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Reid's smoking ban attacked by both sides
By Jeremy Laurance, Health Editor and Rachel Stevenson
17 November 2004
The Health Secretary, John Reid yesterday surprised medical organisations and the public by announcing a complete ban on smoking in almost all enclosed public places.
The move is one of the most dramatic health interventions in recent years, but immediately drew criticism from both sides of the debate.
Almost 12 million people smoke, and Mr Reid pledged to reduce the total by two million in five years. But some medical organisations argued the pace was too slow and the measures did not go far enough, while the pub trade hinted that publicans would sidestep the ban.
It will be implemented in stages, applying to government offices and the NHS by 2006, in all workplaces (eliminating office smoking rooms) by 2007 and in pubs and restaurants serving food - 80-90 per cent of the total - by the end of 2008.
The only public places where it will be legal after that will be pubs that do not serve food and private clubs where the members agree to it. Smoking may also be permitted in hospices, prisons and residential homes.
A legal ban was not expected from the Health Secretary who had declared he was opposed to "nannying". But protecting other people from the damage caused by cigarette smoke justified this exception, he told the Commons yesterday.
The decision to exempt pubs that do not serve food and private clubs from the ban provoked charges of a "bodge" and "missed opportunity". Professor Alex Markham, chief executive of Cancer Research UK, said it was bizarre to accept the wisdom of a ban but then deny its benefits to people who worked in licensed premises where food was not served. He said: "The Government has failed in its fundamental duty to protect our citizens' health and safety by opting out of a total ban. It's like having the legislation to fit all cars with seatbelts because we know seatbelts save lives and then stopping some passengers from wearing them."
But the Tories accused Mr Reid of adopting Old Labour interventionism. Andrew Lansley, shadow Health Secretary, said: "Five years ago the Government said they did not believe in the old nanny state approach. So now they believe in the new nanny state approach."
The Liberal Democrats' spokesman, Paul Burstow, said: "This White Paper demonstrates that this Government, far from having courage, lacks the courage to take the necessary action to deal with the wide range of public health threats posed in this country."
Four years was too slow an implementation for the British Medical Association. "When lives need saving, doctors act immediately. The Queen's Speech is next week and these proposals should be in it," said James Johnson, BMA chairman.
THE MAIN POINTS
* From 2006 smoking banned in restaurants and pubs serving food, enclosed public places and workplaces
* Limits on amount of TV advertising of unhealthy foods to children
* National campaign on risk of sexually transmitted infections and unplanned pregnancies; chlamydia screening programme to cover all England by 2007
* NHS lifestyle trainers to work in disadvantaged areas
* New Health Direct service available on telephone, online, and digital TV
* Clearer food labelling with simple code on fat, sugar, and salt content
* Stark picture warnings on cigarette packets and further curbs on tobacco advertising
UK Health Secretary John Reid has proposed widespread legislative and health care changes in a new white paper on public health released Tuesday. Titled "Choosing Health", the paper details government plans to restrict smoking in public places, limit 'junk food' advertisements to children, make available "lifestyle trainers", campaign against sexually transmitted diseases and tobacco, and improve food labelling.

The white paper comes after extensive public comment that involved 150,000 people.

Smoking would be restricted in enclosed public spaces, restaurants, workplaces, and some pubs. The ban would be enacted gradually, affecting government and NHS buildings in 2006, enclosed public places in 2007, and private property in 2008. Permanent exemption would be granted to pubs that do not serve prepared food -- though not at the bar -- as well as private clubs, a decision that has provoked some to call the measure incomplete. Up to 90% of pubs are expected to be affected. The Scottish executive proposed a complete ban on smoking in enclosed public places last week, and Ireland has already banned smoking in pubs and restaurants.

Food advertisements targeted to children would be banned until 9pm, under the White Paper's proposals. The restriction is a measure to tackle rising rates of childhood obesity. The government also intends to develop voluntary standards on food and drink advertisements to children with industry, only threatening legislation if an acceptable standard is not reached by 2007. Additionally, low income families would receive vouchers for fresh fruit, vegetables, milk, and infant formula. School lunches would also be held to stricter nutritional standards. Reid has warned that unless childhood obesity is tackled, "we face the prospect of children having shorter life expectancy than their parents".

Food labelling would also be improved, with a "traffic light" system implemented. Packaged food would be evaluated based on its fat, sugar, and salt content.

The paper is unusual for suggesting a more holistic approach to health care, offering for the first time "lifestyle trainers." The National Health Service would be funding with an additional £1bn to make people's overall lives healthier, which is expected to save £30bn in preventable illness.

The paper additionally makes mention of reducing accidents, which affected 2.7m people last year and is a leading cause of child death, curb binge drinking, and reduce substance abuse among youths.

The paper has been criticized by many parties. The Tory Shadow Health Secretary has criticized the Labour government's comprehensiveness and creation of a "new nanny state approach". He has additionally described it as "gimmicks". The Liberal Democrats have accused the government of not being comprehensive enough. It has also been criticized by the British Medical Association as being implemented too slowly, saying "When lives need saving, doctors act immediately".

Mr. Reid has argued against the nanny state label, saying "In a free society, men and women ultimately have the right within the law to choose their own lifestyle, even when it may damage their own health. But people do not have the right to damage the health of others, or to impose an intolerable degree of inconvenience or nuisance on others ... This is a sensible solution which balances the protection of the majority with the personal freedom of the minority in England".

The full white paper "Choosing Health" can be read  here.