Secondhand smoke contains many chemicals that pollute the air around a person who is smoking, with some of them causing extreme harm to the health of those nearby.
Laws to restrict where and when people can smoke have been introduced in various forms across the world to protect people when visiting public places and at their workplaces including in vehicles.
Laws are necessary because voluntary measures, although popular, rarely protect everyone. The UK laws are regarded as good examples since they are clear and contain few exemptions or loopholes.
Smoking in workplaces and public places: The Health Act
Smoking has been prohibited by law in virtually all enclosed and substantially enclosed workplaces and public places throughout the United Kingdom since July 2007. Smokefree legislation in England forms part of the Health Act 2006 and The Children and Families Act 2014. Implementation followed the introduction of a similar law in Scotland in 20061 2 and in Wales and Northern Ireland in April 2007.
Under the Health Act, “substantially enclosed” means premises or structures with a ceiling or roof (including temporary and retractable coverings such as awnings) and where there are permanent openings, other than windows or doors, which in total are less than half of the area of the walls. So, for example, market stalls and bus stops can be required to be smokefree if their structure is substantially enclosed.3
As part of the Health Act 2006, smoking in all public transport was prohibited as well as vehicles used for work purposes by more than one person at any time. The regulations require that a vehicle must be smokefree if it is used “in the course of paid or voluntary work by more than one person” (even if those persons use the vehicle at different times, or only intermittently).4 Vehicles used for work purposes include taxis and minicabs, as well as business vehicles such as vans and lorries and specialised transport e.g. farm tractors. Public transport and vehicles used for work purposes must display a “No Smoking” sign at all times.5 In addition, the Highway Code 2007 advises against smoking and driving because it can cause a distraction.6
Smoking in private cars: The Children and Families Act 2014
The Health Act 2006 was amended by the Children and Families Act 2014 granting the Government power to introduce regulations to make private vehicles smokefree when carrying children under the age of 18.7
The regulations took effect on 1 October 2015, with the law applying to England and Wales. A similar law in Scotland was implemented on 5 December 2016.8 The Northern Ireland Assembly also enacted a ban on smoking in cars when children are present in 2016.9
Background to the law
In 1998, the Government’s White Paper, “Smoking Kills” proposed an Approved Code of Practice (ACOP) to supplement the Health and Safety and Work Act 1974 (HASAW) to protect workers from secondhand smoke, with an opt-out for the hospitality trade, which became known as the Public Places Charter. This voluntary scheme was designed to encourage places such as restaurants and pubs to increase provision for nonsmokers and improve overall air quality. Despite extensive publicity to promote the Public Places Charter, awareness of and compliance with the initiative were low. A progress report published in April 2003 revealed that 46% of restaurants and pubs surveyed still allowed smoking throughout, with only 22% having separate smoking and non-smoking areas. Less than 1% banned smoking entirely.10
In November 2004, the Government published a White Paper on public health, which proposed to end smoking in the majority of workplaces and public places except for private clubs and for pubs which did not serve food.11 Despite a public consultation which revealed overwhelming support for a comprehensive smoking ban, the Government retained the proposed exemptions for pubs and clubs when it published the Health Bill in late 2005. However, on 14 February 2006, MPs voted by a large majority to remove the exemptions for pubs and clubs. The bill also received majority support in the House of Lords and became law in July 2006. The law was implemented on 1st July 2007.
The need for smokefree laws
The evidence that exposure to other people’s smoke is dangerous to health is well established. Comprehensive reviews of the effects of passive smoking include reports by:
- the US Surgeon General12 13
- National Health and Medical Research Council of Australia14
- US National Research Council15
- World Health Organization (WHO)16 17
- California Environmental Protection Agency (EPA)18
- International Agency for Research on Cancer (IARC)19
Prior to the implementation of the smokefree law, it was estimated that exposure to secondhand smoke in the workplace caused around 617 premature deaths in the UK each year.20 By comparison, the total number of deaths in the UK from all other industrial accidents was reported to be 235 in 2003/4.21 The degree of risk depends on the extent and duration of exposure. Particularly at risk were bar staff, casino workers and other employees in workplaces where smoking was routine. It was estimated that secondhand smoke caused one premature death a week among workers in the hospitality industries.20
For more information about the health impacts of general secondhand smoke, see ASH Fact Sheet: Secondhand Smoke.
