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Smoking rates may have fallen but what about the health of bar workers?

Ten years ago, on April 2, 2007, I was in Cardiff to comment on the introduction of the smoking ban in Wales.

I arrived the night before and checked into my hotel (the same hotel I stayed in last week).

Receptionist: "Good evening, sir. Are you here on business?"

Me: "Yes, I'm here for the smoking ban."

Pregnant pause.

Receptionist: "Are you a tobacco control officer?"

Seriously, that really happened.

The next day, as I described here, I was interviewed on BBC Radio Wales, BBC News 24, Wales Today (BBC1) and Channel 4 News.

Since then we've struggled to engage with the Welsh media which seems to prefer local, anti-smoking voices.

Last weekend, as I reported here, we released the results of a Populus poll that found that 58% of adults in Wales would allow well-ventilated smoking rooms in pubs and clubs.

The poll was reported by Wales on Sunday, Wales Online and the South Wales Evening Post (all owned by Trinity Mirror).

It was also discussed on BBC Radio Wales where I went head-to-head with Suzanne Cass, CEO of ASH Wales.

In the light of our struggles with the Welsh media that wasn't a bad return. I was disappointed though that BBC News Wales and ITV News Wales both overlooked the poll, despite several calls to the respective newsdesks.

Today, on the direct anniversary of the ban, ASH Wales hit back with their own angle on the smoking ban.

Since the introduction of the ban, we're told, smoking rates have fallen from 24 to 19 per cent and there are 94,000 fewer smokers in Wales.

Conveniently it implies that the smoking ban is directly responsible, ignoring the fact that other anti-smoking measures have been introduced in that time, not to mention that the decline in the number of people smoking only accelerated after 2012 when the Chancellor reintroduced the tobacco tax escalator and an increasing number of smokers began switching to e-cigarettes.

Also, unlike our poll which was conducted only last month, the decline in smoking rates is hardly news. ASH Wales is quoting 2015 figures that have been in circulation for some time.

They've also trotted out 'research' that found that "81% of people in Wales supported the ban - including three quarters of smokers themselves".

I'm guessing this is based on a YouGov/ASH poll, and not a particularly recent one either.

What you can be sure of is that YouGov (whose president is on the ASH Board of Trustees) did not give respondents the choice of allowing well-ventilated designated smoking rooms when they asked them if they supported the ban.

Despite this ASH Wales' spin on the smoking ban has been reported by Wales on Sunday/Wales on Sunday, BBC News Wales and ITV News News.

The good news is that BBC News Wales has finally given the Populus/Forest poll a mention, unlike ITV News Wales which has published - not for the first time - a report that is so one-sided it's actually laughable.

(It's just past ten o'clock on Sunday morning and I've already been on the phone to complain!)

More interesting, perhaps, ASH Wales' spin on the 'success' of the smoking ban focuses largely on the number of people who smoke.

They argue that "hundreds of thousands of people are no longer subjected to the deadly [sic] effects of passive smoking" but there are no actual facts that prove the smoking ban has improved public health.

In particular there's no suggestion that the health of bar workers has benefitted from the ban.

Mention of bar workers is of course problematic for tobacco control for two reasons.

One, there's no evidence their health has benefitted (it's pure conjecture).

Two, as a result of the smoking ban hundreds of pubs in Wales closed and thousands of bar workers lost their jobs.

So the smoking ban was never about the health of bar workers, as we were told. It was designed, quite simply, to force people to quit smoking.

In other words, ASH Wales has just confirmed what we've known all along.

Update: Following a second call to ITV News Wales this morning (and a couple of derogatory tweets) they have now updated their report to include a quote from Forest and a reference to our poll.

It shouldn't have to be like this!!

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Reader Comments (14)

Given unemployment has inherent health risks (partly from stress and substance abuse), I can't see how the overall effect would be anything but negative.

Sunday, April 2, 2017 at 10:48 | Unregistered CommenterAndrew Thompson

"... there are no actual facts that prove the smoking ban has improved public health."

Have you tried any of the references below from Hoffman, S. J. and C. Tan (2015). "Overview of systematic reviews on the health-related effects of government tobacco control policies. BMC Public Health 15(1): 744. For example, the Tan and Glantz review alone included 45 studies of 33 smokefree laws with median follow-up of 24 months. How many actual facts do you want?

