, awnings, and sunscreen use.

We tolerate workers being exposed to levels of carbon monoxide and diesel exhaust products in indoor garages that would never be acceptable in a day-care centre: we do not simply ban indoor garages, however we accept the partial protection afforded by modern ventilation and air filtration technology.

Freedom to Choose (Scotland) is urging that the same sort of thought be applied to allowing pubs freedom of choice in deciding their own smoking policies based upon the wishes of their owners, workers, and clientele.

The ambient air, into which tobacco smoke is released, is not clean in the first place, making it well nigh impossible to isolate secondary smoke as the cause of sickness because pollutants contained in smoke are not limited to smoke. So not only is smoke not avoidable, but removing it still leaves air containing viruses, bacteria, spores, pollen, and plain old smells.

If the advocates of smoking bans are interested in clean air, their method of extracting one specific source of so-called ‘toxins’ (tobacco smoke) and leaving us with record-breaking pollutant levels in the general atmosphere lacks all logic. Their purpose is clearly and simply to discourage tobacco use by pinning all kinds of respiratory, heart and lung conditions on to smoking (or secondary smoke), in spite of the exposures to other toxins or adverse environmental conditions in the workplace, on the battlefield, or even in the home.

There are specific, measurable standards of occupational exposure to airborne contaminants, and permissible exposures vary between different jurisdictions. In saying that there is ‘no safe level’, the enemies of tobacco smoke declare that there is no point in measuring tobacco smoke which, because it is so lethal, one cannot be exposed to at all. In fact it is a mix of particles and gases, each constituent of which can be said to have a permissible safe level expressed in parts per million or billion. If people are smoking in a given air space and these permissible levels are not exceeded (for whatever reason: the room is large with a high ceiling, the window is open) there cannot be said to be a danger. When the level of smoking approaches impermissible levels, air-cleaning equipment can be used. Permissible standards are the guide regardless of whether or not a facility allows smoking.

Equipment that cleans air employs various technologies: extraction and filtration, ionising technology, and others: sometimes combined within a single unit. Any equipment that cleans air has to be maintained and serviced to ensure efficient running.

Any venue that wishes to permit smoking needs to ensure that its air-flow can cope with it. The industry should carry an audit of recommended equipment for all sizes of venue and price ranges but with specific air quality requirements in mind. Establishments that wish to allow smoking can then obtain the equipment, and once in place, patrons can be invited to smoke.

The result should be that ambient air, even with the addition of smoking, treated with air cleaning equipment, gives a cleaner result than ambient air in a non-smoking establishment where no treatment of air has taken place.

Of course upholding such standards would be an ongoing concern of the industry, with the assistance of environmental officers. But using local environmental officers to uphold and maintain air quality standards rather than simply hand out tickets to smokers is a far better use of local resources. This is about priorities.

Freedom to Choose (Scotland) believes that smoking bans damage people, increasing their isolation; and damage businesses, when they are helpless to alleviate a problem because of overzealous regulation. Taken to extremes, both isolation and business failure are measurably detrimental to health. With the rapidly increasing air pollution rates and increasing numbers of lung cancers found in non-smokers (Glasgow is one of the most polluted cities in the UK), sending people outside on to the street to smoke is worse than fiddling while Rome burns.

The power of the health lobby is a significant obstacle. We should be able to allow the hospitality industry (together with the appropriate government agency) to set standards for air quality, to give the air-cleaning industry the specifications it needs for improving ambient air, and in doing so create spaces with improved air quality where smoking can take place with the minimum of inconvenience to anyone else.

¹ Freedom to Choose (Scotland) includes both smokers and non-smokers and receives no support from any industry.

No new evidence? New petition launched

Four years ago the European Commission published an indoor air quality standard entitled:

Ventilation for non-residential buildings - Performance

requirements for ventilation and room-conditioning systems

The document refers to smoking several times. One example:

The level of air quality required, and the method of classification applied shall be specified. Whether smoking is allowed or not is an important input. The necessary air flow rates to achieve the specified requirements shall be calculated. If nothing is declared, the rates of outdoor air per person for Indoor Air Quality category IDA 2 can be used as a default.