Smoking in motor vehicles
Smoking in motor vehicles causes harm in several ways:
- It harms the smoker when inhaling tobacco smoke.
- It harms other occupants of the vehicle when inhaling second-hand smoke.
- It normalises smoking behaviour for children.
- There is potential harm to the driver, passengers, and other road users from the driver’s temporary
lapse in attention to driving when lighting or extinguishing a cigarette.
A US study examined 100 different air change rate measurements in four vehicles. Results showed that under all ventilation circumstances, even with windows open and the fan on high, second-hand smoke concentrations in a vehicle were greater than in any other small enclosed place.22 A Canadian study found that when the driver’s window is open and the cigarette is held at the opening when the driver is not puffing, the level of second-hand smoke produced by a single cigarette is about two-thirds of the level of an average smoky bar.23
Although opening a window or using air-conditioning reduces the level of second-hand smoke, exposure for occupants in a vehicle remains significant. A systematic review revealed that exposure to second-hand smoke in cars can lead to extremely high concentrations of atmospheric markers of exposure even with air conditioning or open windows.24
A review of studies on smoking and driver distraction found that smokers have an increased risk of involvement in motor crashes and “actual distraction caused by the act of smoking is a likely factor.”25 The review concludes that “it is clear that smoking while driving is a hazard.”26 A Taiwanese study examining the risk of injury for drivers who smoke found that smoking almost doubled car death risk. Smoking was associated with at least one in five male injury deaths.27
Opinion polls show that public support for smokefree legislation is strong and has continued to rise since the law came into effect in 2007
Table 1: Support for smokefree legislation (2004 - 2014)
|Year of survey||Support for smokefree legislation|
among adults in England (%)
|May 2004 (MORI)||51|
|Dec 2005 (YouGov)||66|
|May 2007 (YouGov)||72|
|Feb 2008 (YouGov)||76|
|Mar 2010 (YouGov)||80|
|Mar 2014 (YouGov)||82|
The Smoking-Related Behaviour and Attitudes Survey for 2008/09 found the following high level of support for smoking restrictions among adults in Great Britain:28
- 85% agreed with restrictions on smoking at work
- 93% in restaurants
- 91% in indoor shopping centres
- 94% in indoor sports and leisure centres
- 85% in indoor areas at railway and bus stations
- 94% in other public places such as banks and post offices
- 75% in pubs
- As of 2020, 90% of children report that people are never allowed to smoke in their home.
- 86% of children report they are never inside a car where someone is smoking.
- 82% of children and 66% of adults believe that smoking should be banned inside all cars, whether or not children are present.
According to the Department of Health’s report “Smokefree England - One Year On”:31
- 81% of businesses agreed that smokefree legislation is ‘a good idea’
- 40% of businesses reported a positive impact on the company, compared with 3% reporting a negative impact
- 38% of licensed premises reported a positive impact on the company, outnumbering those reporting a negative impact by three to one (12% reported a negative impact)
- 59% of businesses and 62% of licensed premises reported that staff reactions to the law were positive (4% and 15% respectively reported negative reactions)
Studies in the USA have shown that banning smoking in restaurants has either had a beneficial or neutral economic effect and may increase tourist business.32 33 A review of studies examining the economic effects of smokefree policies found that those studies claiming a negative economic impact were backed by the tobacco industry and that most were subjective and of poor quality.34
Evidence of the harm from exposure to second-hand smoke (also known as passive or involuntary smoking) is well established and because of its carcinogenic content there is no safe level of exposure.35 Breathing in other people’s tobacco smoke is known to cause a range of health issues. These include immediate effects such as eye and throat irritation, headache, cough, dizziness, and nausea.
