Health Bill

– in the House of Lords at 3:07 pm on 19 June 2006.

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Report received.

Clause 2 [Smoke-free premises]:

Photo of Lord Russell-Johnston Lord Russell-Johnston Liberal Democrat 3:13, 19 June 2006

moved Amendment No. 1:

Page 2, line 11, at beginning insert "Except as provided in section (Premises serving food),"

Photo of Lord Russell-Johnston Lord Russell-Johnston Liberal Democrat

My Lords, the amendment that I am moving is essentially the same as that moved by my noble friend and colleague Lord Steel when the Committee met under the calculating eye of Moses on the wall. Unfortunately, my noble friend has a lunch engagement in Edinburgh, connected with cancer research, oddly enough, so I am standing in for him. I hope that he will be here later.

The amendment must be read in conjunction with the new clause, in which there is a small change—the word "adequate" having been removed before the word "ventilation". While "adequate" is a word that is understood in common sense, it appears to have no clear legal definition.

The amendment is about choice, which I regard as being fundamental to a liberal society. Having spent much of the weekend reading the Official Report of the Committee stage, I believe that the clear distinction between those who support my amendment and related later ones and those who do not is our wish to provide choice and the Government's intention to deny it. The Government are, I am sad to say, supported by my own Front Bench, which in my 42 years in Parliament I have never previously opposed but now very firmly do so.

This is not a divide between smokers and non-smokers; it is about the rights of both. I support many non-smokers who want to find a fair way forward. People like me who are equally aware of the more harmful effects of excessive drinking do not preach prohibition. It is one of the moral contradictions of previous and proposed legislation, as the noble Lord, Lord Stoddart of Swindon, has often pointed out, that at the same time as imposing draconian laws preventing smoking we are easing restrictions on drinking. The number of deaths from alcoholism is about the same as that from smoke-induced cancer, but the pain, misery and crime related to drinking exceeds that related to smoking by 100 per cent.

In my opinion, the whole Government case rests on poorly substantiated arguments about the supposed dangers of passive smoking. Having looked at the evidence on display, I suspect that going into a room in which three or four people are smoking puts you at rather less risk than walking down Victoria Street. The noble Lord, Lord Harris of High Cross, has written an excellent pamphlet, Smoking out the Truth. I quote only the British Medical Journal's publication of the work of the American Cancer Society, which tracked 118,000 Californians over 40 years and concluded that the results did not support the existence of a causal relationship between passive smoking and tobacco-related mortality. More recently, we have the report of our own Select Committee on Economic Affairs on responses to risk. It said that,

"evidence we received suggested that the health risks associated with passive smoking are relatively minor".

I mention passive smoking right at the beginning of our debate because the issue affects every aspect of the Government's proposals and the Government's case is clearly not scientifically substantiated. My amendment is nevertheless an attempt to compromise, suggesting a solution in which the risk of passive smoking—if risk there indeed be—is removed by the provision of physically separate smoking and non-smoking areas in restaurants. The amendment also stresses that the smoking areas should be well ventilated. A letter that I have received from AIR states:

"Sensibly constructed smoking rooms prevent any movement of smoke into adjoining non-smoking areas. This is reflected in the regulations implemented in Sweden and Italy. Hospital operating theatres and high-tech clean rooms rely on ventilation and filtration to stop contamination. The technologies used are equally effective against environmental tobacco smoke".

I question the view cited by my noble friend Lord Clement-Jones, who is not with us today, that there is no such thing as adequate ventilation. Effective ventilation basically means air displacement and replacement; therefore, there is such a thing. This amendment, if implemented, would in no way detract from the Government's intentions to isolate smoking, even though I consider their argument ill founded. It would, however, protect freedom of choice and uphold the rights of smokers and non-smokers alike. I beg to move.

Photo of Baroness O'Cathain Baroness O'Cathain Conservative

My Lords, I draw the attention of the noble Lord—who quoted a letter from AIR—to paragraph 63 of the brief prepared for us by the Smokefree Action people, which says that research by D Kotzias and others at the European Commission Joint Research Centre's INDOORTRON facility concluded that,

"changes in ventilation rates simulating conditions expected in many residential and commercial environments during smoking do not have a significant influence on the air concentration levels of ETS constituents, e.g. CO, NOx, aromatic compounds, nicotine. This suggests"— this is the important part—

"that efforts to reduce ETS originated indoor air pollution through higher ventilation rates in buildings, including residential areas and hospitality venues, would not lead to a meaningful improvement in indoor air quality. Moreover the results show that 'wind tunnel' like rates or other high rates of dilution ventilation would be expected to be required to achieve pollutant levels close to ambient air limit values".

We should not take what various people say for granted, but go back to the experts. These are the experts. I am that sure the noble Lord has also received the same briefings as we all have.

Photo of Lord Walton of Detchant Lord Walton of Detchant Crossbench

My Lords, many of the arguments put forward by the noble Lord, Lord Russell-Johnston, and others are based on the view expressed by a number of noble Lords in Grand Committee that passive smoking carries very little, if any, health risk. When a lawyer says, "With respect", he means, "I do not agree with you"; when he says, "With great respect", he means, "You are talking nonsense"; and when he says, "With the greatest possible respect", he means, "You have gone off your head". With the greatest possible respect to the very distinguished Members of your Lordships' Economic Affairs Select Committee, I find the remarks made in its recently published report quite extraordinary and, indeed, inconceivable.

The evidence that has been accumulated over the past five years has become increasingly powerful in demonstrating the devastating effect that passive smoking may have on the health of those exposed to it. Second-hand smoke is now classified as a class A substance—a known human carcinogen—by the US Environmental Protection Agency. Other class A carcinogens include asbestos, arsenic, benzene and radon. About 50 international studies of second-hand smoke and lung cancer risk in people who have never smoked have been published over the past 25 years. Most recently, in 2004, the World Health Organisation's International Agency for Research on Cancer reviewed the literature and concluded that second-hand smoke is cancer causing and that non-smokers living with smokers increase their lung cancer risk by approximately 20 per cent for women and 30 per cent for men. For non-smokers exposed in the workplace, the risk of lung cancer is increased by 16 to 19 per cent. The Government's own advisory committee on the effects of smoking, the Scientific Committee on Tobacco and Health, concluded that there is an increased risk of lung cancer for non-smokers of about 24 per cent.

In Grand Committee, a noble Lord referred to the fact that Sir Richard Doll was quoted some time ago as saying that active smoking was harmful, but that second-hand smoke did not worry him. He said that as a throwaway remark when being interviewed on Radio 4's "Desert Island Discs" in February 2001. I knew Richard Doll very well and, some years ago, I had the privilege of succeeding him as warden of Green College, Oxford. In February 2005, just a month or two before he died, he wrote:

"We first established the causal link between smoking and lung cancer in 1950, but the tobacco industry spent decades arguing that our results did not justify our conclusion . . . Now tobacco companies are using the same technique to undermine the conclusion that passive smoking causes fatal disease. The evidence that it does is clear", and incontrovertible. He continued:

"As a responsible citizen, I believe that nobody should have to work in an atmosphere polluted by other people's smoke".

