Let poor smoke, says health secretary

The health secretary, John Reid, angered health campaigners and anti-smoking groups when he said yesterday that smoking is one of the few pleasures left for the poor on sink estates and in working men's clubs.
Mr Reid said that the middle classes were obsessed with giving instruction to people from lower socio-economic backgrounds and that smoking was not one of the worst problems facing poorer people.

"I just do not think the worst problem on our sink estates by any means is smoking, but it is an obsession of the learned middle class," he said. "What enjoyment does a 21-year-old single mother of three living in a council sink estate get? The only enjoyment sometimes they have is to have a cigarette."

His statement provoked an angry reaction from anti-smoking campaigners. A spokesman for the anti-smoking group Ash said: "It's incredibly patronising to talk about smoking in this way. The argument is that we should have smoke-free work environments. John Reid has got this hang-up about the middle class imposing itself on the lower class, when it's the least empowered, people like bar workers, who are having smoking imposed on them."

According to Ash, men in socio-economic groups AB are twice as likely to reach the age of 70 as those in groups DE, with smoking being the biggest contributing factor. Women in social class 5 are almost twice as likely to die from lung cancer as women from social class 1.

Mr Reid's deliberately challenging remarks at a Labour Big Conversation event in south London suggests he will be cautioning against an outright ban on smoking in public places being included in the Labour manifesto.

He said he was an advocate of informed choice for adults, rather than bans, describing himself as favouring empowerment, rather than instruction. Mr Reid fears advocates of a ban are behaving as if members of the public are incapable of coming to their own sensible decisions.

Mr Reid's views were welcomed by Simon Clark, director of the smokers' lobby group Forest (Freedom of the Right to Enjoy Smoking Tobacco), who said: "We're not looking to encourage people to smoke. There's a lot of people out there for who smoking is a lot of pleasure and it's encouraging to see that John Reid recognises that."

Mr Reid's comments put him at some distance from Tony Blair, who said last week the government was considering measures to ban smoking in public places but hinted such measures could be left to local authorities. Tessa Jowell, the culture secretary, has also made clear that legal bans would be a last resort.

Faced by calls for a ban at the meeting attended by health professionals and the local community, Mr Reid said: "Be very careful, that you do not patronise people because sometimes, as my mother used to say, people from those lower socio-economic backgrounds have very few pleasures and one of them is smoking. I worry slightly about the unanimity of the middle class professional activists on this."

Ministers are currently wrestling over whether to back a nationwide ban on smoking in public places, allowing councils to impose bans.

Mr Reid insisted the government had not come to any decision, but added that if the government imposed any smoking restrictions, it would be done "in the British way", and not ape the bans introduced in either New York or Ireland.

Dr Reid, who gave up a 60-a-day habit himself 18 months ago, is deeply suspicious of bans on choice for adults.

He argued these people really needed help by changing the fundamental social conditions which led them to smoke. "My argument is that empowerment is different from instruction. You have got to be very careful that you do not say to the 75-year-old that 'you are better off if you are not going to be able to go to a working men's club and smoke'."

The British Medical Association said that it was surprised by Mr Reid's remarks, but it would continue to lobby for a ban. "Quite apart from the individual damage to smokers, there's passive smoking to consider. It isn't just damage they do themselves, it's the damage they do to others."

The minister was more sympathetic to calls for compulsory simplified food labelling setting out the sugar, salt and fat content of products. He also recognised that children needed better advice on nutrition and better school diets.

Mr Reid also said he wanted to find a new way to involve the ethnic minorities and working class in their own health, including by opening health care centres in shopping centres, or by using health advice from football clubs. "We need to find places where people work, that are more accessible, more identifiable for them, less preachy, less hectoring, less dictatorial, then we may achieve success in the field of public health," he said.