Adults with asthma can experience a decline in lung function while new cases of asthma may be induced in children.13 26 For adults already suffering from cardiovascular diseases (CVD), acute exposure to second-hand smoke can trigger heart attacks while cessation of exposure reduces the risk. Other research has shown that there is a strong dose-dependent association between passive smoking and risk of stroke, even at low levels of exposure.37
In addition to the physical risks faced by children exposed to second-hand smoke in cars, there are wider social issues to consider. Observational studies examining the prevalence of smoking in cars by socioeconomic area suggests that children in lower socioeconomic groups are likely to be more frequently exposed to second-hand smoke than other children, compounding the already unacceptable health inequalities faced by these children.38 Furthermore, children who are exposed to smoke in cars more likely to report smoking themselves.39 Researchers, academics and health experts agree that it is ethically justifiable to ban smoking in cars carrying children because children are not fully autonomous and are therefore unable to act to protect their own health, wellbeing and interests.40
The smokefree legislation in England resulted in 1200 fewer emergency admissions to hospital for heart attacks (a reduction of 2.4%) in the 12 months following implementation of the 2007 law.41 Other jurisdictions have shown reductions in hospital admissions for heart attacks ranging from 8% to 40%. Other health benefits associated with smokefree legislation include reduced incidence of childhood asthma and an increase in the number of people cutting down or quitting smoking.42 43
The law in practice
Legal requirements for smokefree public places, workplaces and work vehicles
The persons in control of premises and work vehicles (the owners, occupiers or managers) are required to uphold the law by ensuring that no one smokes where it is against the law to do so. They must also display at least one legible no-smoking sign in smokefree the premises or vehicle.
Note: The Smoke-free (Signs) Regulations 2012, relaxed the requirement for signs to be displayed at every entrance to smokefree premises. The requirement is now for at least one legible no-smoking sign to be displayed in all smokefree premises and commercial vehicles. The person in control can decide the size, design, and location of the signs.
The persons in control should also take reasonable steps to maintain compliance for example:
- Ensuring that staff, customers, visitors, and members of the public are aware that premises and vehicles are legally required to be smokefree.
- Identifying areas inside their premises where smoking might be taking place and displaying additional no smoking signs or installing smoke detectors and alarms.
- Including their smokefree requirements in their personnel procedures and being prepared to use their disciplinary procedures if necessary.
There are very few exemptions to the law and where they do exist, they do not apply to the entirety of the premises but to “designated rooms”. In practice, many of these exemptions are still covered by voluntary smokefree policies. Exemptions to the law include:
- Guest bedrooms in hotels and guest houses and certain rooms in care homes, hospices, and prisons.44
- Private homes.45 However, if part of a home is used as a workplace, for example a room set aside for childminding or music lessons, that room must be smokefree. Where work is undertaken solely to provide personal care for a person living in the dwelling, to assist with domestic work or to maintain the building, the private dwelling is not considered to be a workplace and is exempt from the smokefree legislation.
- Places which are open-air, such as sports stadia,46 are exempt. However, the owners of such premises may choose to implement a smokefree policy.
- Bus stops and other shelters may be exempt if the structure is not “substantially enclosed”.
- In England, smoking by actors may be permitted if appropriate for the artistic integrity of the performance. This exemption does not apply to other countries of the United Kingdom.
- Offshore installations, such as oil rigs, may designate a room for smoking.
- Specialist tobacco shops. Exemptions are allowed only for the sampling of cigars or pipe tobacco and are subject to stringent conditions. Full details can be downloaded here.
Local authorities enforce the smokefree laws in workplaces, public places and work vehicles, however voluntary compliance with the law has been high and there has been little need for enforcement measures. Offences for which individuals can be fined or prosecuted occur when the law is not complied with in the following ways:47
- Failure to display no smoking signs.