The evidence to the effect that to create smoking and non-smoking areas in places where food is served may overcome that risk is not at all convincing. All the medical bodies that I have consulted, and a huge number of public bodies acting on behalf of the communities in which they live, have come to the conclusion that that will not be an effective solution to the problem and that the only way in which the public at large and the workers in the catering and public house industries can be protected is by banning smoking entirely in those enclosed spaces. For that reason, I certainly could not support the amendment, particularly as recent public surveys have, in response to questionnaire exercises, indicated that across the country, and particularly in my native north-east of England, where the problem is very serious, more than 70 per cent of the public at large wish to see this ban imposed, as in the Bill that stands before us for consideration.

Photo of Lord Monson Lord Monson Crossbench

My Lords, with the greatest respect to my noble friend Lord Walton, I believe that the committee chaired by the noble Lord, Lord Wakeham, is broadly right. Experts can probably be found to advance a different point of view from those cited by the noble Lord and the noble Baroness, but we should look at the empirical evidence. I would guess that almost everyone in this Chamber today was born before 1955. Anyone born between, let us say, 1925 and 1955 would inevitably have been brought up surrounded by smoke, as everybody smoked in almost every public place and many people smoked at home as well, but we are all here, fit and well.

Photo of Lord Clinton-Davis Lord Clinton-Davis Labour

My Lords, has the noble Lord ever been to a hospital and seen the effects of passive smoking on people?

Photo of Lord Monson Lord Monson Crossbench

My Lords, I do not think that anybody has ever had a death certificate with the words "passive smoking" on it. I agree that heavy, active smoking is dangerous—although not everybody is affected by it because it depends on one's genes—but the danger of passive smoking is, as yet, unproven. There is bound to be a slight risk, but I do not think that it is very great.

To return to the amendment, the Minister will no doubt argue that the amendments are too narrowly drawn and therefore somewhat illogical. Why confine the Liberal approach—using "liberal" in both senses of the term—to places where food is served? I would agree, but that can easily be rectified at Third Reading or when the Bill returns to the other place. The principle is the important point. Under the arrangement proposed by the amendment, all employees would be protected from risk because no permission would be granted unless the room was totally segregated and sealed off and there was ventilation. That answers the point made by the noble Lord, Lord Walton. That protection would be at the cost of minor inconvenience to smokers, because they would either have to collect their food from a buffet and carry it to the smoking area, or there would have to be an updated version of the 19th century dumb waiter if they wanted to smoke at the table. Actually, I believe that in 90 per cent of cases people would not wish to smoke at the table and would be perfectly happy to eat their meal with non-smokers and then retire to a separate smoking room for a cigarette or cigar, coffee and, possibly, something stronger. In that way, although the restaurant, pub or hotel would have had to go to some trouble and expense to provide a fully sealed and well ventilated smoking room, everybody ends up a winner and there are no losers.

Rather than tamely following in the footsteps of New York City, California and a couple of other places in the United States that seem to have been seized by a modern form of puritan zealotry in matters of health, reminiscent of the disastrous experiment of prohibition about 80 years ago, we would do far better to emulate the Scandinavians. Indeed, the Government's marginally more liberal original proposals went, to some extent, in that direction before they were messed up on the Floor of the other place. Nobody could accuse the Scandinavians of being politically incorrect or in the slightest degree lax where health and safety are concerned; they are quite the contrary. Yet even the Scandinavians recognise that smokers deserve a fair deal and therefore they allow separate smoking rooms and smoking areas, provided that they are fully segregated. In that way, nobody loses out. That is surely far more in tune with our tradition of fair play than the puritanical absolutism we see across the Atlantic, an absolutism that is quite unnecessary for the purpose of protecting employees.

Photo of Lord Faulkner of Worcester Lord Faulkner of Worcester Labour 3:30, 19 June 2006

My Lords, when I seek advice on medication, I tend to ask my doctor. When it comes to other health matters, I prefer to listen to medical experts rather than to people who regard themselves as experts in other fields. The Economic Affairs Select Committee is made up of individuals of extraordinary quality and huge ability, but if one looks at what they have done in their lives, one sees that not one of them has any medical experience whatever.

Medical experts are united on passive smoking. There is not one reputable medical authority opposed to what the Government seek with this Bill. Their Scientific Committee on Tobacco and Health describes second-hand smoke as,

"a controllable and preventable form of indoor air pollution . . . a substantial health hazard", and says:

"It is evident that no infant, child or adult should be exposed to secondhand smoke".

Similar points were made in a letter to the Times, which was published last Thursday, signed by the chairman of the council of the BMA, the chairman of the Academy of Medical Royal Colleges and the general secretary of the Royal College of Nursing. They said:

"To the medical and nursing professions the evidence is clear, overwhelming and unequivocal. There is no safe level of exposure".

The approach proposed in this amendment is not novel, although, interestingly, it was rejected by the Labour and Liberal Democrat parties at the last election. Both parties were committed to a smoke-free policy wherever food was served, whether in a pub or a restaurant. The noble Lords, Lord Russell-Johnston and Lord Monson, are correct that the policy has been followed in a number of countries, but, inconveniently for them, in most cases where that approach has been followed, it has either been abandoned or found to be unworkable. The report published by the Health Select Committee in another place reported at paragraph 36 that,

"the law in Italy provides for separate smoking areas with illuminated signs, automatic doors and an approved ventilation system. However, because of practical difficulties in creating such an environment in many premises, it is estimated that 97% of outlets in Italy have in fact introduced a complete ban on smoking".

In Scandinavia, Norway is an interesting example. I had the good fortune to visit Oslo with the All-Party Parliamentary British-Norwegian Group during the Whitsun Recess. We met Dr Bjrn-Inge Larsen, the director-general for health and social affairs in the Norwegian Government; he is the equivalent of our Chief Medical Officer. He has since written to me and is happy for me to quote from his letter:

"Prior to 1 June 2004, Norwegian legislation on smoking in bars and restaurants allowed smoking in 50% of the premises. An evaluation study from 1999 showed that the smoking zones were not a satisfactory arrangement. Results from this study showed that the enforcement of the law was not satisfactory. In at least 30% of Norwegian communities, there was no supervision at all. In the remaining communities supervision was random and often superficial. Approximately 50% of the inspectors said it was impossible to follow the regulations concerning zones in practice. Few of them were satisfied with the current regulations, and a majority wanted stronger restrictions. Among guests, a majority—two-thirds—reported that they preferred staying in smoke-free areas. Evaluations after the ban came into force, show that the hospitality industry itself reports that compliance after the total ban is 90% as opposed to only 51% when the legislation required smoking zones".

The noble Baroness, Lady O'Cathain, has said exactly what I wanted to say on ventilation, so I will not tire your Lordships by repeating it, although it is interesting that again the Select Committee dealt with the matter very convincingly in the other place.

The noble Lord's amendment proposes that staff would not be forced to work in smoking rooms. How workable is that? Just imagine what it would mean. Let us suppose that it has been a long, tiring day working in the pub. The smoking room is full of dirty glasses and perhaps the remains of uneaten food. The ashtrays are full. The atmosphere is disgusting. Then the boss asks the 19 year-old waitress from Poland to go in and clear up. She says, "I am sorry. I am taking advantage of the protection given to me by Lord Russell-Johnston's amendment and I refuse to do it". It is not a conceivably sensible or workable proposition.

Finally, paragraph 49 of the Select Committee report says:

"The argument that workers can choose where to work and therefore can decide whether to take on health risks goes against the grain of most legislation to protect workers. The same point could have been made about child chimney sweeps".

