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Speech – Smoking Ban in Public Spaces

A speech written for the Deputy Chief Medical Officer, who was due to speak before a group of employers in the weeks leading up to the nation-wide ban on smoking in public spaces.



Everyone here today is making history.

Why do I say that? Because we’re on the verge of an event of such significance that it will reshape the landscape of the nation’s health.

That’s a powerful statement. Slightly overdone some of you may think. However, it is no exaggeration. There is no risk of overstatement when it comes to the matter of saving lives – in this case, many thousands of lives.

To understand history, we need to appreciate how past events have changed and shaped society. Events remembered for what they accomplished or for being the catalyst for change: unforgettable moments in our lives.

Dr Ron Doll and Dr Bradford Hill made history in 1950 when they proved for the first time the causal link between smoking and cancer. From that moment on, it would no longer be credible for anyone to claim again that the risks associated with smoking were unknown.

Their pioneering research was the precursor to the groundbreaking report in 1962 from the Royal College of Physicians, which proved to be a turning point in educating the public about the dangers of smoking.

Nine years later, their second report would lead to a 5% drop in cigarette consumption and crucially, expose the divide in tobacco use between manual workers and professional grades.
These are just three out of countless moments in the long history of warnings against tobacco use but they each stand out for being a turning point for the impact they made on the health of the nation.

And that’s exactly where we are today. On the verge of yet another milestone; another turning point. A defining moment that if grasped will forever be remembered for having saved thousands of lives.

We need to make the most of it.

I know that I don’t need to remind you of the stark facts about smoking. They are, after all, well known.

Not without considerable thought did the Department of Health endorse the graphic images that accompany the current media campaign promoting the smoking ban.

Messages about smoking have to be hard-hitting. Campaigns like these are now the number one reason smokers in the UK decide to try to stop.

Smoking isn’t just a social habit. The average smoker is hooked on 5,000 cigarettes a year.

It’s the single greatest cause of preventable illness and early death in the UK. It accounts for 80 per cent of the incidence of lung cancer. One in two smokers will die prematurely – half of these in middle age when they are still likely to be in employment, possibly having experienced significant ill-health and absence from work in the lead up to their deaths.

Estimates of the number of deaths from second-hand smoke vary widely. The Royal College of Physicians puts the figure at 12,000 people a year in the UK. Whatever the exact figure, over 95 per cent are due to exposure to second-hand smoke in the home.

And let’s not forget that the people who stand to benefit the most from a society that is reshaped by the smoke free mentality will be those who are most disadvantaged.

Smoking is one of the main causes of health inequalities in England. It’s a significant factor in the variation in death rates between the rich and the poor and those people in lower skilled jobs are more likely to work in places where they’ll be exposed to second-hand smoke.

So we have to think about our responsibilities as well. What is our message to the cleaner, who works long hours, for scant reward, cleaning up the aftermath of countless cigarette butts in a fug of stale, cloying smoke, year in year out?

Thanks to the immense cultural shift in thinking and action on smoking, we now stand armed and ready to respond.

This legislation could not have worked ten years ago. Not because government lacked the will but because the country simply wasn’t ready.

I suspect that many of you will remember when smoking was allowed in cinemas, on trains and buses, in factories and offices. Smokers would light up casually, without fear of weary looks from passers by who were seemingly inured to its affects. A truce of sorts was in place with cigarettes the constant companion of smokers and non-smokers alike.

Today the public are more informed about what promotes their health and well-being than at any time before. Many people will no longer tolerate the invasion of second-hand smoke – many smokers are among them.

That’s why this legislation has received such overwhelming popular support. It’s estimated that up to 600,000 will give up following its introduction. People wanted it, supported it and spurred the government to go even further than it had originally planned.

Health magazines and books are now hugely popular and new health fads are being latched onto with zeal. Everyone’s heard about Jamie Oliver’s campaign to improve the nutritional content of school dinners; many of us will know about the latest advice from self-styled food doctors. Yoga competes with Pilates as the new trend in exercise and programmes on health easily compete for viewers alongside popular drama and films on TV.

