Doctors push for UK smoking ban

Doctors were today stepping up pressure on the British government to ban tobacco in public places after a study showed the dangers of passive smoking could be even greater than previously estimated.

Delegates at the British Medical Association’s conference in Llandudno, Wales, were set to call for smoking in workplaces, including pubs and restaurants, to be outlawed.

It came after a study claimed that the risks of heart disease faced by passive smokers were double what was previously estimated.

Previous research has found that passive smoking is linked with a 25-30% increased risk of coronary heart disease.

But the latest study, published on bmj.com, found that non-smokers faced a 50-60% increased risk of falling victim to the disease.

The researchers noted that most studies on passive smoking examined the risks of living with someone who smoked.

They said while this was important it did not take into account the additional exposure at work and other places like pubs and restaurants.

The team said that by measuring cotinine – a by-product of nicotine – they could get a more accurate measure of exposure to smoke from all sources.

The study focussed on 4,792 men from 18 British towns who were monitored for 20 years.

The researchers took blood samples to measure cotinine, concluding that higher concentrations in the blood of non-smokers were associated with a 50-60% greater risk of heart disease.

They said that the risks were increased in the early follow-up period, indicating that the link between cotinine levels and heart disease seemed to decline with time.

This suggested another source of underestimation of the effects of passive smoking because other studies have had much longer follow-up periods.

The researchers said more studies were needed to find the link between cotinine and other biomarkers and the increased risk of heart disease to help assess the impact of passive smoking.

Researcher Prof Peter Whincup, of the Department of Community Health Sciences at St George’s Hospital Medical School in London, highlighted the case for tackling passive smoking.

“This study adds to the weight of evidence that passive smoking is harmful and strengthens the case for limiting exposure to passive smoking as much as we can.”

He added: “People are smoking less now so non-smokers are exposed to lower levels of second-hand smoke.

“But this study suggests the harmful effects of passive smoking have been underestimated in the past because previous studies only looked at the effect of a non-smoker living with a partner who smoked.

“They gave a 25-30% increased risk.

“Using a biological marker for passive smoking allowed us to assess the effect of wider exposure on heart disease risk.”

Deborah Arnott, director of anti-smoking campaign group ASH, said: “This important study provides yet more evidence of the serious health risks posed by second-hand smoke.

“It suggests that if you regularly breathe in other people’s smoke at home or at work your chances of getting heart disease may rise by more than a half.

“This is a much bigger increase in risk than was previously thought – and the difference with previous estimates seems mainly due to smoking in the workplace.”

Dr Tim Bowker, associate medical director of the British Heart Foundation, said: “The need for a ban on smoking in public places in the UK has never been better illustrated than by this potentially pivotal study.

“We have known for some time that passive smoking was strongly associated with increased risk of coronary heart disease, but this study strengthens the evidence considerably.”

But Simon Clark, director of the smokers’ lobby group Forest, said: “We would all like to know whether passive smoking kills and the jury is still out.

“An increased risk of 50-60% may sound alarming but in statistical terms it would have to be 200-300% before it was significant.”

Mr Clark added: “This new report needs to be seen in perspective.

“It is one of over 100 studies on the subject and the vast majority have failed to find any connection between passive smoking and ill health.

“On the few occasions a link has been detected it has been too small to be significant.”

:: Other topics set to be discussed by BMA delegates today included banning junk food adverts aimed at children and over-the-counter drug addiction.