Photo of Lord Wakeham Lord Wakeham Conservative

My Lords, I thought it possible that there might be some reference to the Economic Affairs Select Committee's report on risk management and therefore I thought I would take the earliest possible opportunity to repeat what we said in our report, not what I think most people who have probably not read the report will deduce as what we said. It was a report on the Government's management of risk in its widest sense. The report is favourable to the Government and states that they have rather good policies in relation to risks. We gave one or two examples, but the one that is clearly of interest to the House at this stage of the Bill is what we said about passive smoking.

First, we said that we accept that there are health risks in smoking and that it is better not to smoke. Secondly, we said that there are health risks in passive smoking but that the issue is how much risk. This was not based upon our views, as one noble Lord on the other side of the Chamber said. Everything in our report was evidence-based and anyone who cares to look at it will see that the people who gave evidence actually know what they are speaking about. We had evidence on this issue, particularly from Sir Richard Peto, the professor of medical statistics at Oxford University, who—if I may summarise what he said in his evidence—is in favour of banning smoking for entirely different reasons from the Government. He is in favour of banning passive smoking because that will make it so damn difficult for anyone to smoke anywhere that they will not smoke. That is his reason. But he said that the risks are small and difficult to measure.

The Minister's colleague, Caroline Flint, also gave evidence. She pointed out to us that 95 per cent of all the deaths from cancer take place from smoking in the home. The Bill does not deal with smoking in the home. Indeed, the argument put to us is that it might actually increase smoking in the home because, in so far as people are not able to smoke in the way in which the noble Lord, Lord Russell-Johnston, would like, they will smoke in their homes. So, in that sense, the Bill will increase the risk of cancer because more people will smoke at home and more children will be affected.

Photo of Lord Wakeham Lord Wakeham Conservative

My Lords, the noble Lord has distorted what I said already. He has had his go so perhaps I may finish what I have to say, which will not take many more seconds.

The issue about which we were concerned and which we wished to put to the Government is that there is a little bit of risk but there is also an infringement of human liberties. It is the necessity of government—and the Government's responsibility—to judge those two factors and to reach a conclusion. Having listened to the evidence, we came to the unanimous conclusion that the infringement of human liberty was sufficiently high in our scale of priorities and the risk of passive smoking—particularly as the Bill does not affect matters in the home—was sufficiently small that in our judgment it did not justify this policy. So that is what we said.

Anyone who wants to read the report is welcome to do so. No doubt there will be a debate on our report in another place, but it does not quite say what some people wish to interpret it as saying. I think that the report is fairly moderate and reasonable. I agreed with the noble Lord, Lord Faulkner, when he said that the committee was made up of eminent people—that was a good start—but his speech went downhill a little after that. The report was unanimous—and the overwhelming bulk of the members of our committee do not smoke.

Photo of Lord Clinton-Davis Lord Clinton-Davis Labour

My Lords, the speech that we have just heard is a little prejudiced by reason of the fact that the noble Lord, Lord Wakeham, presided over the committee. That does not mean to say that the committee came to the right conclusion.

Photo of Lord Wakeham Lord Wakeham Conservative

My Lords, it was a unanimous vote.

Photo of Lord Clinton-Davis Lord Clinton-Davis Labour

So what, my Lords? I do not care whether it was unanimous or not; it was wrong. The noble Lord did not speak about the infringement of the human liberties of the people who suffer from passive smoking, or any sort of smoking. Whether it occurs in the home or outside is irrelevant. I would support a conclusion that there should be no smoking in the home at all.

I am not persuaded by the idea that what is proposed now represents an infringement of human liberty at all. Nor is the question of choice relevant. Does the victim of passive smoking have any choice? I think not. For that reason I also unreservedly support banning smoking in the workplace and in enclosed public places. I would go even further, but we are considering today what is in the Bill. The question of choice therefore represents a sort of blindfold to which we should not be subject at all.

It has also been proposed that the Bill include other concerns. The fact that we do not deal with everything is no reason for not dealing with something. Therefore, although we ought to consider road vehicles on other occasions, on this occasion we are considering smoking. For that reason we should come to the conclusion that is consistent with pretty well all the medical and health organisations that have opined on this issue. Their views unmistakeably are that smoking, particularly passive smoking, is injurious to health.

The noble Lord, Lord Monson, flies entirely in the face of the opinion of people well qualified to opine on these issues because it is part of their everyday experience. People such as nurses, doctors—and I am not talking only about consultants, but ordinary doctors—unreservedly, through their professional bodies, come to the view that smoking is harmful. It is a view that I agree with. I do not think that any noble Lord ought readily to fly in the face of the opinion of people such as those to whom I have referred.

The issue has been well tried in Ireland, Scotland, New Zealand, New York and elsewhere. It would be idle to pretend that we can ignore the views of people as widely based as that. I admit readily that I am prejudiced about this because I smoked until 1992, when I became ill. I smoked cigars; I think I was wrong—I exposed people to risk who had no choice about what I was doing.

Photo of Baroness Carnegy of Lour Baroness Carnegy of Lour Conservative

My Lords, I have never smoked. I dislike smoking, particularly in restaurants. But I consider that Parliament, encouraged by the Government, pushes people about far too much. I support the noble Lord's amendment but I ask him: am I not right in thinking that the Liberal Democrats, who are in power in Scotland, brought about the total ban in Scotland? What is the Liberal point of view on this? What is liberal? Does choice matter, or does it not? In Scotland, nobody can smoke in a restaurant. I quite enjoy that, I am bound to say, but Parliament had better stop messing people about.

Photo of Lord Skidelsky Lord Skidelsky Crossbench 3:45, 19 June 2006

My Lords, I yield to no one in my great respect for the medical evidence of the noble Lord, Lord Walton of Detchant, but he really must not be allowed to get away with this. I served on the much-abused Select Committee, whose excellent report has been cited. In considering the medical danger, there are two sides to the question—the epidemiology, on which the noble Lord is very qualified to speak, and the statistics. Both give an idea of the risk.

The two experts on our committee were not doctors but statisticians. They understood the statistics and on the basis of their examination of the statistical evidence, they concluded that the risk from passive smoking was actually quite small. There was a risk, but it was quite small. On the basis of their conclusion, we concluded that the response of the Government was disproportionate. It is not that there is no risk and that it should not be addressed in some way, but the blanket response of banning smoking in all public places is using a sledgehammer to crack a nut. The Government gave up too soon, propelled by their own Back-Benchers. There are alternative things that can be done.

The noble Lord, Lord Walton of Detchant, said that he was unconvinced by the possibilities of ventilation. The possibilities are there, and technology means that they are improving the whole time. There is a lot of evidence that ventilation reduces ETS by up to 90 per cent where it is properly installed and properly applied, and it does not cost that much. That is a route we should explore; it is the method used in many countries in the European Union. We would be in a minority in the European Union in going for a blanket ban. For those reasons, I support this amendment.

The noble Lord, Lord Faulkner, talked about supervision. That is a problem with any legislation, whether you have to supervise separate accommodation, ventilation systems or total bans. I should have thought, on balance, that it would be more difficult to supervise total bans than more targeted measures, which arouse less hostility.