The European Commission, the details of whose forthcoming (and rather savage) revised tobacco directive have been leaked to the press, have published evidence that tobacco smoke can be dealt with in the same way as any other toxin. In essence this is (1) establishing a safe air quality standard; (2) advising how to remove the toxins in cases where the air quality standard is breached.

Somehow in spite of having published this guidance on air quality, the European Commission has adopted an authoritarian stance recommending smoking bans in all indoor workplaces everywhere in Europe, as if there were no other solution available to a mild toxicity problem.

PE 01451, Review of smoking ban

The smoking ban in Scotland is based on this extreme position, and the new petition PE 01451 asks the Scottish Parliament to request the Scottish Government to take seriously the existence of a European standard that should enable smoking rooms to operate.

A FOI request established that the Scottish Government had no record of this standard as of last summer, even though it was published in 2008. It is therefore new evidence, which the Parliament did not have access to when the legislation went through in 2005. All they had (or all they paid attention to) was the mantras 'there is no safe level of secondary smoke' and 'ventilation doesn't work'.

Protest the Offensive Behaviour at Footbill Bill

The Stage 3 debate will take place on Wednesday 14 June, in the session beginning at 2 pm. A rally is expected to gather outside the Scottish Parliament around 1 pm.

Opposition to the Bill is growing:

Who's in charge over there?

What do Scottish Parliamentarians do if they want to smoke at work?

It's all written down here, in a policy statement from the Scottish Parliamentary Corporate Body, the organisation that runs the Parliament building and its affairs. It tells you where and when you can smoke and what you must not wear while doing so. It tells you what will happen if you flout the policy. The sugar on the pill is an offer to cover half the costs of treatment to any employee who wants to give up smoking (what's in it for them – being known as Investors in People, perhaps?). (This looks as if it could add up considerably, but it is limited to £292 per person per year. We might never know why they don't just round it up to £300.)

I don't know what the Macedonian equivalent to the SPCB is but wouldn't it be fun if this situation kicked off here?

Netherlands and Scotland plough different furrows

A short Dutch report tells us that the smoking ban is a far more relaxed affair in Dutch bars, with ashtrays in over half of them (note, you can still get a drink in a non-smoking environment in the Netherlands if that's what you prefer).

In Scotland further bans are still being discussed. Sheila Duffy explains in her (comment-free) blog that ASH Scotland supports a public consultation on extending the smoking ban to private cars (smoking is already banned in work vehicles) – whereas the British Medical Association has called for an overall ban on smoking while driving.

It's unusual for ASH Scotland not to bid for the most extreme action going on smoking. Ms Duffy claims that household exposure is a more important problem ('likely to be a greater source of exposure for children'), but is 'not an area for legislation'. Does this mean that she takes issue with Dr Douglas Noble's conclusion (quoted here) that:

In cars, particle concentrations are 27 times higher than in a smoker’s home and 20 times higher than in a pub, in the days when you could smoke in public places.

Even if ASH Scotland has not advocated a total ban in cars, the idea will go before legislators. It's interesting to speculate whether, in responding to the public consultation it seeks, ASH Scotland would oppose a smoking ban in cars, or whether it would simply sit on the fence.

A report and summary of last year's study on smoking in cars by NHS Greater Glasgow (with a headline designed to sensationalise the issue) can be found here (same text here with comments). Also discussed here.

We won't know the legislative programme on smoking in Scotland until after the Scottish Parliament reconvenes in September. But it won't resemble the Dutch one.

Policy by public opinion poll according to ASH Scotland

The lull in anti-smoking legislation will soon be over, and Sheila Duffy will soon stop reminding the incoming government of its obligations to children and get down to some serious work. Her latest effort claims:

Our polling shows that the public are aware that there are risks to children’s health from exposure to tobacco smoke with a huge 88% saying that they think second hand smoke increases the risk to a child’s health ...

The agenda has clearly moved to children (adults are no longer exposed in the workplace), meaning we can expect restrictions on smoking in homes and cars. The reasoning is superbly executed ... most people think smoke endangers children, therefore policy must be 'x'. (Are most people right? We should be told, but not only by Sheila Duffy.) More:

This is not necessarily about getting smokers who look after children to quit. Rather it is about informing people about the harms caused by tobacco smoke and showing parents and carers that the best way of protecting their children from the harm caused by second hand smoke is to not smoke around them.