The public have turned a cultural tide and are embracing health and the significance of this shift cannot be overstated.

Let me be emphatic. This is a tipping point. We must seize it or be faced with the bitter aftertaste of having missed an opportunity that will be to our everlasting regret.

How will businesses respond?

We hope that you’ll not only be inspired into rethinking your obligations to public health but that you’ll go further and become trail blazers. We want you to exemplify best practice when it comes to creating healthy, smoke-free environments.

The Public Health Minister Caroline Flint was delighted recently to see a pub in the North East proudly declaring that they’re “Ahead of Blair by being ahead of the ban”, having gone smoke-free 7 months ahead of the rest of the country.

J D Wetherspoon have long-boasted of their success after bravely introducing a ban in their pubs throughout England, a year ahead of the legislation.

These businesses were undeterred in the wake of gloomy predictions about the supposed adverse economic affects of the ban – and rightfully so.

They knew the ban was coming but they didn’t wait for it. How prepared are you?

(Ashtray slide)

The keyword is opportunity. I make no apologies for its use or its repetition. It’s a word I want you to get used to.

The ban on smoking is a fantastic opportunity.

It’s an opportunity to millions of smokers to give up a dangerous and powerful addiction and it’s the greatest opportunity in a generation to improve the nation’s health, literally over night.

What will a smokefree workplace look like? Is it simply the absence of smoke? Certainly it’s the absence of ashtrays. (This is a lame reference to the slide that Fiona wants to use.)

The workplace has long been overlooked in terms of promoting health potential but with up to 60 per cent of waking hours spent at work, it offers an ideal setting for the selling of good health messages.

Targeting the workplace means we can reach large numbers of smokers, especially young men, minority communities and manual workers, all of whom are often harder to reach.

There of course will also be the added bonus that employees will quit together and in doing so benefit from the extra motivation they’ll receive through peer support.

Will you be proactive in providing accessible information on stop smoking services? Will messages of support be within easy reach, alongside advice about avoiding stress, taking more exercise and making better and healthier food choices?

What incentives will you offer to those smokers who want to stop? Will you give them time-off to attend stop smoking sessions?

Employers that take the initiative and provide ongoing, practical assistance, will benefit from improved compliance with their new policies and better relationships with their staff.

It’s important that I make clear that no smoker will be compelled to stop against their wishes. Smoke Free England isn’t dogma or ideology. This isn’t about forcing a lifestyle change on anyone but every smoker will be given the opportunity of being carried along on a momentum of change in the hope that they’ll make sensible choices about their health.

The Prime Minister addressed this issue last summer as part of his lecture series where he talked about an enabling state that sees its role as being to empower the individual to be able to make the choices and decisions about the life that they want: not trying to make their choices for them.

And if we can support employees and consumers to make practical changes we can really build a momentum for health.

Boot have demonstrated this with their recently launched Change One Thing website, where visitors can register online pledges to quit smoking, motivated by the smoking ban.

They’re leading on a range of ways to help 500,000 of their customers stop smoking as well as providing a range of advice on ideas for healthy living.

Sainsbury’s have introduced the Wheel of Health, a simple style of food labelling which helps to better inform shoppers about nutritional content and so make healthier food choices. Others companies have pledged to follow.

We expect to get record numbers of people to stop smoking and inspire them to make positive changes to their lifestyles. But they’ll need your support.

The government has called on employers time and time again to embrace new ways of protecting their workforce. Whether through anti-discrimination legislation or the requirements under the laws of health and safety, employers have had to act decisively and innovatively, in adapting to new ideas about safeguarding the welfare of their employees.

Many of you will have led the way – setting the pace for others to follow. Now is the time to do so again.

Your employees are crying out for change. We know that through our polls and the response to our consultations.

