You will no doubt have heard about the proposal to ban smoking in cars when children are present. This is an amendment (57BB) to the ‘Children and Families Bill’, which was passed in the Lords on the 29th of January 2014.
Amendment 57B, a rather disturbing enabling clause that would allow government to introduce plain packaging without recourse to parliament, was also passed.
It seems that the bill is to be debated in the House of Commons very shortly. Possibly as early as 10th February on a ‘free vote’.
www.theyworkforyou.com/lords/?id=2014-01-29a.1215.0
www.parliamentlive.tv/Main/Player.aspx?meetingId=14666
As chairman of freedom2choose I’m writing to strongly recommend voting against this amendment and also amendment 57B. I lay out my reasoning below.
Introduction
I suspect everyone would agree that some children may experience discomfort if an adult is smoking in a car with them. The vast majority of smoking adults play safe just in case and do not smoke in the car for that very reason. So we are talking about a tiny minority of people.
In fact University College Dublin and its Public Health Department studied 2,230 cars coming in and out of Dublin and found ‘Eight adult passengers and just one child were observed as being exposed to a smoking adult driver’. Just one. It is impossible to be certain that the ‘smoker’ was not actually using an -e-cigarette, in which case there would have been no passive smoke exposure(1).
Holden Pearmain on behalf of the Tobacco Manufacturers’ Association surveyed 1,000 smokers and drivers. They found that 76% did not smoke in the car with children and 11% would ask(2).
Legislating against something that is no more than a lack of consideration is taking a very large hammer to crack a very small nut. Many parents will act inconsiderately on occasion but that is no excuse for the state to take over parental responsibilities. The state should only get involved if there is real demonstrable harm being done. Evidence on harm is examined later on here.
Amendment 57BB introduces two worrying precedents:
The Government will be invading people’s personal domains for the first time. This could be the anti-smoking lobby’s first step towards banning smoking in private homes. Other pressure groups will use this in future as a precedent to enforce their lifestyle beliefs on the population backed by the force of Government.
The police would have to enforce a health directive for the first time. Surely the police have far more important things to do. In any case, even with police commitment, the law will be impossible to enforce. The enforcement angle will be used as a foot in the door to banning smoking in cars where no children are present which would be an entirely different matter and not one to be undertaken lightly.
Amendment 57B is an enabling clause:
It gives the present and any future health secretary carte blanche to introduce further laws on tobacco (which could be seen as a precedent for other policy areas) without recourse to Parliament. Democracy, anyone? Surely this in itself should be sufficient to reject it.
Harm?
Lung cancer risk:
Numerous studies have been carried out looking at the potential risk of lung cancer comparing children brought up by smoking parents with those brought up by non-smoking ones. One and only one such study achieved statistical significance. This was a study organised by the World Health Organisation and published in 1998(3). It found a negative correlation, yes negative. In other words it suggested that children of smoking parents were 22% less likely to contract lung cancer in later life. Not proof of a protective effect but certainly not evidence of harm.
Asthma:
Asthma rates, particularly amongst children, have tripled over the last forty years while smoking rates have halved. Again not proof of protection but certainly not evidence of harm.
A major 32-year study(4), of parents with allergies and their children, found that the children had, by the age of 13, a 45% reduced chance of developing allergies. Asthma is primarily caused by an allergic reaction although attacks can also be induced by fear and other stresses. Once again this is not proof of protection but certainly not evidence of harm.
Until the 1950s smoking was recommended, in medical textbooks, for the treatment and prevention of asthma. Even today many people find that it works better than anything else. This is not to recommend smoking but is nonetheless relevant. Usual rider here: it is not proof of protection but certainly not evidence of harm.
SIDS:
One area that smoking quite regrettably been mentioned as a cause of mortality is Sudden Infant Death Syndrome (SIDS) or cot deaths.
In a recent BBC Radio Five Live interview Professor Terence Stephenson was unable to answer my question how that between 1970 and 1988 SIDS rose five-fold but smoking halved in that time(5).
