Semple, Sean and O’Donnell, Rachel and Purdy, Joanna (2023) An overview of progress on reducing secondhand smoke exposure in Northern Ireland and policy options for the future. A report to inform the end-of-term review of the Northern Ireland Tobacco Control Strategy 2012-2022. Dublin and Belfast: Institute of Public Health. DOI: 10.14655/11971-1084910.
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Second-hand cigarette smoke (SHS) is known to cause a wide range of ill health and disease. The burden is likely to be greatest among our most vulnerable including those with pre-existing illness such as respiratory and heart disease. SHS can also cause acute and long-term consequences for children. Northern Ireland has been on a long journey to protect her population from the dangers of SHS exposure. Gone are the days of smoky pubs, cinemas and offices. The Ten-Year Tobacco Control Strategy For Northern Ireland looked to continue this journey with one of the three key aims of that policy being “protecting people from tobacco smoke”.
This report examines progress towards that aim over the past decade. It reviews evidence from policy documents, reports, survey data and primary research, in order to provide an overview of how exposure to SHS in different settings and among different populations has changed since 2012. There has been progress in introducing policy and regulation to reduce the number of settings where non-smokers are exposed to SHS. Legislation to prohibit smoking in vehicles carrying children came into force in February 2022, while measures to ban smoking across all Health and Social Care (HSC) Trust sites were introduced in 2016. Awareness raising through national campaigns have focused on smoking cessation or prevention of initiation, with some local measures targeting smoking at school entrances and parks.
Compliance with the public space restrictions introduced in 2007 continues to be high and most exposure in the workplace and leisure settings has been reduced to passing or incidental SHS. There are a small number of exceptions, including workplace vehicles, outdoor hospitality settings where definitions of enclosed spaces continue to be stretched, and health care workers who visit patients at home. There is a need for a future strategy to continue to tackle these settings and work towards protecting the workforce from exposure to SHS. No-one should have to breathe SHS while at work. Northern Ireland gathers world-leading, longitudinal survey data on smoking and smokingrelated behaviours through the Health Survey Northern Ireland (HSNI) and the Young Persons’ Behaviour and Attitudes Survey (YPBAS). These data show some marked changes in population level exposure to SHS. Over the past decade the proportion of homes where smoking is permitted indoors has fallen from 28% in 2011/2012 to 14% in 2018/2019. This is a significant achievement that should be celebrated. It represents approximately 114,000 homes where smoking is no longer viewed as the social norm within the space of just 7 years. However, these changes have disproportionately benefited those living in wealthier areas: children living in poorer areas are less likely to have experienced reductions in SHS exposure at home.
In terms of future focus, it is important that the next strategy recognises the need to continue to tackle smoking in the home. Those living in the remaining 1 in 7 smokingpermitted homes across Northern Ireland will breathe concentrations of SHS often much higher than those measured in the smoky pubs of a bygone era. They will do so for many hours of their day and, as a result, be at much higher risk of cancer, stroke, respiratory disease and heart disease. Future strategy should commit to setting bold targets to drive down both the prevalence of smoking and the proportion of children and adults who live in smoking-permitted homes. These include consideration of a tobacco endgame with policies that further restrict smoking in indoor spaces as well as investment in mass media campaigns to continue to shift social norms and support people who smoke to make their homes smoke-free. Further, objective measures of SHS exposure such as collecting salivary cotinine in an annual nationally representative survey will bolster SHS data collection and policy evaluation data by establishing a monitoring system to track population levels of SHS exposure.
B Substances > Tobacco (cigarette smoking) > Environmental smoke (passive smoking)
HJ Treatment or recovery method > Substance disorder treatment method > Cessation of tobacco use
MM-MO Crime and law > Substance use laws > Tobacco / cigarette laws
MP-MR Policy, planning, economics, work and social services > Policy > Policy on substance use > Harm reduction policy
VA Geographic area > Europe > Northern Ireland
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