Editorial: Creating smoke-free public places

Medical research has for decades concluded that tobacco is the leading preventable cause of death. These deaths do not affect smokers only.

In the European Union, 19,000 non-smokers die each year due to second-hand smoke, which impacts mainly children and women.

The latest EU health ministers meeting in Brussels invited member states to crack down on secondhand smoke and vaping.

A health ministry spokesperson said Malta was always in favour of strengthening standards that protect public health and promised: “the Maltese government will be considering this (non-binding) recommendation further”.

Curtailing the ability of people to smoke in outdoor spaces represents a vital next step in the denormalisation of smoking. Some may frame this as an economic issue for the hospitality industry or an individual choice issue for smokers. This plays into the hands of some businesses that hold the value of human life in a very different regard to most of the rest of humanity. 

Various scientific studies confirm that when it doesn’t kill, second-hand smoke causes serious illnesses, such as coronary heart disease and lung cancer. Children exposed to second-hand tobacco smoke have a 50-100 per cent higher risk of developing acute respiratory illness.

Moreover, second-hand smoke exposure also increases the incidence of ear infections and the likelihood of developmental disabilities and behavioural problems. Put simply, secondhand smoke contributes to inequality and imposes significant economic burdens on individual and our public health system.

However, curbing second-hand tobacco risks is simply not enough and may become a red herring in the broader debate on protecting the public from other environmental hazards.

For instance, airborne chemicals caused by other polluters can also lead to cardiovascular diseases. There is ample scientific evidence that non-chemical environmental variables like temperature, occupational dangers, socio-economic factors, mental/psychosocial stress, agricultural practices and built environments can interact with air pollution, potentially amplifying the link between chemical and non-chemical pollution.

The World Health Organisation states that 90 per cent of the world’s population is exposed to levels of air pollution greater than its air quality standards. A large body of studies confirms that air pollution is increasingly implicated in the rise of cardio-metabolic threat factors such as insulin fighting and hypertension.

The war against second-hand smoke risk remains an important priority, and the local health authorities will do well to speed up measures to curb secondhand smoking. However, equally important is a laser focused awareness of the other pollution risks that, for too long, have been ignored by those responsible for shielding the public from avoidable environmental risks.

Public health policymakers, individuals, businesses and all stakeholders must work together to reduce the environmental risks we face daily. Whenever possible, people should reduce the time spent outdoors during times of high pollution, particularly during rush hours, which, unfortunately, are more extensive than necessary.

Reducing the number of cars on our roads must be a crucial objective. A decade of unbridled economic expansion has led to a loosely controlled construction industry and a proliferation of vehicles on our road network.

The pollution caused by these factors is compromising people’s health and well-being. It is, therefore, time for the government to upgrade the inadequate public transport service. Despite the free service, the cars on our roads keeps increasing.

More efforts are also needed to help people quit smoking and avoid secondhand smoke exposure. Smoking remains a major contributor to air pollution and increases disease risk. 

Our public health system is already overstretched. Its sustainability must be a higher priority than any economic consideration.