Photo of Lord Turnberg Lord Turnberg Labour

My Lords, I very much enjoyed listening to the noble Lord, Lord Wakeham. He spoke very eloquently about the views of his committee, but I am afraid I cannot support the amendments. I believe that they would dilute the effect of a very important part of the Bill and allow all sorts of loopholes to be opened. I declare my interest as an ex-practising physician and past president of the Royal College of Physicians, which had a view on smoking.

It has been suggested, I think by the noble Lord, Lord Monson, that smoking at home would increase if this part of the Bill were not amended. But experience from other countries shows the opposite, and that smoking at home decreases as a result. We are talking about a health hazard, the risks of which are absolutely clear. We know that passive smoking at home clearly increases the risk of lung cancer, heart attacks and strokes. An enormous number of studies have shown that—it is a toxin. Furthermore, we know that smoking in pubs and clubs raises pollution in those places to levels much higher than in most other places, including Victoria Street and the Marylebone Road, where they have been measured. When measured, the levels of cotinine, a smoke pollutant, in the saliva of pub workers who do not smoke are very high. In fact, they are higher than those of non-smoking spouses who live in the same house as those who smoke.

We also know that there appears to be a straight-line relationship between smoke exposure and the risk of disease and death—the more exposure, the greater the risk—and there is no absolutely safe lower limit. In fact, for coronary heart disease, it is non-linear. That is, low levels of exposure are almost as risky as high levels. Incidentally, that is quite different from the case of alcohol, where we know that a large amount of alcohol is dangerous—which I have spoken about on a number of occasions—but a small amount is actually protective. The relationship with alcohol is not linear; it is U-shaped, so comparisons with alcohol are not reasonable.

Then we have the epidemiological evidence that it is likely, on a conservative estimate, that about one hospitality industry non-smoking worker a week dies from the effects of exposure to smoke. That was published in the British Medical Journal last year. Even Philip Morris, the United States smoking giant, seems to accept that and has published it.

In talking of choice, it does not seem credible that we would allow anyone to spray carcinogens into an atmosphere where others could breathe them in—we would be down on them in a flash. Faced with all that, I find it hard to accept the proposal that we should weaken the Bill by agreeing to this amendment. It just does not seem right and I cannot support it.

Photo of Lord Vinson Lord Vinson Conservative

My Lords, I declare a non-interest as a non-smoker, as someone who does not like smoking, has never wished to smoke and does not enjoy the company of people who are smoking, although I enjoy the company of smokers. I do not particularly like to cross swords with my neighbour, the noble Lord, Lord Walton, but there is another side to this: people's enjoyment of their social life. An Englishman's home is his castle and an Englishman's club is his home. We should not deny people the right to smoke in a segregated room in which the staff do not have to serve, where people can meet and damage their own health if they want to—where they are fully aware of the risk. It is quite wrong for us to protect people from their own foolishness.

A member of staff may sign the fact that she does not wish to serve in a smoky zone and then be pressed into it late at night to clear up the dishes when the smokers have gone. To suggest that that small exposure to passive smoking—three or four minutes of old smoke—will lead to her rapid demise misses the whole question of the nature of poisons. The nature of poison is in the dose—the greater the dose, the greater the risk. Provided that there are adequate staff safeguards, we should not stop people doing what they wish to do in segregated rooms in their clubs, albeit that they are damaging their own health. This is indeed a freedom issue and I know that in my own constituency, where I live, many people are now deeply upset by this social deprivation—something that will be denied to them which they have hitherto had. This is a freedom issue of the first importance and I intend to vote for this measure.

Photo of Lord Stoddart of Swindon Lord Stoddart of Swindon Independent Labour

My Lords, I call the attention of the House to the fact that the Bill before us is not the Bill which appeared in the Labour Party manifesto; nor is it the Bill which the Government presented to Parliament in accordance with that manifesto. We are discussing a Bill that goes much further than the Government wanted and much further than the people voted for. When people are discussing this Bill they should take that into account.

Secondly, I support the amendment moved by the noble Lord, Lord Russell-Johnston. I think that it is too weak, but it is better than nothing. I support it for the reasons that he and other noble Lords have given. There has been a witch hunt against smokers for a long time. It is now continuing apace and in a completely irrational way, because in spite of what people have said about ventilation it is possible to separate smokers from non-smokers in public places. Modern ventilation techniques are very efficient in cleaning air; they are used in factories, offices and aircraft. Why on earth, if they can be used in such situations, they cannot be used in social situations—in restaurants and public houses—I simply do not know.

I believe that the agenda is completely and utterly different and that the junk evidence that is given is designed to demonise smokers in order that eventually we can have a smoking ban. Indeed, the noble Lord, Lord Clinton-Davis, envisaged exactly that when he said that he would like to see smoking banned in the home. So there is a different agenda.

On the evidence, which of course is statistical only, we are told that we should listen to the doctors. Well, of course we should—but doctors are not always right. There is adequate evidence to show that doctors are often very wrong indeed. There are 5,000 cases a year of medical negligence in hospitals, so we know that they are not always right. What is more, there is no clinical evidence to tie passive smoking to a higher death rate in many of the diseases claimed. The evidence is totally statistical, so why should we be told to listen to the doctors rather than the statisticians? And, of course, the statisticians are much divided on this: of 147 studies undertaken, only 24 have shown any statistical evidence at all that passive smoking represents any real danger, so even the statistical evidence must really be examined very closely.

I come back to the question of separation. It can and should be done, and this amendment enables it to be done. The noble Lord, Lord Turnberg, is qualified, I appreciate that—

Noble Lords:


Photo of Lord Stoddart of Swindon Lord Stoddart of Swindon Independent Labour

My Lords, I cannot see why that is amusing. When I throw a compliment to one of my colleagues, why should that be considered amusing? I meant it as a serious compliment, and I hope that the noble Lord will take it as such. But he did say that if we saw anybody spraying carcinogens into the atmosphere, we would be down on them. Well, there are about 35 million vehicles spraying carcinogens into the atmosphere every single day. What are we doing about them? Many people believe that the fumes from vehicle exhausts are far more dangerous than passive smoking and perhaps smoking itself. Indeed, the ODPM claims that some 20,000 people die every year from vehicle exhaust fumes. So why are we clamping down on smokers? The number of deaths estimated from passive smoking even by those in favour of this Bill amounts to about 600 a year, not 20,000.

I believe that noble Lords are being misled by this Bill and many of the arguments put forward for it. It is a totally illiberal Bill; it is, in its present form, unnecessary. If the Government had brought forward the proposals contained in the manifesto and agreed by the people, there would have been little argument about it. They have not, and for that reason I shall support the noble Lord's amendment and, indeed, some others, which I hope will come later.

Photo of Lord Tebbit Lord Tebbit Conservative 4:00, 19 June 2006

My Lords, the noble Lord, Lord Stoddart, was just a little ahead of himself in the context of the amendments and was really rather pointing towards a later amendment about smoking in clubs. That will come later in the evening. I certainly look forward to it, because I look forward to the noble Lord telling noble Lords on this side of the House that we ought to vote against the Labour manifesto. This is a nice occasion. Having been told so frequently recently that it is very wicked to vote against the Labour Party's manifesto, tonight we will be told that it is very good to vote against it. I will save that touch of enjoyment for later.

I certainly enjoyed the speech of the noble Lord, Lord Walton, who spoke of the curious way in which lawyers insult those with whom they disagree. He then went on, in his own way, to say that it was inconceivable that the committee chaired by my noble friend Lord Wakeham could have reached the conclusions that it did. It is not only conceivable; it is a fact that it reached those conclusions. I worry when medical experts use the English language in such a sloppy manner as to say that something is inconceivable, when it has not only been conceived, but done.