Also in 2010 Harvard University uncovered the real cause of SIDS, a lack of serotonin production by the baby’s body(6).
SIDS has to have no attributional cause of death under both pathologists’ guidelines and the definition of SIDS itself. If they are claiming smoking causes SIDS then the cause of death cannot lawfully be SIDS.
The anti-smokers’ case:
On the other hand the anti-smoking lobby tends to quote a document by John Britton, published by the Royal College of Physicians (RCP) which claims X many hospital admissions due to passive smoking from various ailments(7 & 8). These are, however, estimates and statistical projections by a long-term anti-smoking activist and trustee of ASH, an organisation founded by the RCP in 1971. It is based on selected studies that show a slight positive correlation.
Remember that these studies are epidemiological ones. These are the studies that lead to the scare stories so beloved of the mass media. So on one day you can read that ‘coffee causes cancer’ and the very next day that ‘coffee protects against cancer’. Campaigners will usually try to discredit the studies they don’t like by claiming financial motives but these contradictory findings are the direct result of modern epidemiological methods(9). There is also a very simple but serious mathematical flaw in using these correlations to project attributable numbers of cases(10).
Hyperbole
Last year the British Medical association (BMA) claimed that the air in such a car would be 23 times more smoky than a pub. This is untrue and the BMA had to issue a formal retraction. Unfortunately it is still widely quoted.
Here is the amended press release:
CORRECTION TO BMA briefing paper: ‘Smoking in vehicles… is 23 times greater…’ THIS SENTENCE HAS BEEN REPLACED WITH: ‘Further studies demonstrate that the concentration of toxins in a smoke-filled vehicle could be up to 11 times greater than that of a smoky bar’(11).
An ‘expert’ doctor claimed that smoking in a car is the same as piping car exhaust fumes into it. Whilst it is true that the same chemicals are involved, car exhaust fumes are 1,000 times more concentrated. In any case, people have always smoked in cars so if it were true then people would have been dropping like flies ever since cars were invented.
The concentration/quantity of chemicals is the key issue in determining harm. This was first formally stated by Paracelsus 500 years ago when he said that ‘the poison is the dose’. It is true that tobacco smoke is estimated to contain thousands of chemicals and that some are known carcinogens. However everything is comprised of chemicals. Chocolate, tap water, toast, city air, clean mountain air and every human body also contain thousands of chemicals of which some are known carcinogens. What’s more, these are the same chemicals as those in tobacco smoke.
The office of the US Surgeon general issued a press release in 2005 to coincide with their latest report. The press release trumpeted that ‘There is no safe level of environmental tobacco smoke (ETS)’. This statement is obviously wrong yet has been endlessly repeated. In the main body of the report it turns out that what they actually said was that no safe limit for ETS exposure has been decided. National and international bodies have set safe levels for all of the chemicals found in ETS. And these levels are miles above anything that could reasonably be encountered in the real world. They have also set safe limits for particulate matter but these are given as levels averaged over long periods such as a working day. Anti-smokers like to quote peak levels as though they were the same but they are not. Peak levels can fluctuate wildly in all manner of environments with or without tobacco smoke being present and yet remain well within these guidelines.
The anti-smoking industry is fond of quoting surveys that suggest 70% of smokers want to quit. However when asked whether they want to quit within a month or so the figure drops to about 20%. The Government spends around £100 million a year on stop smoking services and they are heavily advertised. But they record less than 1 million cessation attempts per year and many of these will be repeat ones. So less than 10% of smokers per year have shown a serious interest in quitting. The explanation for these mismatches in numbers is that, in surveys, smokers tend to give the answer they are expected to give and probably reflects their view that perhaps they should give up one day.
The black lung myth. Ask a pathologist whether smoker’s lungs look different and they’ll confirm that they don’t. Unless of course they are diseased, which can happen to non-smokers too, albeit a little less commonly(12).
The Historical Backdrop – A Lesson from History:
In a word, we may gather out of history a policy no less wise than eternal; by the comparison and application of other men’s forepassed miseries with our own like errors and ill deservings.
Sir Walter Raleigh, History of the World, Preface, Para IX.