From Hoffman and Tan: "Twelve reviews summarize the health-related effects of smoking bans and restrictions in public spaces, workplaces or residences. ..... all six reviews investigating primary health outcomes found decreases in adverse events [16, 20, 21, 22, 23, 25]. Tan and Glantz looked at hospital admissions data and found a reduced risk of admission for coronary events (relative risk (RR) = 0.85, 95 % confidence interval (CI) = 0.82 to 0.88), other heart diseases (RR = 0.61, 95 % CI = 0.44 to 0.85), cerebrovascular accidents (RR = 0.81, 95 % CI = 0.70 to 0.94) and respiratory diseases (RR = 0.76, 95 % CI = 0.68 to 0.85) with smoke-free policies [22]. The reductions were greatest with comprehensive policies that banned smoking in workplaces, restaurants and bars. Therefore, there is very strong evidence that smoke-free legislation reduces smoking behaviour, exposure to SHS and adverse health outcomes."

16. Been JV, Nurmatov UB, Cox B, Nawrot TS, van Schayck CP, Sheikh A. Effect of smoke-free legislation on perinatal and child health: a systematic review and meta-analysis. Lancet. 2014;383(9928):1549–60. doi:10.1016/S0140-6736(14)60082-9.

20. Mackay DF, Irfan MO, Haw S, Pell JP. Meta-analysis of the effect of comprehensive smoke-free legislation on acute coronary events. Heart. 2010;96(19):1525–30. doi:10.1136/hrt.2010.199026.

21. Mozaffarian D, Afshin A, Benowitz NL, Bittner V, Daniels SR, Franch HA, et al. Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association. Circulation. 2012;126(12):1514–63.

22.Tan CE, Glantz SA. Association between smoke-free legislation and hospitalizations for cardiac, cerebrovascular, and respiratory diseases: a meta-analysis. Circulation. 2012;126(18):2177–83. doi:10.1161/CIRCULATIONAHA.112.121301.

23. Lin H, Wang H, Wu W, Lang L, Wang Q, Tian L. The effects of smoke-free legislation on acute myocardial infarction: a systematic review and meta-analysis. BMC Public Health. 2013;13:529. doi:10.1186/1471-2458-13-529.

25. Callinan JE, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst Rev. 2010;4:CD005992. doi:10.1002/14651858.CD005992.pub2.

Sunday, April 2, 2017 at 10:59 | Unregistered CommenterRichard Edwards

Public opinion doesn't matter according to debs Arnott - except when she makes up figures about how popular the ban is with the imaginary public in her head.

I am sick of being bullied by these thugs and more than that i am sick of my govt funding these liars and giving them power to abuse, exclude, demonise, and criminalise law abiding people who always knew the ban was not about health but the means to attack consumers they vehemently despise and get more money out of them to replace the tax lost from quitters that pays these scumbags' wages.

I am also fed up of how the antismoker industry grooms children to become the next generation of smoker and quitter by shoving the issue of smoking right under their noses in infant school and upwards hopefully until they come out as teens curious to know what smoking is really like.

The Welsh media is disgusting. Next time i hear them talking about equality and anti hate, I think i will vomit at their hypocrisy.

Sunday, April 2, 2017 at 12:34 | Unregistered CommenterPat Nurse

We could all point to so called studies to prove our points but only those paid for and manipulated by the antismoker industry are used but that doesn't make them valid.

I trust the likes of ASH and its smokerphobic partners about as much as big tobacco. Anti-smokerism is corrupt and rotten to the core and cannot be believed anymore than big tobacco.

Leave us alone and take your smokerphobia elsewhere.

Sunday, April 2, 2017 at 12:41 | Unregistered CommenterPat Nurse

A.Thompson brings up a useful observation in a previous comment (though not the one he intended). You are quite right, Simon, that this -- along with almost everything tobacco control claims will have a particular effect -- is never studied after the fact. There is an established technology of outcomes prediction and evaluation, and they do not do it. The obvious reason is that they do not want to demonstrate they are lying. But there is also the problem that they don't understand enough science/methodology to do it.