Of course, doctors are, we all agree, extremely useful technicians, but they are not always right. If I were a statistician, I could observe that 100 per cent of patients who go to doctors die. This is statistical fact. I am surprised that on this Bill somebody has not by now ridden away with statistics of that degree of idiocy. The medical consensus of today is sometimes the medical heresy of tomorrow—and, very frequently, vice versa.

What worries me in all this is the attitude of the Government. We have not heard what the Minister is going to say today, but some of us who were in Grand Committee have heard a bit of it. If I am right—I am sure the Minister will indicate immediately if I am wrong—this Bill does not apply to prisons. Despite everything that has been said by supporters of the Bill and supporters of the Government about the monstrous injustice of condemning people to work in dangerous conditions, warders, who are government servants, will be required to work in public places. Is a prison a public place? It is a bit hard to distinguish just how public it is these days, as people come and go.

Photo of Lord Warner Lord Warner Minister of State (Reform), Department of Health, Minister of State (Department of Health) (NHS Reform)

My Lords, I just wanted to see how far the noble Lord would go. I watched him going agreeably along this path. If he reads the Bill, he will see that there will be discussions about how the Bill will apply to prisons. I wanted to see whether the noble Lord had read the Bill and understood the explanatory memorandum. It is quite clear that he has not.

Photo of Lord Tebbit Lord Tebbit Conservative

My Lords, I always come here looking for guidance from Ministers about legislation. It is a bit rough when you say to a Minister "Have I understood this correctly?" and he says "I am going to stay mum". What is certain is that this Bill does not apply to prisons in the way that it would apply to clubs, pubs and restaurants.

Photo of Lord Warner Lord Warner Minister of State (Reform), Department of Health, Minister of State (Department of Health) (NHS Reform)

My Lords, it does not apply to old people's homes in the same way, either. There are all sorts of other places akin to the home where there are different arrangements. That is why it is an extremely well structured Bill.

Photo of Lord Tebbit Lord Tebbit Conservative

My Lords, it is interesting that a prison is seen as being akin to somebody's home. It is quite extraordinary. It is also akin to somebody's place of work. However, I will let the Minister argue his way out of his own convoluted legislation. As a non-smoker myself—I have always been a non-smoker—it is a great pity that the medical profession and the Government have not been more assiduous in bringing forward information that would help us to make our minds up about these things.

I mentioned in Grand Committee that the noble Lord, Lord Tunnicliffe, and I, having shared the same profession years ago, sat on the flight decks of civil aeroplanes for many long hours over many years, almost always in the company of smokers. I do not know whether the noble Lord, Lord Tunnicliffe, is a smoker but I, as a non-smoker, certainly had to put up with an awful lot of smoke—and so did all of my colleagues. All our medical records are held by the Civil Aviation Authority, which has watched our health through all our years. It would not be difficult to follow us up since we retired. It would be simplicity itself to look at those statistics and establish the facts with that perfect control group. Wonderful!

When I wrote to the Chief Medical Officer to suggest that he might do that, he said that he did not think it would be helpful. When one offers such information in that way and is told that it is unhelpful, the question in my mind is, "Unhelpful to whom, or to what?" Is it unhelpful to rational debate, or to the irrational debate that the Government have produced to justify large parts of this Bill?

Photo of Baroness Morgan of Drefelin Baroness Morgan of Drefelin Labour

My Lords, as one of the few Members of your Lordships' House to be born after 1955, I have had the experience of growing up alongside some very fast-changing attitudes to smoking in this country. I am delighted that we have now come to the stage where, I believe, public opinion is much in favour of introducing the measures set out in this legislation. It is extremely important to remind ourselves of the point made at the start of this debate, that ventilation is not a suitable alternative.

When I was 12, my father was diagnosed with lung cancer; he also had asthma. I spent many years trying to go with him to a restaurant or pub, or trying to enjoy some kind of experience of social life outside the home. That was virtually impossible, even where cigarette smoking was supposedly banned and ventilation was in place. So, I really want to add my support to those of your Lordships who have reminded us of what the experts have to say. In spite of modern developments in ventilation systems, I do not believe that they are good enough to warrant supporting such an amendment.

I also want to make a point about the strength of medical evidence. Yes, it is true that there are statistics and damn lies, and so on. Yet we must recognise that while there may well be much diversity of opinion in the research community, it is really time to accept that the balance of medical opinion is very clear on this subject—that passive smoking costs lives. In fact, I think we can agree that we are losing one life every week in this country because of passive smoking. We have to listen to what the medical profession is telling us.

My final point is that I am delighted that the Government took time to consult fully last summer and that the Government strengthened the Bill. I do not feel that we should hang our heads in any way about the development of the Bill. I am so proud that we are here today discussing the potential step forward in public health that this Bill represents. Cancer is the single biggest cause of health concern in this country. If we can make smoking in enclosed public places a thing of the past, it will be a huge benefit to all of us in this country. I am not just talking about non-smokers, but smokers who would like to give up—and do not forget that the majority of smokers would very much like to give up. There is nothing worse than sitting in a pub watching all your mates having a fag when you are trying to give up. I have had experience of that.

Please can we reject the amendment today? Please can we make this Bill as strong as possible and as enforceable as possible? Let us not argue any further about the strength of medical evidence on this subject.

Photo of Lord Jopling Lord Jopling Conservative

My Lords, listening to the debate, I am struck by the fact that relatively few of those who oppose the amendment are prepared to discuss the important issue of choice. I was not sure how my mind would end up on this, but my instinct at the beginning of the debate was to support the amendment.

I do not need any lessons from anyone on the dangers of smoking and lung cancer. At the end of my first year at university I had a pleural effusion and spent 12 weeks in hospital. At the end of that period, the professor of thoracic surgery who had looked after me said, "Do you smoke?", and I said, "Yes, I do". He said, "How many?", and I said, "I do not know; I suppose 20 or 25 a day". He said, "You should not". I said, "Obviously my father has been talking to you and saying that this is a good opportunity to get the boy off smoking". He said, "No, I swear to you that I have not talked to your father at all about it. One of our students in the university"—this was in Newcastle, and the noble Lord, Lord Walton, knows this story—"has just written a thesis where he claims to have found a connection between smoking and lung cancer". This was in 1950. He said, "I have not been through it properly myself yet, but I think it is extraordinarily impressive. You have finished the first year of a science degree and you will understand most of it. I will give you the thesis to read". I read it in bed, and I was so horrified that I said, "I shall from this day stop smoking". I have never had a cigarette since the day I put down that thesis in 1950. I do not need any lessons on the danger of smoking and lung cancer.

I was hugely puzzled by the argument made by the noble Lord, Lord Monson, that most of us here were born before 1955 and were brought up in smoke-filled rooms but we are all here. That seemed to me a good argument for claiming that passive smoking does not kill 100 per cent of those who are exposed to it. It was a very strange argument. I detest smoke-filled rooms; I find them most unattractive and most irritating. When it comes to whether I believe that passive smoking is dangerous or not dangerous, or over-dangerous or only marginally dangerous, and I have to choose between my noble friend Lord Wakeham and the noble Lord, Lord Walton, on the evidence that I have read my mind comes rather towards the noble Lord, Lord Walton. I understand very much the dangers of passive smoking.

