PUBLIC SMOKING BAN IN THE PIPELINE

Health think-tank calls for lighting-up to be made illegal in pubs, clubs
and offices in bid to slash Scotland's high death toll. By Jim Maclean

California-style bans on smoking in public places are being proposed in
Scotland to reduce deaths from tobacco-related diseases.

A think-tank involving some of the country's leading figures in public
health believes stricter rules are necessary because of the dangers of
passive smoking.

In a report to be published later this year, the Scottish Needs Assessment
Programme also attributes the west coast's high death rates from heart
disease to the effects of lack of hope, poverty and higher levels of social
deprivation.

It urges the new Scottish parliament to make the fight against 'social
exclusion' a priority, a stance already favoured by Scottish Health
Minister Sam Galbraith, who will unveil a green paper on health
inequalities at the end of the month.

The California ban on smoking in all bars, clubs and casinos - likely to be
followed in other American states - came into effect on December 31.
Bartenders and other leisure industry workers will be able to ask smokers
not to light up. If they fail to prevent smokers indulging in their habit,
owners will face a range of state-imposed fines.

Scotland is being urged to go down the same route by the SNAP, which says:
"The harmful effects of 'passive smoking' suggest the need for policies to
ensure that all public and working spaces were smoke free."

The SNAP think-tank includes Glasgow's director of public health, Dr Harry
Burns, and Dr Jennifer Webb of Lothian Health Board's department of public
health. They are now preparing a final draft of their report for publication.

The report outlines the scale of Scotland's coronary crisis with 2,800
heart attacks in Greater Glasgow last year, 750 of them fatal. It estimates
that half a million Scots have underlying heart disease problems with
180,000 receiving treatment. About two million Scots have symptoms of high
blood pressure, a major contributor to heart disease, and many are unaware
of the problem.

The doctors raise the contraversial question of the effects of social
deprivation on disease. They make the point that people living in deprived
areas share risk factors such as an unhealthy diet, smoking too much and
taking too little exercise.

But Glaswegians suffer from an extra dimension - greater deprivation,
higher unemployment and a lack of money and options to improve matters -
that pushes death rates higher.

Their findings point to the lack of hope endemic in sprawling west of
Scotland housing schemes and inner city areas, as an actual cause of heart
disease.

Also, researchers found that poor people are less likely to get to hospital
in time for treatment or to be motivated to attend rehabilitation classes.

Health cures and care are not enough, according to the report. Eradicating
deprivation "in the physical environment, health-related behaviours and the
human spirit is the key to beating heart disease."

Further investigation is called for into the effectiveness of new so-called
"cholesterol-busting" drugs. Estimates for the cost of treatment are
currently put at 500,000 UKP per life saved.

The emphasis on lifestyles emerges as Unison, the health union, is warning
that Glasgow is getting a raw deal over NHS cash. It estimates the city has
lost out on 80m UKP of state and European funding over the past nine years
and could lose another 10.6m UKP by 2000 unless it is given special staus
as a health black spot.