Introduction
Passive smoking is what non-smokers experience when they breathe in the tobacco smoke that others have released into the surrounding atmosphere. This smoke is the result of the burning of tobacco and the air exhaled by someone smoking: only 15 % of smoke from a cigarette is inhaled by the smoker (mainstream smoke); the remainder (secondhand smoke) is dispersed into the surrounding atmosphere and can be breathed in by other people present.

Tobacco smoke contains more than 4,000 chemical substances of which more than 50 are known to be carcinogenic and more than 100 to be toxic. Some of these substances are more concentrated in secondhand smoke than in mainstream smoke (that inhaled by the smoker).

The dangers of passive smoking
A study published in April 2004 in the British Medical Journal[1] emphasises the devastating effects. According to the authors, there is a 15 % higher risk of mortality in adults who live with a smoker even if they have never smoked themselves. In May of the same year, the WHO?s International Agency for Research on Cancer classified passive smoking in the group of human carcinogens and showed that typical levels of involuntary exposure caused lung cancer in people who had never smoked[2]. This organisation also pointed out that people who lived with smokers ran a 25 % greater risk of suffering from a coronary heart disease[2].. Furthermore, tobacco smoke particularly affects children in whom it causes an increased risk of respiratory infections, recurring ear infections, asthma attacks, delayed intra-uterine development, low birth weight and cot death. Not to mention the fact that non-smokers may experience unpleasant effects in a smoky environment such as: coughing, headaches, irritated eyes, nausea, respiratory problems, etc. It was estimated that in 2001 within the EU-15 alone, exposure to second-hand smoke accounted for 50 to 100,000 deaths each year[3]
The Europe Community is actively developing a complete anti-smoking policy. You can find out more on the following two websites, featuring many articles, news items and information: http://www.help-eu.com and http://europa.eu.int/comm/../tobacco_en.htm.

The WHO Framework Convention on Tobacco Control (FCTC), the world?s first public health treaty, adopted unanimously by WHO?s 192 member states on May 21st 2003 at the 56th World Health Assembly, is the first international legal instrument designed to reduce tobacco-related deaths and disease around the world. Entered into force on the 27th of February 2005, this treaty has been signed by the 25 EU countries and ratified by 13.

The legislative framework
At EU level, passive smoking is addressed in a directive and a recommendation. The directive concerning health and safety at work (89/391/EEC) stipulates, in particular, that ?In rest rooms appropriate measures must be introduced for the protection of non-smokers against discomfort caused by tobacco smoke?.. Furthermore, in 2002, the Council adopted a recommendation inciting member states to take legislative measures in order to provide appropriate protection against passive smoking in workplaces, closed public places and public transport. [4]
The legislative framework and the actions to curb the harmful effects of passive smoking vary from one country to another. Ireland and Norway are currently the only countries where there is a complete ban on smoking in all workplaces, including bars and restaurants. Aim: to protect workers from being exposed to a smoky environment and thus protect their health. In Ireland the ban is respected up to a level of 94 % in all sectors. In fact, one smoker in five no longer smokes in the presence of others. Irish smokers also confirm smoking less at home, which signifies that the law has made people aware of the damaging effects of passive smoking. Most EU member states have opted for a law banning tobacco in public places. Some others, such as Ireland, Italy, Malta, Finland, the Netherlands and Sweden, have banned smoking in workplaces but not all have included the hotel and catering industry in this application. Numerous countries (France, Belgium, Poland, Hungary, Estonia, Finland) have offered this sector the possibility of creating smoking and non-smoking areas.

Obstacles preventing enforcement of the laws
There is a lack of or a weakness in the inspections and sanctions, which should be intensified.? A smoking area is also a vague concept, difficult to enforce and providing no health protection as the smoke in the smoking area can mix with the air in the non-smoking area.? A total ban remains the best option.? If not feasible, an alternative for smoking areas is a closed room.

Specific actions that could be used to promote a ban on smoking
Between the moment an anti-passive smoking law is voted and it actually comes into force, debates, surveys and articles in the press can serve to raise awareness in populations (Sweden, Spain, France, Belgium, etc.).

Tools to support an anti-passive smoking law
Besides the major means of control, Ireland and Malta have deployed a wide range of tools to help their populations for example :
- A telephone line to obtain information on the new law as well as on stopping smoking (?Quitline?) (whose number figures on cigarette packets in Malta).
- An advertising campaign conducted beforehand throughout the whole country.

Positive effects of a non-smoking
legislation have been noted in numerous studies. In 2002, the British Medical Journal demonstrated that a total ban on smoking in workplaces leads smokers to reduce the amount they smoke by 29 %. [5]

Conclusion
Should regulations on passive smoking (like in Ireland) at a European level be called for?

It is strongly recommended that all governments follow the Irish example and ban smoking in public places/workplaces. The ban will afford protection not only to workers but also to customers who are exposed to the harmful carcinogens of toxic environmental tobacco smoke. Focusing on prevention as indicated in recent papers (i.e. reflection paper for the new EU health strategy 2004) supporting smoke-free public places/workplaces, would present a great opportunity to make a convincing, visionary and effective change! The hope is to see more good practice based on this principle promoted by the Commission and national governments using the outstanding evidence to argue against simplistic calls from traditional industry lobbies for less tobacco legislation!

Exchange of good practices
The majority of member states committed to reviewing their laws are focusing on Ireland, Italy, Malta and Norway. There is evidence that a total ban is easier to enforce than a smoking restriction leading to confusion and disputes between smokers and non-smokers. Compliance with the legislation in Ireland and Norway improved when a total ban was introduced in 2004.

Comments:
- This press release has been compiled based on the expertise provided by the members of the European Network for Smoking Prevention (April 2005).
- “The views expressed may not in any circumstances be regarded as stating an official position of the European Commission"
- Links and sources are to be part of the body of the text.
- As part of the new anti-smoking campaign “HELP – For a life without tobacco” launched by the European Commission, regular press releases will be sent out (from April to November) to provide media with relevant health-related information in order to accompany, prolong and intensify the “HELP” campaign measures.