That brings me back to the amendment. Few noble Lords in the debate have referred to choice and liberalism. There are so many things in our lives in this world that we tolerate that are dangerous; for example, alcohol and dangerous sports. I could go through a whole list of things that we tolerate. The noble Lord, Lord Russell-Johnston, has proposed this amendment, which I think is worth giving a try. It could work, if there are properly physically separated areas, and if there is proper ventilation. It is no use noble Lords saying that ventilation may not work. The Act, if this were agreed, would say that there would have to be a ventilation system. It is worth while us giving this a try. I suspect that we shall be talking about smoking and smoking bans for decades. This will just be the first stage of it. Therefore, I think it would make sense for your Lordships to agree to accept this amendment as a first step forward. If it does not work, at some future time we or our successors can come back to this issue and negate the effects of this amendment. I hope that your Lordships will give it a try.

Photo of Baroness Cumberlege Baroness Cumberlege Conservative

My Lords, I declare an interest as a trustee of Cancer Research UK. It is the biggest cancer charity in the world and it employs more than 3,000 scientists, doctors and nurses, mostly in this country but also abroad.

I was very interested in some of the points put forward by the noble Lord, Lord Stoddart, that in fact doctors are not always right. Of course, that is absolutely true. I do, though, draw a distinction between doctors and negligence in hospital—when they are taking firm action in operations, anaesthetics, drug giving, and so on—and those who are doing research. When it comes to the scientists and researchers, it is the body of opinion that matters. It is also the credibility of the individuals who do the research, produce their reports and have their work peer-reviewed. Cancer Research UK has recently had two Nobel Prize winners: Sir Paul Nurse and, as of Saturday, in the Queen's Birthday Honours, Sir Tim Hunt.

I want to address the very narrow point made by my noble friend Lord Jopling on ventilation. Cancer Research UK is absolutely convinced, and its research shows, that ventilation systems may remove the smell of smoke but they cannot effectively remove the harmful chemicals that it contains. Levels of air flow equivalent to those produced by tornadoes and wind tunnels, would be needed for ventilation systems to remove the smoke effectively.

On a practical basis, systems can cost tens of thousands of pounds to install, and they are difficult and costly to maintain. This can be a particular burden for non-profit-making private members clubs, and others. Reports have shown that many proprietors leave their ventilation systems switched off, because the running costs are so high. Recent research in venues in Sydney, Australia, has shown that designated no-smoking areas in hospitality venues provide at best partial protection, and at worst no protection at all, against the damaging effects of second-hand smoke. I have all the references for what I have said, but I will not bore the House with that right now.

If it is a question of choice, then ventilation certainly has to work. I am absolutely convinced that it does not.

Photo of Lord Rea Lord Rea Labour 4:15, 19 June 2006

My Lords, I had not intended to speak, because of my voice. However, I disobeyed medical orders—my own—to speak in this debate, because it is such an important topic. I also had not expected that on the very first amendment we would be talking about the Economic Affairs Committee chaired by the noble Lord, Lord Wakeham. Since, however, a discussion on that committee has occupied a certain amount of time in this debate—it is not a short debate but a quite long debate—it might be worth pointing out to your Lordships that of the 13 members of that committee, two were former Chancellors of the Exchequer, two professors of economics, and six, possibly seven, had links to commerce and industry. Not one member, however, had any professional experience in medicine, nursing or public health.

Furthermore, the committee appears to have overlooked evidence that demonstrates the harmful effects of passive tobacco smoke. I want briefly to mention one or two people who gave evidence. The first is Caroline Flint, who was then the Minister for public health. In relation to exposure to second-hand tobacco smoke, she quoted the study which found that in adults lung cancer is up 24 per cent, an increased risk of heart disease is up 25 per cent, and that the risk of heart disease increases substantially even at low levels of exposure to second-hand smoke. Perhaps more significantly—much has been made of this, albeit statistical, evidence, and two of the expert advisers to the committee were statisticians—the committee heard evidence from Sir Richard Peto, one of the most eminent epidemiological statisticians in the whole country. He said that, if there was proportionality, you would expect to get up to a 20 per cent excess from inhaled environmental tobacco smoke. He said that that was what you saw in the average of all studies. So I think that the composition of the committee, and perhaps the views of the chairman, eminent though they all are and excellently written though the report is, may be slightly biased.

Photo of Lord Patel Lord Patel Crossbench

My Lords, I was not going to go with the argument that my medical colleagues have already put across in case I was accused of colluding with my fellow medics.

It is true that doctors make mistakes, but I defy anyone to produce evidence that, on balance, they do more harm than good—I look forward to receiving that evidence from the noble Lord, Lord Stoddart. It seems to me that those who are against the Bill accept the evidence that suggests that there is genuine harm not only from smoking but from second-hand smoke. They might not accept the level of the ill effects but they accept that there is harm.

So the argument now concerns choice and whether effective ventilation can be put in place to separate smokers and non-smokers. But whose choice are we talking about? Even the Economics Affairs Committee report states that the majority of the population by far is in favour of legislation to ban smoking in enclosed public places. When it comes to ventilation, the noble Baroness, Lady Cumberlege, gave the evidence: the kind of ventilation required to remove even 90 per cent of the harmful effects of second-hand smoke would be equivalent to that found in a wind tunnel. That is why ventilation is not being implemented in Italy and other countries where it was thought that it would work, and the cost would be prohibitive. So those who argue on the basis of choice and of ventilation being effective do not have a cogent argument. I shall not rehearse the health argument. I said before Second Reading that it is rather like burying your head in the sand. I was challenged on that, but that is what it is and I do not need to go over that argument.

Photo of Viscount Simon Viscount Simon Deputy Chairman of Committees, Deputy Speaker (Lords)

My Lords, I shall be very brief. I got asthma 12 years ago. We have heard numerous noble Lords talking about passive smoking and about how it can be harmful in certain ways but not always necessarily so. I am the only person here who can give practical examples of what happens to a person in my position. If I am in a car on a motorway travelling at 70 miles an hour with the windows closed and the ventilation turned off and a car overtakes me, and I can see not only that it is exceeding the speed limit but that the driver is smoking a cigar, I will have an asthma attack. I will have to take Ventolin as well as numerous other things. If my windows are open, it is likely that I will have to stop and that the paramedics will have to come very quickly indeed as I will be very ill.

The noble Lord, Lord Palmer, who is sitting in his place, has known this in the past when he used to smoke cigars. Passive smoking is a killer. It can kill. It could kill me. I am led to believe that one in five children nowadays has to use an inhaler because of asthma and passive smoking. We are also ignoring them today, as it is the quality of their lives as well as ours. The amendment moved by the noble Lord, Lord Russell-Johnston, refers to definitely separated areas. What happens when the doors open? My definition of a smoking area and a non-smoking area has always been that the non-smoking area is a place where smoke is present but smokers are not.

Photo of Lord Cobbold Lord Cobbold Crossbench

My Lords, I support the amendment. I am not a smoker, but it is important to resist the advance of the nanny state. It is a matter of individual choice, and it is important that the amendment should be accepted.

