The noughties are best known for questionable fashion choices, the first series of Big Brother, the release of the iPod and the controversial Millennium Dome. It was also a decade marked by significant change in terms of public health, culminating in the smoking ban, which came into effect in England on 1st July 2007.
For those of us under a certain age, it’s hard to imagine being forced to spend the night in smoke-filled rooms, coming home with the smell of stale cigarettes permeating your clothes and hair. Luckily, those days are now long gone.
The smoking ban has been described as the most important piece of public health legislation for a generation. It was a huge achievement, aimed at cutting the number of smokers, driving down cancer rates and improving the nation’s health, paving the way for other future developments; including the branding of cigarette packaging being replaced with uniform packs in the ‘world’s ugliest shade of green’ and smoking in cars with children banned.
The smoke-free law, and the campaign that supported it, also helped to change attitudes towards and behaviour surrounding smoking. An extra 300,000 smokers were inspired to attempt to quit as the law came into force. More people have given up smoking and fewer people are being hospitalised with smoking related diseases, such as heart attacks, asthma and lung infections. According to Cancer Research UK, there are now 1.9 million fewer smokers in Britain, a reduction which is no mean feat. It was, however, far from an inevitable story.
Tony Blair’s Labour government had a less than smooth start in terms of its public stance on tobacco – indeed it was the cause of the first accusations of sleaze to hit the administration. Labour had pledged a ban tobacco advertising in its 1997 general election campaign but once in office, made an exemption for Formula 1. It later emerged that F1’s boss, Bernie Ecclestone, had donated £1 million to the Labour Party and a funding scandal ensued.
During their early years the Labour government also feared being perceived as an agent of the “Nanny State”. They were concerned that calling for a blanket ban on smoking in public places would increase criticism of them as overburdening and preachy – the “Daily Mail effect”, as the late Dame Tessa Jowell once called it.
As a result, the first government White Paper to tackle the issue, Smoking Kills (1998), emphasised education programmes and nicotine replacement therapy, giving people the choice to give up smoking, and supporting them to do so. However, civic society was already going further. As the public heard more about the growing evidence showing the risks of passive smoking, views began to shift. Smoking bans started to be implemented in many offices, as well as enclosed public places, such as cinemas and public transport.
But the Labour Party’s 2005 manifesto proposed only a partial smoking ban, exempting pubs and bars that did not serve food. Just one year later, a full ban on smoking in public places was implemented. What changed?
The contribution – and then reshuffling – of John Reid, Secretary of State for Health from 2003 to 2005, was crucial. Reid had been a heavy smoker, only quitting 18 months before taking office. He was initially sceptical about calls for a comprehensive ban, believing that a total ban would be seen as the patronising, particularly in the eyes of the party’s core voters. Seeking to protect institutions such as working men’s clubs from any potential ban, Reid fought for the 2005 manifesto only included a pledge to ban smoking in enclosed public places, restaurants, and bars where food was served.
His successor, Patricia Hewitt, was more open to a complete ban, stating that she would consider strengthening the ban if campaigners could demonstrate public support. Campaigners seized the opportunity. Rather than risking alienating smokers themselves, they focused on the dangers of second hand smoke to workers and non-smokers. Smoke was described as a pollutant, shifting responsibility to protect people onto the government.
This clever messaging framed the policy debate as in the interests of the majority, who were by now firmly behind the policy. As the national mood shifted, public opinion overtook political resistance and persuaded the government to offer a free vote on the issue of a full ban, and a majority of MPs to back it.
The new smoke-free laws were welcomed by the majority of the general public in England. In a survey conducted by pressure group Action on Smoking and Health (ASH) on the eve of the legislation’s implementation in 2007, 78% of respondents said they supported the law. A further survey conducted on the smoking ban’s ten-year anniversary showed support had risen to 83%. You’d be hard pressed to find people who disagreed with the law today.
Bringing in radical changes to the way we live is never an easy task. What was different with the smoking ban was that the public was convinced, the challenge was getting the government to deliver it. With clear evidence and strong public opinion, it may in retrospect seem inevitable that the government followed suit. But as we can see with public health battles today, from childhood obesity to safe injection rooms, the battles are never easy.