I'm a cancer specialist - here's why the smoking ban should be expanded to pub gardens and other outdoor places, says Professor Robert Thomas

Sir Keir Starmer’s Labour government is reported to be considering an announcement surrounding the banning of smoking in more public places. It comes ahead of the Tobacco and Vapes Bill, which was announced in the King’s Speech earlier this year and will see a progressive increase to the minimum age to legally buy cigarettes and a limit on the sale and marketing of vapes.

The Sun reported that secret Whitehall papers revealed that smoking may now be banned in pub gardens, outside nightclubs, outdoor eating areas in restaurants, outside sport stadiums, children’s parks, pavements outside hospitals and universities, and shisha bars. Private homes and gardens, and large open spaces, such as parks and streets, would not be included in the ban. 

View from Professor Robert Thomas

Having just seen hundreds of patients and one of my close friends smoke themselves into an early grave, I am fully in support of these new measures which will encourage people to smoke less. These new measures may just be the trigger for some people to quit.

Every cigarette can cause harm but of course the more people smoke the higher the risk. Even if a smokers do not contract a fatal disease they age prematurely and reduce their lifespan by at least ten years. What’s more during the last 10 years of their life smokers often have reduced exercise tolerance making activities of daily living difficult.

Light or intermittent smoking which is becoming increasing more common also still carries significant health risks. Quitting cigarettes completely, remains the number-one modifiable lifestyle habit which has biggest impact on reducing preventable disease and death in the western world, including:

• Cardiovascular diseases such as heart disease, stroke and peripheral artery disease.
• Respiratory issues such as chronic bronchitis and emphysema.
• Cancer of the lung, mouth, throat, oesophagus, bladder, cervix, and pancreas.
• Infertility, pregnancy and menopausal symptoms such as hot flushes
• Mental health issues such as anxiety and depression
• Blood clots such as deep vein thrombosis and pulmonary embolism
• Memory loss, dementia and Parkinson’s Disease
• Osteoporosis, arthritis

A reminder of why cigarettes are harmful

Tobacco smoke contains over 4000 different chemicals, many of which cause considerable damage. They can be categorised into four groups:

Chemical toxins including benzene, formaldehyde, ammonia, cyanide and arsenic can directly damage the DNA of cells, causing locked cancer genes to become active. They can also damage the immune system, allowing early cancers to progress more rapidly, and promote chronic inflammation, thereby contributing to the onset of degenerative diseases.

Nicotine is a powerful, fast-acting and addictive drug whose effects are felt immediately. These include increased heart rate and blood pressure, constriction of the small blood vessels in the skin, stimulation of nerve impulses, causing anxiety and tremors, and adverse effects on mood and behaviour.

Carbon monoxide a poisonous gas found in high concentrations in smoke. It combines with haemoglobin, to form carboxyhaemoglobin. As it combines more readily with haemoglobin than oxygen does, up to 15% of a smoker’s blood may be carrying carbon monoxide instead of oxygen around the body. Oxygen is essential for body tissues and cells to function efficiently, and a reduction in supply can cause problems with cognition, growth and repair.

Tar is deposited in the lungs which causing narrowing of the bronchioles and damage to the small hairs that help protect them from dirt and infection.

Remember, quitting smoking is one of the best things you can do for your health. It’s never too late to quit, and every cigarette you don’t smoke is a step towards a healthier, smoke-free life. Reducing, if you are heavy smoker is a short term interlude but chronic light and intermittent smoking should not be presented to as a healthy long term choice. Complete cessation is the only one of the most cost-effective, logical solution.

A government spokesperson neither confirmed nor denied the claims that the smoking ban would be expanded, saying in a statement: “We don’t comment on leaks. Smoking claims 80,000 lives a year, puts huge pressure on our NHS, and costs taxpayers billions. 

“We are determined to protect children and non-smokers from the harms of second-hand smoking. We’re considering a range of measures to finally make Britain smoke-free.”

The smoking ban, which criminalised lighting up inside indoor public places, was introduced almost 20 years ago in the UK - first in Scotland in March 2006, Wales and Northern Ireland in April 2007, and England a few mins later in July 2007. Charity Smokefree Action stated that in the year following the introduction of the ban, there was a 2.4% reduction in hospital admissions in England relating to heart attacks, saving the NHS £8.4m in the first year alone.