In his speech today, at the BMA’s (British Medical Association’s) fringe meeting at the Labour Party Conference in Brighton, BMA Chairman, Mr James Johnson, called upon the Health Secretary, John Reid, to introduce a total ban of smoking in enclosed public places and emphasised that a ban must include pubs and restaurants.

Mr Johnson, said: \"Tomorrow sees six months of workplace legislation in Ireland. In that short time, 96% of pubs are smoke-free, tobacco sales are down, and more than 7000 smokers have quit successfully.

The last six months in the UK has meant at least 350* more deaths among workers because of second hand smoke - that’s two workers dying every day. Among the most heavily exposed are workers in bars and clubs, just 1%** of which are smoke-free.

What is John Reid waiting for? The health risks are beyond any doubt. The Irish experience shows that smoke-free laws are workable and enforceable.\"

In his speech - \"Making Health Choices: the balance between individual and collective choice in public health\" - Mr Johnson argues that individuals should be free to make their own choices wherever possible, but sometimes it is only possible to make a single collective choice. If there is indisputable evidence of danger to others from unhealthy behaviour, the Government should take decisive action - as with seat belt and drink driving laws. But if there is not a danger, then the Government should seek to create an environment that helps people to make informed choices. \"The Government cannot simply proclaim ’choice’ as a euphemism for individual responsibility and as an excuse to abdicate its own\" Mr Johnson said.

Mr Johnson urges the Government to lift the barriers that can hinder a person’s ability to act upon their choice: \"If people are allowed to smoke in pubs and clubs, and this is the norm, then a major barrier is placed on the individual’s power to stop smoking. Smokers trying to give up must either resist the temptation of a smoke-filled environment or they must give up their social life along with their cigarettes. And what choice is there for bar workers who are exposed to second-hand smoke levels six times that of office workers?\"

There are other aspects of public health, where the Government can act now to safeguard the nation’s future health:

-- Improving access to sexual health clinics to help tackle the spiralling number of cases of sexually transmitted infections.

-- Working with the food industry to ensure effective labelling of food products to allow individuals to make informed choices about what they eat.

-- Creating safe cycle routes and developing walking networks to encourage a higher uptake of physical exercise.

-- Demanding warning labels on alcoholic drinks to alert the public to the dangers of excessive alcohol consumption.

These are just some of the measures that the Government can take to tackle the public health agenda. But Mr Johnson warns that this may involve an entirely different approach to planning health care. He said: \"Advancing public health requires a different way of thinking from health service management. It requires more lateral thinking - beyond acute care and hospital beds - and willingness for Government to invest in initiatives that will not necessarily show immediate return.

\"A difficulty for any government is the need to demonstrate short-term impact to maintain popular support and show a return against its policy. This results in a tendency towards shaping policy for a relatively short time span. Some of the initiatives needed are medium term and others are long term. The results of policy on behaviour and economic change may show up decades later.\"

Ends

Notes to Editors:

Useful facts and figures follow:

*350 workers: - Paper presented to Royal College of Physicians by Professor Konrad Jamrozik, Imperial College London, May 17 2004.

**1% pubs are smokefree - The Charter Group (April 2003) The Public Places Charter on Smoking - Industry Progress Report. Charter Group: London.

Smoking, drinking and drug use

-- The BMA estimates that each year, second-hand smoke kills at least 1,000 people
-- Second-hand smoke increases the risk of lung cancer by 20 - 30% and heart disease by 25 - 35%
-- 8 out of 10 asthmatics say second-hand smoke can trigger an attack
-- More than a million people are regularly exposed to second-hand smoke at work
-- Bar workers’ exposure is six times that of office workers
-- A quarter of 15 and 16 year olds in the UK smoke at least once a week
-- UK adolescents have one of the highest levels of alcohol use and binge drinking in Europe
-- In 2003, 21 per cent of 11 to 15 year olds in England reported using drugs at least once in the last year. 28 per cent of 16-24 year olds in England and Wales took drugs in 2002/03. Cannabis is the most frequently reported illicit drug used

Sexual health

-- The prevalence of sexually transmitted infections among adolescents is high and increasing
-- As many as one in 10 women aged between 16 and 19 may be infected with chlamydia
-- Around 3 per cent of women conceive under the age of 20

Nutrition, exercise and obesity

-- Around one in five young people aged 13-16 is overweight or obese
-- Less than 15 per cent of girls and 20 per cent of boys aged 13-15 eat the recommended amount of fruit and vegetables
-- By the age of 15, only around one third of girls undertake 30 minutes of physical activity on most days

Mental health

-- One in five adolescents may experience some form of psychological problem. These range from behavioural disorders to depression, eating disorders, self-harm and neurosis.

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