Wednesday, 12 January 2011

Smoking in front of Children - Time for Legislation

This is a bit of a hobby horse of mine. I hope that I do not upset or offend the readers of this who smoke, but if it prompts you to quit, then it will have been worth it.

In the departure lounge of a small airport from where I was awaiting a flight earlier this month, several people were smoking. I found the environment sufficiently unpleasant to necessitate my going outside to get some fresh air. But what was more distressing was the fact that the parents of two families were smoking in the presence their small children. One was a mere infant of not more than two or three weeks of age, cradled in the arms of his smoking mother.
In an age when it is no longer considered acceptable to beat children why is it that we should we be allowed to poison them with tobacco smoke when the risks are clear and quantified? Just when and where it is socially acceptable to smoke has been a matter of increasing public concern. Even those areas where, traditionally, smoking had always been a part of the scene, such as in bars and restaurants, outright bans are becoming more commonplace and have generally been welcomed - after initial protestations.
Yet it seems incongruous that the comfort of non-smoking adults should somehow have been given a social precedence over the protection of children who are not empowered to object to or protect themselves from this sort of abuse.
Certainly there are arguments to support any claim that legislation designed to protect children from the effects of tobacco smoke would be difficult to draw up and impose. These would include the contention that such a law would be discriminatory, victimising parents who may already be the victims of poverty - for we live in a society bedevilled by the demands of political correctness - and that it would probably not be enforceable in any event.
In our society there has long been an perverse reluctance to appear to be "blaming" parents for the consequences befalling their children as a result of their ignorance or selfishness. We seem to put the "rights" and liberty of parents above their responsibility to protect their children from harm. Which of us would be ready to add guilt to the grief of a mother - a smoker - at the inquest on her baby who had suffered a cot death? Yet on the other hand we may send to prison the mother who has caused the death of her own child by dangerous driving. The sense of outrage felt by the public may be on quite a different scale in this second scenario. The outcome for the defenceless child is the same in either case.
In time, smoking in front of a child may become as unacceptable as it is now to leave her or him unrestrained while travelling in a car. Indeed, in the early days after legislation was passed requiring adults to wear seat belts when driving, the law was widely flaunted by a public who failed to see the point of it. Yet in time it produced the desired effect, not because it was readily enforceable but rather because it became a catalyst for an eventual change in attitude by the driving public.
A sustained effort to protect abuse of children by forcing them to suffer the injurious effects of tobacco smoke is long overdue. It should be an offence to smoke in the vicinity of a child in any circumstances. Convictions might be few and far between, but the message would be stark and uncompromising. Children’s lives would undoubtedly be saved. But nothing will divert the accusing finger that condemns our society for its negligence to those children for whom protection came too late- not because we did not know of the danger, but because we had not the courage to act firmly and effectively when first we realised the harm that was being done to them.
For the present, though, it would appear that we value the freedom of a minority to smoke when and where they choose more than we do the health and lives of our children.
How might the general practitioner advise and assist patients in the context of the enactment of a law requiring that children must not be exposed to tobacco smoke? No doubt there would be enormous resistance, both within and outside the medical profession, to the notion of the family doctor acting as a policeman on behalf of the State. The role of the doctor must remain one of working together with the patient to give support, practical assistance, and factual information. Criticism, coercion, or, worst of all, threats of referral to Social Services or the police ought to play no part in the way in which doctors approach the smoking parent. It would be unkind and unhelpful to suggest that parents who smoke care any less for the welfare of their children than those who do not. They are seldom comfortable with their addiction and increasingly they feel stigmatised and resentful of repeated insistence by health professionals that they should quit. An attitude of understanding, the giving of sensible and sensitive advice with regard to minimising the risk to their children while they remain smokers, and making every effort to help them to break the habit will be far more likely to have a good result. The medical profession would need, as well, to make the strongest representations to the Government to provide the resources to enable them to help parents who are smokers and their children.

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