It’s now up to you. But we’re not asking you to act alone. We know that effective partnership between government and business will be the key to our success in the months and years ahead.

We’re working to ensure that businesses have the right information to cascade to their members. Almost 1 million mail shots went out last month and more will follow in March and April.

The NHS stands ready and equipped to support those smokers that are ready to quit.

The government gave a commitment in 1998, to help the estimated 70 per cent of smokers who want to give up and the NHS plan in 2000 promised to deliver smoking cessation services that would be a world leader in its field. Since then, over £76 million has gone into those services in every health authority in England.

We know that of those smokers who want to stop, relatively few have tried Nicotine Replacement Therapy or support through the Stop Smoking Services, two methods which have proven to be most effective.

Both methods are readily available through Primary Care Trusts throughout England.

NHS Stop Smoking Services have expanded to help more people than ever before successfully attempt to stop – providing a range of high quality, evidence based smoking cessation interventions, which include a range of workplace options.

Where there’s sufficient demand, stop smoking courses can be delivered on-site, in work time or out-of-hours.

I read recently about an experiment with some American college students where the risks of tetanus was first explained to them and then they were told that without inoculation, they faced serious risks. Three per cent of them were vaccinated. The same experiment was repeated with a different group except they were given a map showing where the clinic was and times when they could get free inoculations. Twenty eight per cent of that group went on to be inoculated.

Imagine how that might translate to smokers?

Your employees need to be told about the myriad of stop smoking services that are available to them and be provided with helpful information about where to find them. And we’re relying on you to tell them.

We know that the ban presents significant benefits to the workplace and employers in terms of reduced costs, reduced staff absences, reduced cleaning costs and reduced time taken in smoking breaks.

Statistics have proven that a healthy workforce returns dividends. Your staff will thank you for respecting their health.

And importantly, international experience shows that this landmark change will encourage significant number of smokers in England to try to stop.

No one thought the Italians would ever accept that country’s smoking ban. A few years later, studies show that smoking is down, bar business is up and that more people are showing support for the ban than before its implementation.

The hospitality sector in Ireland report an increase in customers and researchers at Dundee University reported dramatic heath improvements in bar staff in Scotland within two months of the introduction of the ban.

France, California, Norway, New Zealand, Ireland, Australian, Scotland…..the international experience is positive and upbeat. We are now falling into line with the steady and growing adoption of smoking bans across the globe.
There is nothing to fear and every reason,12 million in fact, to be hopeful.

Our actions in the months leading up to the ban, and in the months and years that follow will re-shape the landscape of the nation’s health.

The success of 1 July will hinge on the support we provide to our employees and on whether we take the opportunity that lies before us.

Our advertising messages will adapt as we get closer to July 1 and we will be guided by our research findings but for now, we are determined to support businesses in raising awareness of the implementation date and of the basic requirements for public spaces and workplaces.

But I would like to ask more of those of you here today. I ask that you go further and look beyond merely complying with the legislation. I ask that you think about how you can create new approaches to smoke-free work environments and positively healthy workplaces; where employees get the support they need and are empowered to make healthier choices so that they can lead healthier lives.

The smoking ban will beckon by far the most overarching cultural shift that this country has seen in decades. The public are ready and the changes are welcomed.

Derek Wanless, writing in his report to the government, was unequivocal about the impact of the ban. It will be, he wrote, the most significant piece of public health legislation of the last 50 years.

This is a historic event and we are about to take an enormous step for healthy living.

Thousands of lives will be saved.

Countless others will be spared the misery of watching family and friends die prematurely.

Consider the consequences of inaction – of failing to take this opportunity?

Be innovators, visionaries, find the x-factor, make a difference, be ambitious, talk the loudest, stand out as a business and an employer for caring enough to go further than was ever asked of you in finding new ways of protecting and promoting the health of your employees.

Get rid of your ashtrays and become perfect messengers with the perfect message.

Thank you.


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