Photo of Baroness Barker Baroness Barker Spokesperson in the Lords, Health

My Lords, I rise to sum up on behalf of our Front Bench on this matter. The noble Lord, Lord Walton, presented me with a problem because I wish to start by putting on record my genuine and long-held admiration for my noble friend Lord Russell-Johnston. In the past 25 years, he is one of the people whose speeches I have followed with great care; they were always of great interest to me when he was expanding on liberalism and the need for liberals to stand up for unpopular subjects. I am sorry to be the person on the Front Bench with whom he disagrees.

The noble Baroness, Lady Carnegy of Lour, asked about the Liberal view, and rightly cited the actions of my colleagues in the Scottish Executive. The liberal view was best put by John Stuart Mill in chapter three of On Liberty, when he said:

"Acts of whatever kind, which, without justifiable cause do harm to others, may be, and in the more important cases absolutely require to be, controlled by the unfavourable sentiments, and, when needful, by the active interference of mankind. The liberty of the individual must be thus far limited; he must not make himself a nuisance to other people".

As the noble Lord, Lord Walton of Detchant, made clear, the evidence on passive smoking is becoming clearer all the time. I accept that some of the criticism of the Economic Affairs Committee has perhaps been overstated, but as the noble Baroness, Lady Cumberlege, said, it is becoming increasingly evident from research that passive smoking has a harmful effect. I do not wish to go back over the arguments on ventilation because they have been adequately explained by others this afternoon, but I shall return to the question of choice.

In our social life people are now becoming not only used to not smoking in public spaces, but are increasingly expectant that public spaces will be non-smoking. As the noble Viscount, Lord Simon, graphically showed, there are some people for whom there is no choice but to enter a public place to partake of an enjoyable social life with other people. There is always the choice for somebody who wishes to smoke to go outside, and increasingly they do so. Two weeks ago I was in Ireland where an unambiguous complete ban has been implemented. It is fair to say that it has been successful mostly because of its simplicity and clarity. Has it done irreparable harm to the social life of the Irish people? Absolutely not. There is no evidence of that whatever. In fact, it has possibly made it better. Pubs are now convivial places to which people go to enjoy extremely good food, and to which they can take children. The smoking ban has changed the nature of half of them.

There is a danger in my noble friend's amendment, in that it allows the potential to use the provision of food as a means of getting round the regulations. It thereby sets up and causes health inequalities which now exist, but may well be exaggerated if we have a loophole in the future over whether or not somewhere provides food and, if it does, what its means are.

To those who have talked about public opinion and, in particular, the nanny state, I say that it is increasingly evident that the private sector is well ahead of us on this. More and more coffee shops and restaurant chains are seeking to change their ways, way ahead of any legislation. Today's vote—as my colleagues will hope—to keep the Bill as it is will not be detrimental to choice or the economy. It will, however, make an important difference to addressing health inequalities. That is a fundamental role of the state.

Photo of Lord Sandberg Lord Sandberg Liberal Democrat 4:30, 19 June 2006

My Lords, I was at school during the war, and about the only thing I learnt—because we were distracted by the probability of getting killed—was how to smoke. So I am rather sad that the one thing I learnt at school should now be so heinously voted against. My colleague's amendment is sensible and reasonable. I do not see why we should be killjoys in what we are doing today.

Of course, no one pretends that smoking is good for you but, if it gives pleasure to people, we should not takes their pleasure away.

Photo of Lord Warner Lord Warner Minister of State (Reform), Department of Health, Minister of State (Department of Health) (NHS Reform)

My Lords, before turning to the amendment's deficiencies, I must, on behalf of the Government, respond to one or two of the points made during what I can only describe as almost a Second Reading debate.

The provisions in Part 1 are based on robust evidence and the management of risk to health from second-hand smoke. Of course, important issues such as personal liberty and the regulation of business have been important in framing this policy. The risk to health, however, is the driving force behind this Bill. That is, ironically, the vital point that the Select Committee on Economic Affairs seems to gloss over in a slightly cavalier fashion.

The evidence of the health risks of second-hand smoke is now extremely well established. The single medical expert that the committee sought evidence from was indeed Professor Sir Richard Peto, who has already been described as a distinguished medical epidemiologist. He told the committee in his evidence that:

"The definite statement is that some people are killed by breathing other people's smoke".

The risk level is set out in the two reports of the Scientific Committee on Tobacco and Health, of which Professor Sir Richard Peto is a member. In its 2004 report, the scientific committee concluded that there is an estimated overall 24 per cent increased risk of lung cancer in non-smokers exposed to second-hand smoke and a 25 per cent increased risk of heart disease. As a result, the committee advised that,

"second-hand smoke represents a substantial public health hazard".

It was not just Caroline Flint who said that. She repeated that evidence of a committee, one of the members of which gave evidence to the Select Committee.

A number of noble Lords have, I suggest, rather pooh-poohed the evidence that I tried to set out on behalf of the Government in Committee. The evidence base is recognised not just in this country but internationally, not least by the 168 nations that are signatories to the World Health Organisation's framework convention on tobacco control. The evidence on the risk of second-hand smoke comes from across the world, and has been scrutinised and reviewed in great depth. The literature base is substantial and the WHO's International Agency for Research on Cancer report, Tobacco smoke and involuntary smoking, published in 2004, reviewed all the evidence of the health risks associated with smoking and second-hand smoke. It is over 1,400 pages long. The evidence is absolutely overwhelming, whatever people choose to say.

A number of people, including the noble Lord, Lord Monson, have asked for choice and fair play. The Government are very interested in securing fair play for all those who suffer at the hands of second-hand smoke, such as all those with medical conditions like lung cancer, heart disease, asthma attacks, childhood respiratory disease and sudden instant death syndrome. Those are not myths; they are the facts of life in our country regarding people's exposure to second-hand smoke.

The noble Lord, Lord Wakeham, drew attention to the fact that his Select Committee's report was unanimous. I suppose that most noble Lords would pay tribute to his success as a Chief Whip in the past. I am not altogether surprised that he managed to achieve a unanimous report. He also drew attention, as have other noble Lords, to the fact that public bans on smoking may mean more smoking in the home.

Let me give the House the evidence on that. International experience provides no evidence to support the view that smoke-free legislation will encourage more people to smoke at home; we know that bans encourage smokers to give up or to reduce the number of cigarettes that they smoke, which is a beneficial secondary effect. We also know that seven out of 10 people who smoke say that they want to give up. We have assessed the impact that a ban on smoking in public places would have in reducing smoking prevalence: up to 650,000 people would be affected, which would, thereby, have a beneficial impact of reducing smoking at home. Indeed, evidence from New York suggests that 100,000 people have quit smoking since the ban was introduced there. Recent research, reported by the Royal College of Physicians in the publication Going smoke-free points to a statistically significant increase in the percentage of smokers who banned smoking in their own home after smoke-free laws were introduced.

Important research was published on 16 June in the Irish Medical Times, which reported a household survey that was conducted in Ireland before and after the introduction of smoke-free laws. Before the ban, 58 per cent of people allowed smoking in their homes, but after the workplace legislation came into effect, that figure fell to 50 per cent. The evidence points in absolutely the opposite direction as regards smoking in the home to that stated by a number of noble Lords.

Perhaps I can correct the noble Lord, Lord Tebbit, who cited the Chief Medical Officer's failure to take up his suggestion about conducting a study among airline pilots. The Chief Medical Officer has responded that he did not think that that would be helpful, because the research proposed by the noble Lord would not have resulted in a study of a scientific calibre that could be relied on; there were good grounds for not accepting the helpful suggestion from the noble Lord, Lord Tebbit.

