Smoking heads outside in England

With its low beams, wood-paneling, and original flagstones, the Queen's Head Hotel here on the edge of the stunning English Lake District is a most traditional of British village pubs. But now it's facing the biggest change in its almost 300-year history.

Along with all other English pubs, it became completely smoke-free July 1. The far-reaching new legislation bans smoking in any enclosed public space, including offices, shops, restaurants, public transport, and even work vehicles used by more than one person. The only exemptions are prisons, designated hotel rooms, and care homes.

With the change, England has become the last part of the United Kingdom (UK) to bring in a smoking ban, following Scotland in 2006 and Wales and Northern Ireland in April this year.

Martin Farr, the director of postgraduate studies in history at Newcastle University in Newcastle upon Tyne, says that England's decision reflects a major long-term change in public opinion.

"It's been a very profound change," he says. "It was inconceivable 20 years ago, just as it will be inconceivable in 20 years' time that we ever sat around smoking in restaurants or pubs."

Much of the rest of the world has already introduced similar legislation. Ireland became the first country to impose a comprehensive ban in 2004, followed by New Zealand, Italy, and Sweden. Now, most of Western Europe has antismoking legislation, but only Ireland and the other parts of the UK go as far as England in making no allowance for separate smoking areas.

Concerns about freedom of choice

Not everyone in England is convinced that the move is a good idea. Back at the Queen's Head, voted Britain's best pub in 2002, landlord Chris Tomlinson says that while a ban will be welcomed by nonsmoking members of staff and some customers, he has reservations. His restaurant has been nonsmoking for eight years, but he thinks smoking could have remained in the separate bar area.

"There's a certain amount of good in it but I feel sorry for the guys in their 80s who've been coming here for years and smoking their pipes," he says. "Some freedom of choice wouldn't have hurt."

It's that debate about freedom of choice that lies at the heart of this issue. While some smokers complain that their rights are being overlooked, nonsmokers argue that it's their freedoms that are being ignored if they have to socialize in a smoky atmosphere.

But it's not only nonsmokers who welcome the ban.

"I welcome the ban," says Adrian Mallinson, a young man from North Cumbria who is a smoker. "Being in a pub, you get the smell on your clothes and on your chest and it's really rather unpleasant. I stopped smoking for three months, but when I went to the pub, all I could smell was cigarettes and it made me want one."

He's hoping the smoking ban will now help him give up the habit for good. If he does, anti-smoking advocates suggest, he could be one of many, given trends in Scotland, which introduced a ban in March 2006.

"Smoke-free Scotland has been a huge success," says Martin Dockrell, the Policy and Campaigns manager with ASH – Action on Smoking and Health. "Bar workers are healthier, fewer people are smoking, and those who are smoking are smoking less."

Does a ban help people quit?

According to figures from the National Health Service in Scotland, 4.3 percent contacted a stop-smoking service in the first 12 months after the ban. ASH is now estimating that 4 million of England's 10 million smokers will quit.

But the pro-choice organization Forest – Freedom Organisation for the Right to Enjoy Smoking Tobacco – says a ban has no real impact on the number of smokers.

"There is always a little dip," says director Simon Clark. "But in Ireland [where 7,000 smokers reportedly gave up in the first year], smoking rates have gone back to where they were. These bans are totally disproportionate. There must be scope for some element of choice in the future."

The British government rejects criticisms that it is restricting freedoms or producing a "nanny state."

Patricia Hewitt, who until last week's government reshuffle was health secretary, said in the run up to the ban, "What the public have told us loud and clear for some years now is that they don't want government telling them what to do, but they do want government supporting them in making healthier choices for themselves and their families.... [N]early 8 of 10 people support going smoke-free, including a majority of smokers themselves."

Each year some 106,000 people in the UK are killed by smoking, according to research. More than 17,000 children ages 5 or under are admitted to the hospital because of the effects of passive smoking. Second-hand smoke is also a serious health concern.

"If there's a fall in the number of people smoking as a result of this change, then over time we are going to see thousands and thousands of lives saved," says England's chief medical officer, Sir Liam Donaldson.

Figures published in the run-up to the ban suggest that public support is growing. The Office of National Statistics found that 77 percent of people agreed strongly with the move. Eight percent said they would visit the pub less often, but 15 percent said they would go more after a ban.