Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action

Key action area 4: Eliminate exposure to second-hand smoke in public places

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Significant health risks are posed by exposure to smoke from tobacco products smoked by other people.[103] It is well established that second-hand smoke causes coronary heart disease and lung cancer in non-smoking adults, induces and exacerbates a range of respiratory effects in infants, children and adults, and increases the risk of Sudden Infant Death Syndrome (SIDS) and other serious health outcomes in young children.[104, 105] There is no level of exposure to second-hand smoke that is free of risk.[104, 105] At particular risk are the young, who lack control over their environment,[104] and the socially disadvantaged, who are more likely to be exposed to second-hand smoke at home and elsewhere.[105]

The International Agency for Research Against Cancer (IARC) has recently reported results from its expert scientific review,[106] which determined that evidence is sufficient to conclude that laws restricting smoking in workplaces and other public places reduce population exposure to second-hand smoke, consumption of cigarettes and respiratory symptoms in workers. The IARC found that such policies provide net benefits to business, with no adverse effects on overall sales in the hospitality industry.[107] An international study of adolescents from 32 countries in Europe, Israel and North America published in 2008 confirms a strong relationship between the adoption of national smoke-free laws and declines in adolescent smoking.[108] A review in 2008[109] and several additional studies[110, 111] confirm early suspicions[112] that the introduction of smoke-free policies is followed by a rapid reduction in heart attacks among both smokers and non-smokers.

Action 4.1
Amend legislation and departmental policies to ensure that smoking is prohibited in any public places where the public, particularly children, are likely to be exposed.

Smoking in cars
Alarming levels of exposure to toxic substances have been documented in children travelling with adults who smoke inside cars,[113-115] with greater concentrations resulting from airflow when windows are open,[116] and exposure more common in lower SES families.[117, 118] Bans on smoking in cars are being adopted by an increasing number of North American jurisdictions and are or shortly will be in force in all but three Australian jurisdictions (Western Australia, the Australian Capital Territory and the Northern Territory), with Western Australia and the Australian Capital Territory also currently considering legislative proposals. Greater national consistency would be desirable to protect Australian children in all jurisdictions.

Action 4.2
Legislate to ensure that children are not exposed to tobacco smoke when travelling as passengers in cars.

Smoking in workplaces and public places
Over the past four years, all Australian states and territories have extended legislation to reduce public exposure to second-hand smoke. Legislation applies to hotels and nightclubs as well as to restaurants, with exceptions relating to gaming areas in some jurisdictions (New South Wales, Queensland and Victoria) and smoking areas still allowed in hotels in the Northern Territory. Because legislation has been introduced at different times in different places, several loopholes and inadequacies have emerged in some aspects of operation and enforcement. In 2008 a NSW Health Department study of outdoor areas where smoking was still allowed in hotels detected ‘poor’ air quality well above the WHO-recommended 24-hour exposure limit of 25 micrograms per cubic metre. A third of hotels recorded twice the limit, with some areas exceeding it by 500%.[119]
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Action 4.3
Tighten and enforce legislation to protect against exposure to second-hand smoke in all workplaces (including both indoor and outdoor areas in restaurants and hotels, near the entrances to buildings and air-conditioning intake points, and in workplace vehicles).

Action 4.4
Introduce and enforce legislation, and encourage adoption of policies that restrict smoking outdoors where people gather or move in close proximity.

Smoking in multi-unit developments
In several states in the United States there has been much discussion about the problem of smoke-drift between apartments, some attempts at legal action[120] and growing pressure for legislation. In 2006 the NSW Consumer, Trader and Tenancy Tribunal upheld a case brought by occupants of an apartment against their smoking neighbours, requiring them to stop smoking in their adjacent apartment because of smoke drift.[121] This precedent could precipitate other such actions and give license to rental managers to advise tenants that smoking is banned in rental apartments. A Canadian survey found that 64% of apartment dwellers would prefer to live in an entirely smoke-free complex and that 46% had experienced smoke from a neighbour seeping into their apartment.[122] At least 36 public housing authorities in the United States have banned smoking within private apartments.[123]

People would be better able to choose accommodation free of smoke-drift if legislation required that the smoking policy in shared and indoor areas be specified in residential lease agreements in multi-unit apartments, and that all shared areas (lifts, stairwells, walkways, car parks) in multi-storey public housing developments be smoke-free. Currently in Australia, restrictions over smoking in apartment blocks apply in New South Wales and Queensland but not specifically in other jurisdictions.

Action 4.5
Protect residents from exposure to smoke-drift in multi-unit developments.

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