So what do they do? They do those "heart attack miracle" just studies that Thompson cites. They are obviously nonsense. You have to be an idiot to actually believe that a policy that changes the exposure status of maybe 20% of the population, for a factor that even TCers would not claim causes 10% of heart attacks (or strokes, or whatever) in the population, could possibly reduce heart attacks by 20% or even 5%.

But in that exercise in trolling the credulous is an answer to their technology problem: Run the same model for the general population and hospitality workers. The portion of the general population that changes exposure status (i.e., goes from being substantially exposed to nearly unexposed) is a few tens of percent at most. But for bar workers it would be well over half (it is not all of them because many would still be exposed at home or social settings). Thus, the ostensible population effect should be many times as great (we are talking 4 or even 10 times) for the bar workers as for the general population. The elegance of this is that no matter how bad the model is that produced the "miracle" outcome, it should still show a hugely greater effect for the bar worker subpopulation.

Of course they do not do this. And not just because they could not understand this (though few of them could).

Sunday, April 2, 2017 at 15:07 | Unregistered CommenterCarl V Phillips

Ok, so it's clear that for the past 10 years (since smoking ban in Wales and birth of this blog) the strategy used for fighting anti-smokers is NOT working. Don't you think a radical change is necessary?

Sunday, April 2, 2017 at 16:58 | Unregistered CommenterVlad

Preface: I'm not an epidemiologist, but.....

If ETS exposures were sufficient to actually kill nonsmokers, wouldn't every smoker be dead within a matter of hours?

Sunday, April 2, 2017 at 18:44 | Unregistered CommenterNate

Richard Edwards above quoted at length from Glantz.

Does he not realise that Glantz is probably the biggest charlatan in the entire anti-smoking brigade?

Any report or paper quoting his name should immediately be dismissed as complete bollocks.

Sunday, April 2, 2017 at 19:09 | Unregistered CommenterMichael Peel

Carl, I think your comment refers to the post by Richard Edwards, not by Andrew Thompson.

Indeed, as you say, Edwards believes that he is revealing scientific evidence to the ignorant, when in reality he is simply citing a thread of junk science studies that follow from the famous "Helena miracle" piece by Sargent, Shepard and Glantz (published in the BMJ in 2004). The claim that smoking bans produce direct immediate (and measurable) health benefits for a large population sample has been solidly debunked by various studies, for example one by V Ho et al (which Edwards conveniently ignores). In fact, the health benefit claims from the "Helena miracle" and all its sequels (which Edwards cites) are comparable to claims by cranks peddling magical cures for all disease.

However, there is no need to invoke sophisticated "rocket science" to see that the "Helena miracle" studies are fraudulent. Simple plain common sense is sufficient, since extraordinary claims require extraordinary evidence: if there was an immediate direct measurable health benefit from extensive smoking bans, this effect would be specially noticeable (and stable) in large constituencies where those bans have been implemented for a long time, for example San Francisco, CA (not far from the office of Prof Glantz). Yet, as the study by Ho et al reveals, there is no such stable pattern in these constituencies. What the "Helena miracle" studies do is a combination of two tricks: to hunt for short time fluctuations of hospital admissions and to undertake statistical "cook up" techniques (multiple regressions) to obtain results that fit the desired hypothesis (smoking bans produce reduction of hospital admissions). In other words, a regulatory policy is decided and then the "science" is "commissioned" to justify it even if doing so involves a scandalous methodological fiasco.

I hope that Richard Edwards has the courage to reply to the arguments that Carl and I have written on the junk science references that he cited.

Sunday, April 2, 2017 at 20:05 | Unregistered CommenterRoberto

It really impressed me the audacity with which ASH said that "public health is not a matter of public opinion", whereas everything that there is, is not only a matter of public opinion but a matter also of democracy!

Sunday, April 2, 2017 at 20:11 | Unregistered CommenterCostas Kitis

Simon, thanks for keeping the Smoker's viewpoint in the public eye against pitted opposition and relentless propaganda.

Tobacco control seeks to silence all dissent and has disseminated their propaganda masquerading as research so far and wide that many accept their manipulated studies without critical review. A case in point is repeatedly claiming reductions in heart attacks after smoking bans are imposed (so-called 'heart attack miracles'). Several studies with extremely poor research design have made this claim. They have all been discredited but their results are still reported as if factual.