So they are not even bothered about getting adults to quit any more. They are after 'harm reduction', which means nicotine replacement therapy in ASH Scotland's language. This means that they may have absorbed the wisdom imparted by the likes of Tim Coleman that NRT doesn't work for most people once they have left the clinic. That is, it doesn't work as a quit smoking tool, but it can still be used to relieve temporary discomfort.

Ms Duffy then goes on to recommend a 'social marketing campaign' covering the dangers of passive smoke exposure to children. What happened to public information campaigns? The term 'social marketing' is itself instructive, as marketing is a form of deliberate persuasion. The messenger is quite uncritical of the message: it has been taken for granted as fact, removed from the realm of objectivity, and given to the marketers to deliver to the public.

ASH Scotland has yet to start pushing for third-hand smoke awareness, but it's only a matter of time. Third-hand smoke is discussed clearly by Chris Snowdon here; he quotes author Winickoff from a private email regarding his study on third-hand smoke:

Basically, the study found that IF you believe that thirdhand smoke is harmful to infants and children, then you were much more likely to have a home smoking ban.

Not much science there either really, is there? More logic, really, and certainly doesn't address the issue whether third-hand smoke is a danger to children, or an issue that would make it advisable to wear a face mask when changing bed linen. The line of argument is identical to Sheila Duffy's. If enough people believe it's dangerous, there is no need to prove it any more.

Lodging motions on Pell in the Scottish Parliament

Actually some of them really believe what she came out with: 

*S3M-7054 Kenneth Gibson: A Reduction in Smoking Means Fewer Asthma Attacks—That the Parliament welcomes the findings of recent research by the University of Glasgow concluding that the admission of children with asthma-related problems to hospital has dropped by more than 18% since the introduction of the ban on smoking in public places in 2006, a reduction equivalent to three fewer children being admitted each day; recognises that, prior to the ban, the admission of children with asthma was increasing at a rate of over 5% per year; notes that the researchers also discovered that, since the ban, there had been a 17% year-on-year drop in hospital admissions from heart attacks and a significant decline in respiratory problems among bar staff; considers that the smoking ban has resulted in a massive step being taken toward shedding Scotland’s image of being the sick man of Europe, and believes that this legislation has greatly improved the health and wellbeing of the Scottish people.

Chris Snowdon crunches the numbers on this by helpfully breaking down the figures supplied on Pell's graph for each year under study and breaking them down into daily averages: 


2000: 2391/366 = 6.53 per day

2001: 2142/365 = 5.87 per day (drop)

2002: 2034/365 = 5.57 per day (another drop)

2003: 1803/365 = 4.94 per day (another drop!)

2004: 2621/366 = 7.16 per day (rise)

2005: 2103/365 = 5.76 per day (drop)

2006: 2633/365 = 7.21 per day (rise)

2007: 2056/365 = 5.63 per day (drop)

2008: 2235/366 = 6.11 per day (rise)

2009: 1397/304 = 4.59 per day (drop) (ten months only of this year counted)


(I added the 'rise' and 'drop' indicators for additional clarity!) Kenneth Gibson also applauds the 17 per cent figure that Pell came out with in 2007 with respect to heart attacks. I didn't know anyone took that figure seriously any more, especially since the drop in England was 'found' to be only 2.4 per cent: a figure that was also not corroborated by routine statistics.


Isn't it reassuring that Scottish leaders believe what they want to believe, rather than looking squarely at the evidence in front of them? 

Radio controlled vending machines

The National Association of Cigarette Machine Operators has been hit by bans on its vending machines both by Westminster and Holyrood and the machines are expected to go out of commission in October 2011. This means that in future years youngsters will be unable to obtain 16 tabs for the price of 23, but the powers that be clearly feel that they will be thereby less tempted to buy cigarettes.


NACMO has created a vending machine that works by radio control, following age verification. Once the machine is turned on, it allows only one sale before it turns itself off again and must be reactivated from behind the bar before any further use.


I witnessed the final debate at Holyrood when the Scottish Parliaments passed the display ban and vending machine legislation (to a round of applause!) as part of the Tobacco and Primary Medical Services Bill (quite how the display of tobacco was connected with primary medical services was not made clear). A Labour MSP Rhoda Grant proposed an amendment to allow a trial of radio controlled vending machines in Scotland. None of her party supported it, and when the Conservatives pushed it to a vote, she voted against it. Michael Matheson SNP's statement was telling: 'we have no robust evidence to demonstrate that remote-controlled vending machines are a much more secure way of ensuring that young people cannot access cigarettes'. 