- Smoking in a smokefree workplace, public place, or vehicle.
- Failure to prevent smoking in a workplace, public place, or vehicle.
Fixed penalty notices can be issued for the offences of smoking in a smokefree place and for failing to display the required smokefree signs. Failure to pay the fixed penalty, and serious and repeat offenders, can be prosecuted in the magistrates’ court, as well as persons in control of smokefree premises and vehicles who fail to prevent smoking taking place.
Compliance with the 2007 smokefree law has been consistently high since it was introduced. During the first 18 months of the legislation, local authorities in England inspected almost 600,000 premises and vehicles and found that:48
- 98.2% were smokefree
- 89.3% were displaying the correct no smoking signage
Offences for smoking in private motor vehicles when a child is present
Police and local authorities can authorise officers to enforce the law against smoking in a private vehicle with someone under 18 present. A fixed penalty notice can be given to anyone who smokes, or to the driver for failing to prevent someone smoking, if a child is present. Since implementation of the law in England and Wales there have been very few reported breaches and most of these have been dealt with by the police issuing verbal warnings.49 There is little need for enforcement with fixed penalty fines, as overall compliance with the law is already high. A report by the Chartered Institute of Environmental Health found no contraventions of the law in any of the 255 vehicles tested in two locations in England.50 By comparison, efforts to require the use of seatbelts in cars were most successful when legislation was introduced. Seatbelt wearing increased in the UK from 25% to 91% after the law was introduced.51
According to ASH’s Smokefree 2020 survey, 97% of respondents do not allow smoking in their car if children are present.29
ASH Scotland and Cancer Research UK. Smokefree Success: ASH Scotland presents the Scottish experience. 2007.
Flint C. The Smoke-free (Signs) Regulations. Queen’s Printer of Acts of Parliament. 2007.
Department for Transport. The Highway Code S148. 2017.
Earl Howe. Children and Families Bill Report Stage. House of Lords. 2014.
Ellison J. The Smokefree (Private Vehicles) Regulations 2015. Queen’s Printer of Acts of Parliament.
Scottish Parliament. Smoking Prohibition (Children in Motor Vehicles) (Scotland) Act. 2016.
Northern Ireland Assembly. Section 5 of the Health (Miscellaneous Provisions) Act (Northern Ireland) 72/11-16. 2016.
The Charter Group. The Public Places Charter on Smoking: Industry Progress report. April 2003.
Department of Health. Choosing Health: Making Healthy Choices Easier. November 2004.
United States Department of Health and Human Services. The health consequences of involuntary smoking: A report of the US Surgeon General. 1986.
United States Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: A report of the US Surgeon General. 2006.
National Health and Medical Research Council (Australia). Effects of passive smoking on health. 1987.
US National Research Council. Environmental tobacco smoke: Measuring exposures and assessing health effects. 1986.
World Health Organisation. WHO Tobacco Free Initiative, WHO/NCD/TFI/99.10. 1999.
World Health Organisation. International Consultation on Environmental Tobacco Smoke and Child Health: Consultation Report. 1999.
US Environmental Protection Agency. Respiratory health effects of passive smoking: Lung cancer and other disorders. 1993.
WHO International Agency for Research on Cancer. Tobacco smoke and involuntary smoking. Vol 83. 2002.
Jamrozik, K. Estimate of deaths among adults in the United Kingdom attributable to passive smoking. BMJ. March 2005.
Health and Safety Executive. Health and safety statistics: Key figures for Great Britain. [accessed 18 June 2020]
Ott W, Klepeis N, Switzer P. Air change rates of motor vehicles and in-vehicle pollutant concentrations from secondhand smoke. J Expo Sci Environ Epidemiol, 2008; 18.3, 312-325
Sendzik T, Fong GT, Travers MJ, Hyland A. An experimental investigation of tobacco smoke pollution in cars. Nicotine & Tob Res. 2009; 11(6):627–34
Raoof SA, Agaku IT, Vardavas CI. A systematic review of secondhand smoke exposure in a car: Attributable changes in atmospheric and biological markers. Chron Respir Dis. 2015; 12(2):120-31.