Photo of Lord Tebbit Lord Tebbit Conservative

My Lords, I think that a few words were omitted there: "could be relied on to give the answer I want".

Photo of Lord Warner Lord Warner Minister of State (Reform), Department of Health, Minister of State (Department of Health) (NHS Reform)

My Lords, if that is in the Chief Medical Officer's letter, I would be glad to see it.

Amendment No. 1, moved by the noble Lord, Lord Russell-Johnston, paves the way for the new clause in Amendment No. 2, which allows premises that serve food to continue to allow smoking if certain conditions are fulfilled. The scope of the new clause is wide. It would allow smoking not only in pubs that serve food, but also in cafes and restaurants, and even in schools, hospitals and offices that have canteens. In fact, absolutely anywhere that served any food would be exempted provided that it met the specified conditions. I find it hard to believe that the noble Lords who tabled the amendment really intend to exempt all the office blocks with a canteen, yet that might be the effect. Despite explaining that unintended consequence during Grand Committee, the amendment has been retabled unchanged.

As far as the Government are concerned, allowing smoking in premises that serve food has never been an option. It was not put forward in the Labour Party's manifesto and it was not offered as an option in the free vote at Report stage in the other place. I recognise that the noble Lord has tried to put in place certain safeguards in his new clause. However, as I said during Grand Committee, I am not at all persuaded that those will really provide protection for workers or the public from the harmful effects of second-hand smoke. For example, the amendment provides no clarity on what is meant by,

"physically separated smoking and no-smoking areas".

Does the noble Lord propose that some kind of wall should separate those areas? Should there be closing doors between them?

There is very clear evidence, as a number of noble Lords have said, that ventilation does not provide a solution to eliminating the health risks associated with second-hand smoke. Based on evidence, the Government do not recognise that ventilation in any form provides a solution to the health risks associated with second-hand smoke. Noble Lords cited the often quoted research conducted at the European Commission Joint Research Centre's INDOORTRON facility, which found that,

"'wind tunnel' like rates or other high rates of dilution ventilation would be expected to be required to achieve pollutant levels close to ambient air limit values".

I recognise that a number of us like alfresco eating, but I suggest that most people would not choose to have their food in a wind tunnel.

Research that further demonstrates the lack of efficacy of ventilation was published in January 2003 by the Health and Safety Authority and the Office of Tobacco Control in the Republic of Ireland. It states:

"Research suggests that presently available ventilation technology . . . is unsatisfactory for controlling worker exposure to ETS. Air cleaning is similarly problematic. Of proposed new technology, displacement ventilation is viewed as having the potential for a 90 per cent reduction in ETS levels but even this would still leave exposure levels 1500 to 2500 times the acceptable risk level for hazardous air pollutants".

Furthermore, any requirement for ventilation would be significantly costly—a point eloquently made by the noble Baroness, Lady Cumberlege—and, given the lack of effectiveness, it would be a burden for business that simply could not be justified.

The new clause proposes that,

"no employee is required to work in any smoking area".

My noble friend Lord Faulkner made a good point about that, although a number of noble Lords contested it. I ask the House to consider whether it is really practical and whether it would be fair to ask employees to make that choice if, for example, they felt that their job would be at risk if they refused. Indeed, taking the scenario further, what would happen in a premises serving food where no member of staff was prepared to expose himself to harmful second-hand smoke? Would the dirty plates stack up? Would members of staff be coerced into working in the smoking area? I do not believe that this provision is practical. As I set out, I believe that this amendment would create more problems than it would solve, and it has absolutely no support from the Government.

Photo of Lord Russell-Johnston Lord Russell-Johnston Liberal Democrat

My Lords, this has been a long debate. I believe that 18 or 19 noble Lords have participated, so I do not think that it would be a good idea for me to go through each speech. I shall make four simple points. The first is about passive smoking. I shall not make a long speech, because the two sides of the argument have been well set out. It is worth noting that over the past couple of months a number of responsible newspapers have published substantial articles querying the arguments about the extent of the danger from passive smoking, which have not been effectively rebutted. In assessing risk, the Economic Affairs Select Committee was surely right to state that the size of the risk does not seem to be very great and that therefore the reaction of the Government does not seem to be proportionate. That was all that it said. It did not suggest that the basis of the argument was ill founded; it simply said that statistically the evaluation of risk was limited.

I find it extraordinary to be told that ventilation is hopeless and that nothing can be achieved by it. I find that difficult to believe. Although people involved in ventilation may be biased, I receive letters from them saying that that is not the case. As a number of noble Lords have said, techniques are improving all the time.

My amendment is quite limited. It is not very ambitious. As smokers or people who are in favour of choice, we accept the abolition of smoking in public places and on all forms of transport. I am not trying to turn the clock back, but I am trying to have a bit of toleration and less draconian measures. I was horrified when the noble Lord, Lord Clinton-Davis, perhaps in a slip of the tongue, said that he would like to employ such a measure in the home as well. Presumably, inspectors will visit homes every day with "smokometers" or whatever.

Photo of Lord Clinton-Davis Lord Clinton-Davis Labour 4:45, 19 June 2006

My Lords, we are not discussing that issue today. We are discussing this amendment.

Photo of Lord Russell-Johnston Lord Russell-Johnston Liberal Democrat

My Lords, the Minister dealt with ventilation and separation. It seems common sense to separate two rooms physically. It is perfectly true that the cost might be high, but the opportunity should be there. The noble Lord, Lord Faulkner, has moved on this: perhaps he thought that he would be shot at and so had better shift. He gave a colourful example of a poor, wretched 19 year-old Polish girl—I thought that Poland was famous for producing plumbers—being bullied into going into the smoking room and exposing herself to danger. Of course, it is true that people will break laws. Do not forget that the manager or owner of a restaurant or pub is responsible for not doing what has been described, although in some cases he or she might. But I do not think that the possibility of someone breaking a law is an argument against a law. That does not fit.

Photo of Lord Warner Lord Warner Minister of State (Reform), Department of Health, Minister of State (Department of Health) (NHS Reform)

My Lords, does the noble Lord accept the point that I made? As currently drafted, the amendment would provide for virtually anywhere that serves food to be exempt. That is a critical point.

Photo of Lord Russell-Johnston Lord Russell-Johnston Liberal Democrat

My Lords, I assure the noble Lord that the intention is directed at restaurants and pubs. Neither I nor my noble friend Lord Steel would necessarily claim legal drafting expertise, but I am sure that it would be possible to narrow the amendment. Of course, I certainly was not thinking of dividing school canteens into two, although that possibility may exist under certain wording. However, I would think that school canteens come under local authorities. Therefore, this would not apply.

Finally, sometimes individuals choose to do things that perhaps they should not. But we should have the right to choose. This is about freedom and the right to choose one's own lifestyle. I therefore wish to test the opinion of the House.

On Question, Whether the said amendment (No. 1) shall be agreed to?

Their Lordships divided: Contents, 70; Not-Contents, 221.

Division number 1 Health Bill

Aye: 67 Members of the House of Lords

No: 217 Members of the House of Lords

Aye: A-Z by last name


No: A-Z by last name


Absent: 444 Members of the House of Lords

Absent: A-Z by last name

Resolved in the negative, and amendment disagreed to accordingly.