Even the fact that these machines are standard in many European countries and the premium rates charged on top of the UK's rather atrocious retail prices for tobacco would not convince him that stinging operations on vending machines did not reflect where youngsters actually buy their baccy. If the machines are removed it only means that the most expensive choice of cigarettes will be taken off the market.


As for 'no robust evidence'? How about this quotation taken directly from the Stage 1 report by Mary Scanlon (Conservative): 

The Committee notes that strong views were advanced on both sides of the debate. The Committee also recognises that the evidence base for this proposal is at an early stage and that the international evidence to date is inconclusive.

Ms Scanlon points out that there is no evidence base to support the entire Bill (that part relating to tobacco). Yet Mr Matheson quibbles about knowing whether a machine works, even when being asked to consider running a trial. Little difference between this and 'no robust evidence'. 


Isn't that always the answer: any technology that offers a solution that might prevent a ban 'won't work'. Not ventilation. Not radio-controlled vending machines.


The Scottish Government and many of the parliamentarians seem quite myopic on this issue. The present initiative described in the Morning Advertiser is directed at Westminster, and time will only tell whether they will come to the conclusion that there is no need to ban vending machines. 

Official In Scotland Too: The smoking ban did it

Press reports abound yesterday and today of the 737 pubs that have closed in Scotland since the smoking ban was implemented on 26 March 2006. For once the story (in the form of a report for the Save our Pubs and Clubs Campaign) says that the smoking ban is to blame for these closures.

Predictably the response has come that the story has much to do with supermarket prices, property prices, changing habits and anything else but the smoking ban. (Actually I think it fair to say that the legislation was brought in because in spite of a 30-year decline in smoking rates, change was not happening fast enough for those who wanted to bring smoking rates down.)

Of course the trading situation is difficult for the pubs, but the point is that the smoking ban changed pubs from an ideal meeting place for people who wanted to meet friends, colleagues and family for a drink and a chat, to an irrelevance. Smokers made up a larger proportion of pub customers than of the general population. An attack on smokers was bound to hurt the trade (and a significant proportion of cafeterias). The people who wrote the report have been accused of being apologists for the tobacco industry, but it doesn't take tobacco funding to tell you that a smoking ban will put smokers off. In areas and among groups of friends where almost everyone smokes (and some pubs will tell you that nine-tenths of their customers smoke) it just seems more trouble than it's worth to have to keep going outside to smoke.

THE SOLUTION?

Freedom to Choose (Scotland) Chairman Eddie Douthwaite was quoted in the STV version of the story as follows:

Eddie Douthwaite of Freedom to Choose (Scotland) believes that modern air filtration methods mean that the smoking ban should be amended.

He said: "Modern air filtration technology is a far cry from the 'ventilation' considered unable to extract toxins or particulate matter from the air when the introduction of a smoking ban was debated in 2005.  

"These air filtration products are currently fitted in aircraft and in hospitals, where they can remove particulate contamination together with airborne viruses, spores, and bacteria. Their use in the hospitality industry as an alternative to smoking bans is surely a step in the right direction especially as the indoor air quality would be far better than the air outdoors.

 "The Scottish Government should accept that new technology has provided a solution that could eliminate any need for this socially divisive and economically disastrous smoking ban."

HISTORY OF THE CAMPAIGN
Freedom to Choose (Scotland) submitted a petition in 2007 to the Scottish Parliament calling for a review of the smoking ban, and the introduction of Regulated Indoor Air Quality Standards. Such a standard would require the use of air-cleaning equipment if air quality did not meet specific standards, and would cover airborne pollution from any source.

In essence the Scottish Parliament agreed to close the petition and to bring its concerns to any future post-legislative scrutiny of the legislation. (The petition was considered jointly with another petition on the smoking ban from the CISWO (Coal Industry Social Welfare Organisation) club in Glenrothes, calling for designated smoking rooms to be allowed – their evidence included trading figures from licensed clubs in the area.)

These are the terms in which the case was effectively dismissed by the Health & Sport Committee.

