Pub outdoor areas should be non-smoking zones when bars re-open, doctors warn

All outdoor areas in pubs should become non-smoking zones when they re-open in order to protect public health, the Royal College of Physicians of Ireland (RCPI) has said.

The proposal should be implemented as part of the country’s re-opening strategy and the easing of restrictions.

The college’s policy group on tobacco said non-smokers and bar staff needed to be protected from second-hand smoke.

And it warned that the Department of Health should not inadvertently allow another public health crisis develop as a consequence of implementing social distancing policies.

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In a letter on Monday to the Minister for Health, chair of the policy group Professor Des Cox noted the engagement between the licensed trade and the Department of Health about how and when pubs should re-open.

“Currently the outdoor areas of the majority of public houses are designated smoking areas,” he said. “If outdoor areas are to be used to facilitate social distancing when bars open up again, then smoking should be prohibited from all areas of all pubs when they reopen.

“Customers who are seated in the outdoor areas of bars should not be exposed to second hand smoke. If bar staff are providing table service to all customers - including customers seated in the outdoor areas - they too will be exposed to second hand smoke.”

Professor Cox, a paediatric respiratory consultant said there was "no risk-free level of second hand smoke and we need to protect the general public and in particular bar staff from the well-recognised health implications of second hand smoke."

The letter highlights the additional difficulties from Covid-19 faced by smokers. “The latest evidence suggests that smokers are likely to be more vulnerable to Covid-19 infection.

“In addition, the very act of smoking involves fingers touching lips, which increases the possibility of virus transmission. For these reasons alone, smoking in any setting during the Covid-19 pandemic should be strongly discouraged.”

The policy group on tobacco states that “while we welcome the reopening plan for Ireland and support businesses in their proposals to change their working conditions to protect public health, we ask that the Department of Health does not inadvertently allow for another public health crisis to develop as a consequence of implementing social distancing policies.”

The RCPI also pointed out that smoking is still the biggest public health issue in Ireland and 17per cent of the population are smokers. “Tobacco use is the leading cause of preventable death in Ireland, with almost 6,000 smokers dying each year from tobacco related diseases.”

Speaking on Monday Professor Cox said “we want to try to help the pubs to open up safely” but “we don’t want it to happen that suddenly all the people are out in the smoking areas and they’re also being exposed to second hand smoke”.

He said bars should be allowed to open with social distancing in place but “the smoking should be banned from these areas until such time as social distancing is no longer needed”.

He said “smokers are more likely to be vulnerable to Covid-19 infection. So if they do get sick with Covid-19 infection they’re more likely to get sicker. That’s been shown in a few different studies coming from China.”

The act of smoking “involves your hands touching your face. That increases the risk of viral transmission. If you’re allowing an activity in a crowded area that could potentially increase the risk of viral transmission.

“So in the setting of a pandemic those activities should be discouraged and we would strongly recommend that people speak to smoking cessation services such as quit.ie.”