Anti-smoking campaigning has a long and very dark history. In Europe it dates back to the fifteenth century when tobacco was first brought back from the Americas and it has waxed and waned ever since.
I was recently on BBC Radio and Fiona Andrews of Smokefree South West compared smokers to dogs, when she said on exclusion in public parks ‘they gate them to prevent dogs going in there’(13).
De-normalisation and prohibition have been tried many times, often backed by viscious and inhumane punishment, and supported variously by religious and/or scientific evidence.
But it has failed every time. And there is no reason to suppose this time will be any different. Indeed the smoking rate in Britain has flatlined in the last 6 years despite, or perhaps because of, smoking bans and other measures. There are some indications that smoking has become cool and trendy once more. People, especially young people, tend to rebel against state diktats.
A few pointers from the great American experiment on alcohol prohibition. By 1900, the temperance league had managed to force all school science textbooks to devote at least a quarter of their content to temperance science. Those who complied most cravenly would be lauded as the ‘greatest living authority’ or ‘foremost scientist’. These texts included claims, amongst other ridiculous things, that most beer drinkers died of dropsy and that it was addictive and harmful even in small quantities.
The Volstead Act of 1919 did not prohibit alcohol consumption in private nor its production. It simply banned the sale of it and consumption in ‘public places’. After it was passed, one of the temperance leaders, Billy Sunday crowed: “Prohibition is won; now for tobacco!”
In conclusion
So if I may sum up: the civil rights aspects of this Bill appal us, smoking in cars is an issue that most people are aware of and they do not smoke in the car with children present. The science is far from conclusive and this Bill is yet another way to create prejudice and bully and denormalise smokers which for any other minority would be seen to be quite intolerable.
Dave Atherton
Chairman of freedom2choose
If you would like to reply to this email, please do. We would very much welcome your thoughts.
About Us – http://www.freedom2choose.info/about_us.php
Freedom To Choose aims to protect the informed choices of consenting adults on the issue of smoking.
We campaign actively to prevent the victimisation of smokers, social division, social isolation, and to alleviate the negative social and economic impacts of the smoking ban.
We are funded entirely by donations from the general public and have no financial connections either now or in the past with any tobacco manufacturing, tobacco distribution or tobacco retail industries, nor with any pharmaceutical or smoking cessation commercial interests.
Our membership, which is open to all individuals who agree with and support our aims, consists of both smokers and non-smokers.
Footnotes
1 http://www.lenus.ie/hse/bitstream/10147/282336/1/Article6988.pdf
2 http://www.publications.parliament.uk/pa/cm201213/cmpublic/childrenandfamilies/memo/cf131.htm
3 http://www.ncbi.nlm.nih.gov/pubmed/9776409
The figures of interest are the childhood Odds Ratio (OR) of 0.78 and the 95% confidence interval where the lower and upper bounds are less than 1.0. This indicates statistical significance.
4 http://download.journals.elsevierhealth.com/pdfs/journals/0091-6749/PIIS0091674907019549.pdf
5 http://www.telegraph.co.uk/comment/7530949/Fiddling-those-smoking-figures-again.html
6 http://www.sciencedaily.com/releases/2010/02/100202171811.htm
7 http://www.rcplondon.ac.uk/sites/default/files/documents/passive-smoking-and-children.pdf
9 http://www.f2c.org.uk/blog/2013/07/28/the-2-sigma-scandal-of-medical-science/
This is not a peer-reviewed paper but its veracity can easily be verified by anyone with a little basic numeracy.
10 http://www.f2c.org.uk/blog/2013/07/14/the-alice-in-wonderland-world-of-risk-factor-epidemiology/
Also not a peer-reviewed paper but again, its veracity can easily be verified by anyone with a little basic numeracy.
11 http://taking-liberties.squarespace.com/blog/2011/11/17/bma-apologies-for-error.html
12 http://cfrankdavis.wordpress.com/2012/08/06/the-black-lung-lie/
13 https://soundcloud.com/dick-puddlecote/chippenham-outdoor-voluntary