Young KL, Regan MA, Hammer M. Driver distraction: a review of the literature. Monash University Accident Research Centre, Report number:206. 2003.
Wen CP, Tsai SP, Cheng TY, Chan HT, Chung WSI, Chen CJ. Excess injury mortality among smokers: a neglected tobacco hazard. Tob Control, 2005;14 Suppl 1: i28- 32.
Fong GT, Hitchman SC. Levels of exposure to smoke in cars and the Canadian Experience. APPG Inquiry into smoking in private vehicles. ASH. 2011.
Office for National Statistics. Smoking-related behaviour and attitudes, 2008-09. 2009.
All figures, unless otherwise stated, are from YouGov Plc Smokefree Britain Survey 2020. The total sample size was 10,749 adults in England. Fieldwork was undertaken between 17th February 2020 to 11th March 2020. The survey is carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).
All figures, unless otherwise stated, are from YouGov Plc Smokefree Youth GB Survey 2020. Total sample size was 2,505 young people. Fieldwork was undertaken between 11th - 31st March 2020. The survey was carried out online. The figures have been weighted and are representative of all GB young people (aged 11 to 18).
Department of Health. Smokefree England – One year on. 2008.
Glantz, S and Smith L. The effect of ordinances requiring smoke-free restaurants and bars on revenues: a follow-up. American J Public Health 1997; 87: 1687-93.
Glantz S and Charlesworth, A. Tourism and hotel revenues before and after passage of smoke-free restaurant ordinances. JAMA 1999; 281:1911-18
Scollo M et al. A review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. Tobacco Control 2002; 12: 13-20
WHO. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Tobacco Smoke and Involuntary Smoking. Vol 83. 2004:1-452
Sims M, Maxwell R, Bauld L, Gilmore A. Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction. BMJ. 2010;340:c2161. doi:10.1136/bmj.c2161 h
Advani J et al. Long-term cigarette smoke exposure and changes in MiRNA expression and proteome in Non-small-cell lung cancer. OMICS, 2017; 21(7):390-403.
Bogdanovica I, Szatkowski L, Britton J and McNeill A. Smoking in cars in England: a study of school students in an English city. BMC Public Health. 2014.
Glover M et al. Driving kids to smoke? Children’s reported exposure to smoke in cars and early smoking initiation. Addict Behav, 2011; 36(11):1027–31.
Oono IP, Mackay DF, Pell JP. Meta-analysis of the association between secondhand smoke exposure and stroke. J Public Health, 2011; 33(4):496–502.
Dove MS, Dockery DW & Connolly G. Smoke-free air laws and asthma prevalence, symptoms and severity among nonsmoking youth. Pediatrics. 2010 DOI: 10.1542/peds.2010-1532; Mackay D et al. Smoke-free legislation and hospitalizations for childhood asthma. NEJM 2010;363:1139-45.
Bauld L. Impact of smokefree legislation in England: Evidence review. University of Bath. 2011.
ASH. Briefing: The implementation of smokefree prisons in England and Wales. November 2018.
ASH. Smoking in the home: New solutions for a Smokefree Generation. November 2018.
Healthy Stadia. Tobacco Free Stadia Guidance. [accessed 18 June 2020]
For full details about penalties see Smoke-free (Penalties and Discounted Amounts) Regulations 2007.
Smokefree England/Department of Health. Smokefree legislation compliance data: July – December 2008.
BBC News. Smoking in cars with children: Police ‘cannot’ enforce ban. 2016.
Charted Institute of Environmental Health. Smoke-free (private vehicles) Regulations 2015. Demonstration projects using compliance measures in controlled locations. CIEH & Improving Performance in Practice. 2016.
World Health Organisation/FIA Foundation. Seatbelts and child restraints. 2009.