The bulk of tobacco control literature is not science but rather advocacy. The second hand smoke claims are false and when rigorous studies with large data sets over long time frames demonstrated that the tobacco control lobby attacked the authors and suppressed the result.

Bottom line this is a political issue and open debate is required. Hopefully others will join with Forest to ensure the issues get a fair hearing in the press.

Sunday, April 2, 2017 at 21:14 | Unregistered CommenterVinny Gracchus

Readers of this blog are somewhat more informed than most concerning the antics of Tobacco Control (prohibitionism). Yet Dickie Edwards has the gall to peddle here the TC con job of "heart attack miracles following smoking bans".

"Heart attack miracles following smoking bans" has been debunked. A recent "study" from Sao Paolo shows the magnitude of fraud that Tobacco Controllers are engaged in. In the Sao Paolo "study" statistical manipulations produced a heart attack trend post smoking ban in the opposite direction of the raw data trend. If it was not for a handful of bloggers highlighting the con, none would be the wiser.

In Dickie's references Glantz figures highly. It was Glantz that originated the theme of "heart attack miracles" with the small Helena, Montana, "study". It's interesting how Glantz - a long-time, high-profile antismoking activist - refers to the recent Sao Paolo "study". He is unaware (or couldn't care less) that the "study" has a terminal flaw. The only interest for Glantz is that the "study" produces the "right" result for the prohibition "cause".

In Glantz's own blog (that does not allow contrary/critical comments), the heading referring to the Sao Paolo study is "The evidence keeps piling up: Smoke-free law in São Paulo linked to fewer hospitalizations and deaths due to heart attacks"


The header for a recent article in The Conversation that introduces the Sao Paolo study, Glantz opts for the header "No doubt about it: smokefree laws cut heart attacks in big way"


In addition to being uncritical of the severely flawed Sao Paolo study, Glantz omits a considerable segment of evidence that debunks "heart attack miracles". His conduct is delinquent, fraudulent in pushing the prohibition agenda. See comments to the article by "John Anderson" for additional links. In this recent episode, Glantz has been caught out big time...... with his very, vary large pants down.

In this comments section, Dickie Edwards attempts the same con. Just drag out a series (cherry-picked) of "studies", probably copied from an antismoking website, as if definitive evidence. Dickie is either one of the brainwashers or one of the brainwashed.

Monday, April 3, 2017 at 7:46 | Unregistered CommenterForYourInfo

There are a number of points about prohibitionist conduct that require highlight. Prohibitionists are notorious for pathological lying to advance the "cause". Their first interest is in manipulating legislators to pass antismoking laws/policy. Prohibitionists are not interested in facts. They will say and do whatever produces "success". Having succeeded in getting antismoking legislation passed, the interest turns to maintaining the antismoking legislation. Aware that the reasons underlying antismoking legislation might at some time be exposed as fraudulent, the prohibitionists work on another set of "reasons" to maintain antismoking legislation. The "heart attack miracles following smoking bans" is maintenance trickery. The prohibitionists can then claim that, although there have been negatives from smoking bans - e.g., pub closures, loss of employment, isolation of smokers - LOOK, there are wonderful, initially-unforseen advantages/benefits to maintaining smoking bans, i.e., "heart attack miracles". It's a con job from start to finish.

Monday, April 3, 2017 at 8:02 | Unregistered CommenterForYourInfo

Smoking prevalence down to 19%?? How on God's earth do they know that. The anti's have garnered so much hate and disgust around smokers, that a lot of people don't DARE admit to smoking. Personally I don't give a damn. I smoke. I can. End of. But I really do know people who skulk around with their cig turned in towards the palm of their hand, trying to hide the fact that they smoke. The bullying of smokers should be deemed a "hate-crime". Who else would people be allowed to bully so. Waving arms, coughing, and telling folk they stink! If anyone dared speak to me like that I might even contemplate my first ever conviction in all my 60 years!!!!!!!!!!!!!!!!!!!!!!!

Monday, April 10, 2017 at 15:24 | Unregistered CommenterSupergran

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