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Liverpool City Council (Prohibition of Smoking in Places of Work) Bill [HL]

My Lords, like other noble Lords, I look forward to hearing the humour of the noble Lord, Lord Stratford, in making his points. I am only sorry that he is not in his place. I congratulate the promoters of the Bill. I am president of ASH in Wales and a practising clinician there. I have not reintroduced my Smoking in Public Places (Wales) Bill as I have had assurances from the Secretary of State for Wales and Dr Brian Gibbons, the Minister for Health and Social Services in Wales, that the Health Improvement and Protection Bill, already referred to so often, will give Wales the powers and freedoms to implement a ban on smoking in public places as it sees fit. Wales has already held a very comprehensive consultation process chaired by Val Lloyd AM, and the committee has reported to the Assembly. It was a very thorough consultation process and I hope that England can learn from it. The Committee on Smoking in Public Places in Wales drew on much evidence and concluded that,"““there is overwhelming evidence that environmental tobacco smoke is damaging to health. Ventilation equipment is not capable of removing the majority of health damaging particles from the atmosphere; there is no evidence that the introduction of a ban would have an overall negative impact on the economy; [and] while acknowledging the right of people to smoke a product that is obtainable legally, this right should be exercised responsibly. The majority of the public who do not smoke should be able to go to their place of work and other enclosed public places without risk to their health””." A recent survey of the population of Wales shows what is now enormous support for an overall ban. Back in 1998, a report commissioned by the four UK health departments concluded that environmental tobacco smoke exposure is hazardous. The committee’s update in 2004 reviewed all new evidence and concluded that knowledge of the hazardous nature of second-hand smoke has consolidated. It constitutes a serious public health risk. Many major studies have shown the adverse effects of the exposure of non-smokers to workplace environmental tobacco smoke. Time does not allow me to go through them, and the noble Baroness, Lady Gould of Potternewton, has already referred to the effect on pregnant women. There is also an increase in the risk of developing lung cancer by 20 to 30 per cent, and an increased risk of coronary heart disease by 25 to 35 per cent. There is a significant reduction in the lung function of non-smokers exposed at work, and a higher prevalence of respiratory irritational symptoms. Concentrations of salivary cotinine found in exposed workers are associated with substantial involuntary risks for cancer and heart disease. The problem of environmental tobacco smoke is so widespread that the studies are of whole populations. By their very nature, such epidemiological studies need large populations. Taken together, their evidence is very strong. No one in the mainstream medical and scientific community doubts that there is a risk from environmental tobacco smoke. Children, pregnant women, people with existing cardiovascular or cerebrovascular disease or asthma and other respiratory disorders are particularly vulnerable. Relatively small exposures of non-smokers to toxins in tobacco smoke seem to cause unexpectedly large increases in the risk of acute cardiovascular disease. The mechanism is probably through platelet aggregation and vasospasm, as is seen with nano-particle atmospheric pollution. Professor David Cohen modelled the economic and health impact of a ban on smoking in public places for Wales, which has a population of near 3 million. If that is extrapolated for London, with a population of 7   million, and Liverpool with almost half a million, the annual number of lives saved might be 1,012, with a further 150 to 450 resulting from a reduction in active smoking. The Irish model, of course, gives interesting data which completely support the proposals of both Bills. Why are these Bills quite so important? They are particularly important because the major benefit of stopping exposure to tobacco smoke at work is an overall reduction in smoking. I declare that I would like to see that as a secondary result. The Department of Health previously proposed that smoking would be allowed in bars that do not serve food. Like the noble Baronesses, Lady Williams of Crosby and Lady Gould of Potternewton, I have major concerns. Such bars will become havens for tobacco promotion. They will be decked out to attract the young—not the elderly, such as the likes of us. Youngsters, especially those who carry the genetic variant on a single gene, called CYP2A6, are particularly sensitive to the addictive potential of tobacco. These pubs will have loud music and alcohol and tobacco aplenty. It will be a great way to hook in the young—especially young girls, who already seem to smoke more than boys—and get them addicted to tobacco. That will create a long-term market. Wales will have an effective ban. The rest of the UK must also be able to have bans which are effective. That is why I support the Bills for these two important cities in England.