TOBACCO POLICY SPECIAL
Former health secretary Patricia Hewitt looks back on the political battles that led to the smoking ban, and looks ahead to the next challenges for public health professionals – getting people to take responsibility for their own health.
hen Tony Blair asked me to become Health Secretary after the 2005 elec- tion, I inherited a manifesto commitment to legislate for a smoking ban in England. That was the good news. The bad news (apart from the fi nancial crisis that emerged a few months later) was that the manifesto only committed us to a partial ban. Private clubs and licensed premises not serving food were to be exempt.
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It’s hard to remember now, but at the time a smoking ban was highly controversial. My predecessor, John Reid, had made a careful judgment about what he felt was the right balance between the cause of public health, on the one hand, and individuals’ freedom on the other. Underlying the philosophical argument was a political judgment as well – about how far Labour risked being seen as the ‘nanny state’ and how far, as John used
18 | national health executive Nov/Dec 11
to put it, we should allow working-class men to enjoy a cigarette with their pint.
John is an old friend and good colleague. But my judgment was different. The more I looked at the medical evidence, and the ex- perience of other places that had got there ahead of us – including New York City and some of the Australian states – the more convinced I was that our destination had to be a complete ban on smoking in enclosed public places. But manifesto pledges are se- rious things and in any case, John went on arguing his case passionately. To make mat- ters worse, his carefully-crafted compro- mise looked pretty diffi cult to implement. Would a pub serving crisps, snacks and pre-prepared, shrink-wrapped sandwiches from the bar count as ‘serving food’ or not? Could the cigarette-smoking, pint-drinking customer bring his own pizza if he wanted
to? Most important from the health point of view, what about the bar staff who would continue to be exposed to second-hand smoke. Tessa Jowell – who as Labour’s fi rst public health minister had consistently campaigned for a smoking ban – was by now in charge of Culture, Media and Sport, the department responsible for licensed premises; she confi rmed that her offi cials couldn’t see any simple way to implement the manifesto.
For several weeks, the arguments raged – inside government and outside in the me- dia. The medical profession stepped up their pressure for a complete ban. Speaking at the BMA Conference, I got more questions on this issue than any other – although all I could do at that stage was to stress our com- mitment to protecting people from passive smoking, refer to the manifesto commit-
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