Signs are that cigarette bans are working, says Cumbria health boss

But the number of young people taking up the habit has dropped dramatically and experts believe the ban on smoking in pubs, clubs and workplaces has been key.

The county’s public health director, Colin Cox, goes as far as predicting the days of tobacco smoking are numbered, saying it is becoming less and less socially acceptable.

When it came into force across England a decade ago, the smoking ban was controversial legislation.

Those opposing it claimed it was a breach of human rights and predicted pubs and clubs would go out of business as punters would stop going out if they could no longer smoke inside.

But Mr Cox said those fears have proved unfounded and the actual result has been a reduction in smoking which he believes will continue until tobacco smoking is all but extinct in England.

Vaping may have taken over as an alternative but although he’d prefer people to quit completely, he believes it to be safer than tobacco – which he says is still the most harmful thing for your health.

However, despite the ban’s success, Mr Cox is not convinced that similar legislation can be used to tackle other public health issues – such as obesity – with quite the same level of success.

“It’s not quite as straightforward. Food is more complicated. Smoking is easy in a way because the answer is clear. But we all need to eat so the message inevitably becomes more complicated.

“Things like introducing the sugar tax will help but it is a much more complicated issue to legislate,” he said.

When the smoking ban came into force, Mr Cox was working in Manchester. He moved to Cumbria in 2014.

Colin Cox

He believes the legislation was without doubt the right thing to do. “It was something that we’d been campaigning for for a long time. It was one of those where you have a campaign going on for a long time, then public opinion catches up and overtakes it,” he said.

“There were two main things for me. The main scientific reason was about passive smoking in pubs, restaurants and other public places.

“We’d got to a point where, in about 1993, health and safety rules meant it was being banned in most offices. It became unacceptable and people would have been horrified if someone had lit up in the middle of the office, yet it was still accepted in pubs and clubs, despite the fact that most of the population didn’t smoke. Smoking was still seen as normal.

“Because of this smoking was still part of the culture. Particularly for young people coming into the pub culture for the first time, they may not have smoked before but it was easy to get into.

“Legislation can really change culture. If you think back to when a lot of us were younger, nobody thought twice about drink driving. Now it is very much frowned upon.”

Mr Cox, director of public health at Cumbria County Council, said Cumbria still has higher than average numbers of hospital admissions attributable to smoking, though smoking-related deaths are similar to those across the rest of England. However, it is the younger generations that he feels are really benefiting 10 years on from the ban.

National figures show that the number of 15-year-olds who smoke has dropped from about 20 per cent to eight per cent in the last 12 years and locally they have also seen it drop.

“Even in the last five years, both nationally and here in Cumbria, it is estimated that the smoking prevalence has dropped from 20 to 15 per cent. It’s a real success story,” he said.

“The decline among young people has been particularly dramatic. I think a chunk of that is to do with the ban. It has changed the culture and stopped people from taking up smoking. There has also been the rise in vaping but that’s more recent.”

Mr Cox believes the ban’s success has paved the way for further legislation – such as the introduction of plain packaging and removing cigarettes sales points from public view – which is gradually phasing out tobacco use.

“Packaging is about the only form of advertising that tobacco companies had left and they have used it very effectively,” he said.

“When you see the rate that smoking has declined, with only eight per cent of 15-year-olds now smoking, we would hope these people wouldn’t take it up later on as it’s now very much a minority pastime.”

He said tobacco companies are now moving their attention to vaping in line with the declining demand for traditional cigarettes.

“My guess is that, in this country at least, we will get to a point where smoking leaf tobacco in cigarettes is very rare. It may be that people are still using other nicotine delivery systems but not cigarettes. In a way that smoking a pipe still exists but it’s very, very niche,” he said.

Asked whether the ban could be extended much further, he said it was doubtful. “There’s a couple of things that have happened recently. Now smoking isn’t allowed in cars where children are present which is a good thing but is quite difficult to enforce.

"I think that’s probably about as far as these bans can go.

“Hospitals are another issue. I think all hospitals grounds should be smoke-free and they are in theory but it’s not really enforced. There is probably a bit more that can be done there.

Young people don’t even realise you could smoke in pubs

Smoking in pubs is an alien concept to many younger drinkers, who have grown up without it being the norm.

Edith Taylor, who has run the Lion and Lamb in Wigton with partner David Browbank for 15 years, said that although they lost a few customers in the early days, they have adapted.

She said: “I wouldn’t say it’s an issue for us now. People are used to it. They just go outside automatically now.

“When it first happened we lost a few. I personally think it would have been better to allow pubs to have a room where people could go to smoke, but it’s too late for that now.

“Ten years is a long time and I don’t think people smoke as much these days. It’s more these vapes, that’s the trend.

Vaping

“Younger people have grown up with it like this. This is all they’ve known. They don’t even realise you could smoke in pubs.”

She said she was not against smoking, but did feel there was less risk to staff now it was outside.

She added that the atmosphere in pubs is now a lot clearer and they don’t have to redecorate as often.

Public health director Colin Cox said pubs locally do respect the ban and have adapted well.

It is policed by district councils’ environmental health departments, and he is not aware of any recent cases where pubs in Cumbria have had legal action taken against them as a result. He firmly believes a culture change has come about, and there would be no public support for a return to smoking in pubs.

“There are also more specialised places where regulations might be worth thinking about. For example, mental health in-patient units do allow people to smoke outdoors but would moving to vaping be an option?

“There is talk about stopping people smoking in highly populated streets or public places but I’m not sure we are there yet.”

He stressed that although smoking is in decline, it does still happen and he would urge those who do to access local stop-smoking services, which are still available, via community pharmacies.

“The message is that smoking is still one of the most harmful things you can do to your health. If you do not smoke, do not start, and if you do smoke, stop if you can or if you can’t, switch to vaping.

“We do not know fully about the safety of vaping but I can’t see it ever being found to be less safe than smoking,” he said.

As for the pub trade, Mr Cox does not believe they have suffered because of the ban.

“I think pubs have just adapted. There’s no doubt that there has been a declining trend but that had been going on for years, before the smoking legislation changed.

“When you look at graphs you can’t really see where the smoking ban came in. You get people saying that pubs lost lots of business, but they didn’t,” he added.

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Weblink: Healthwatch Cumbria NHS Stop Smoking Service