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Saturday, 8 February 2014

Travel sick - banning smoking in cars

Queuing in traffic around the north circular on the way to relatives was a feature of my childhood. As was my mother's stress at the combination of the length of the journey and my father's nose to tail break hard driving. Her need for a cigarette was pretty overpowering. I remember my brothers and I pleading with both our (health professional) parents not to smoke in the car - something they heeded as best as nicotine addicts can. We had to have the windows wound up to shut out the smell of traffic fumes only to be locked in the car with cigarette fumes. It was only the very real threat of me throwing up due to aforesaid breaking that stopped my mother lighting up.

This experience was probably pretty common in the 1970s and increasingly less common in the decades since - although Labour and co-operative MP Luciana Berger claims here that one in five children may still be exposed to smoke in cars. Whether it is out of ignorance of the harm they do or denial in the face of addiction, only legislation will force parents to confront what they are risking.

It's hard to know why banning smoking in cars is such a contentious issue. Yet it's a real fight - one that may well go down to the wire - just like banning smoking in public places - but we got there in the end with that. We have to hope that this government doesn't once again run scared of legislation to protect the public's health just as it did with plain packaging of cigarettes and minimum unit pricing of alcohol - although it may be tiptoeing back to reconsider the latter.

The House of Lords has backed Labour's proposal to ban smoking in cars carrying children. Ministers are now looking at how to implement such a ban. Disappointingly, however, deputy prime minister Nick Clegg said on his weekly LBC phone in that he was opposed to legislation that would allow the government to ban smoking in cars with children - calling it 'sub contracting parenthood'. But then I hadn't realised that Clegg was a smoker. Does he think car seats for babies is 'sub contracting parenthood' or is it just the smoking thing? Read the story here
Read @COPDdoc Nick Hopkinson's excellent dissection of Clegg's arguments here

There is widespread evidence here and here that second hand smoke harms those who breathe it in. That this is so was a strong feature of the argument for banning smoking in public places - those employed in pubs and clubs were forced to breathe in the cigarette smoke of punters hour after hour. Five years after the public smoking ban, there were reports of improved health amongst barworkers and it has been almost universally welcomed by them and by their customers. Although there are still hardy knots of people gathered outside pubs and clubs sharing nicotine and camaradrie with other smokers.

It was thought that the ban on smoking in public places would drive smokers back into the home to light up. But it seems this didn't happen. Many smokers took the opportunity to give up whilst many more at least took their smoking outside just as they had to when in a public place.

Of course, public health education must continue to be a big part of changing smokers' habits, together with support to help people give up. But we know from experience that public health campaigns are most effective in changing behaviour when they are backed by legislation. That was the lesson from introducing the law on wearing seatbelts, and the drink driving and smoking bans.

Children, of course, have no say in any of this but if they had, I don't believe one would say 'I wish Mum or Dad would smoke in the car.'


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