Smoking, Health and Social Care (Scotland) Act 2005 (PE1037 and PE1042)

Dr Simpson: ...I have just one comment on air pollution. It is interesting that when Kenny Gibson and I made the original proposal for a bill to ban smoking in pubs and restaurants, which was rejected by the health minister at the time, the alternative to such a ban was the installation in premises of air filtration and anti-pollution systems. We now know from information that was provided as a result of freedom of information requests to the tobacco companies in America that such systems do not filter carcinogens from the air. I put on record the fact that, as we tackle smoking problems in the future, we will again face one of the most powerful global industries, so we should be extremely careful not to be duped into taking voluntary measures to curtail smoking that could subsequently be circumvented by the tobacco industry.

Helen Eadie (Dunfermline East) (Lab): It is important to consider all the issues in detail. That is why I agree that when post-legislative scrutiny of the 2005 act is undertaken, consideration of the issues that the petitions raise should be right up there with consideration of the other impacts of the smoking ban. It is right and proper for consideration of such matters to feed into that scrutiny.

The Convener: Without prejudging the post-legislative scrutiny, I think that it would be appropriate for the issues that the petitions raise to be considered along with other issues, such as the impact of the ban on businesses. Are members content with that approach? [my emphasis]

THERE HAS BEEN NO POST LEGISLATIVE SCRUTINY TO DATE ON THIS SUBJECT. In the meantime the Scottish Government has steam-rollered on with more jewels from the tobacco control agenda, such as the tobacco display ban. 

An example of suitable equipment for tackling irritants in smoke is Air Manager, a link obtained from a government web site. It can take out particles down to 0.01 micron and 99.9 per cent of bacteria, spores and viruses. It takes out not only smoke but the rest of the muck too. 

Thankfully at least STV has been able to recognise that people should know that there is a viable alternative to the smoking ban.

MP joins fight against the display ban

Mike Weatherley MP (Hove, Conservative) has joined the fight against the tobacco display ban, and promised to pursue it with written questions in Parliament, according to the Sunday Express.

The Sunday Express itself has launched a campaign to save our newsagents, launched shortly before the General Election. Mike Penning, Shadow Health Minister at the time, promised that Conservatives would review the legislation if elected, and the Express vowed to campaign against any attempts to bring in 'this unfair legislation'. Their decision is awaited.

Meanwhile in Scotland, Imperial Tobacco has challenged the legislative competence of the Parliament to pass the ban in Scotland. The case was heard in July and the result is awaited.

Finally Finland (well, why not?), where prohibition appears to be on the way. A display ban has been passed, much to the delight of Action on Smoking and Health (ASH), which has sent a message of congratulation. Their statement to Medical News Today:

Across the UK those who make and sell cigarettes have been fighting tooth and nail to overturn this legislation but the tide is running against them. Laws for smokefree public places started in a few small jurisdictions and rapidly spread across the globe.

They love calling all the opposition to their plans 'those who make and sell cigarettes'. In the memorable words of the late Gian Turci, late CEO of Forces International:

In the minds of these deranged fanatics all those who:

• Oppose smoking bans
• Defend the freedom of choice
• Uphold real science, and condemn the epidemiological trash science used to justify suppression
• Fight for ethics in science, politics and in the media
• Advocate peaceful coexistence, civilized behaviour and social tolerance, or
• Fight for the survival of their businesses

ARE the tobacco industry when it comes to smoking, ARE the food industry when it comes to eating, ARE the alcohol industry when it comes to drinking, and ARE the oil industry when it comes to denouncing the global warming hoax!

Whatever one thinks of the global warming theory, the validity of Gian's point is beyond question. Opposition to the health agenda is equated directly with commercial interest in some offending industry. If there is no connection they seek to create one in the minds of the public while quietly forgetting, for example, that by far the biggest cut from tobacco is taken by government in the form of taxes.

Back to ASH on the subject of Finland.

We are seeing exactly the same process here, the only question is: Will the UK be one of the first major economies to implement a display ban or will it be the first to cave in to tobacco industry pressure and reverse a law that has already been passed by parliament?

For tobacco industry pressure, of course, read 'pressure from the general public and from tobacco retailers who would like to be viewed as partners in the effort to keep tobacco out of the hands of children, rather than as potential criminals (p. 5)'.