The British Medical Association told Tony Blair yesterday to stop dithering about the health risks of tobacco and introduce an immediate ban on smoking in pubs, restaurants and the workplace.
Doctors at its annual conference in Llandudno gave overwhelming support to resolutions calling for the prohibition of smoking in public places and advertising junk food to the under-12s.
As the Guardian disclosed yesterday, proposals to legislate on both these fronts have been included in draft policy documents that Labour's policy forum will consider for the party's third-term manifesto. The document said that the conclusion of a nationwide consultation was that there should be sustained above-inflation tax rises on tobacco products. "There was overwhelming support for further restrictions on where people should and should not be permitted to smoke."
But doctors' leaders said the prime minister should act more decisively. Peter Maguire, deputy chairman of the BMA's board of science, got the biggest cheer of the conference after he said: "Labour, you are considering a ban. Stop considering it. Get on with it ... Tony Blair get your act together."
On behalf of the BMA he signed a giant mock-up of a doctor's prescription slip that was lowered on to the confer ence hall stage, showing the remedy to improve the health of the nation was "smoke-free workplaces".
James Johnson, the BMA chairman, wrote to Mr Blair last night urging him to introduce legislation in the next session of parliament "to ensure that all enclosed public places in the UK become smoke free".
He added: "I am a vascular surgeon working in one of the most deprived areas of the country. I regularly have to amputate the legs of chronic smokers - and they are not generally from social classes ABC1."
The association's forceful intervention followed research published by the British Medical Journal on Tuesday showing that the risks of passive smoking were double earlier estimates. Previous research found that passive smoking was linked to a 25-30% increased risk of coronary heart disease. But the latest study, published on bmj.com, found that non-smokers faced a 50-60% increased risk.
The results were obtained after measuring the blood of non-smokers exposed to tobacco smoke at work and in public places, such as pubs and restaurants. Researchers identified levels of cotinine, a byproduct of nicotine that was associated with greater risk of heart disease.
Dr Maguire praised the ban on smoking in the workplace that was imposed by the Irish government this year.
He said: "I live in Northern Ireland and yet I travel to the republic because I know that's where I have the choice to enjoy a beer in a smoke-free pub.
"I have seen that the ban on smoking in public places in Ireland has not affected business - business is booming there. Smoke-free places means life not death."
The Irish department of health said there was 97% compliance with the ban. "Disgracefully in the UK only 1% of bars and restaurants are completely smoke-free. Approximately 1,000 people die every year in the UK as a direct result of passive smoking," he said.
Two weeks ago the BMA urged 1,000 doctors to write to Tony Blair urging him to implement a ban. By yesterday it had collected 4,500 such letters. "This shows the strength of feeling among doctors," Dr Maguire said.
Moving the resolution calling for a ban, Michael Cassidy, a GP from Milton Keynes, said: "Every once in a while an opportunity arises in health to make a big gain by doing something simple. Banning smoking in public places is one of those opportunities."
Only one doctor voted against the ban. Faiz Rehman, a Bognor Regis GP, said later: "I don't smoke. I positively discourage smoking because it is bad for you. But it should be a person's right to choose. People should be provided with full information, but I don't think this should be done by compulsion."
The BMA also passed a resolution calling for a ban on "all commercial food advertising aimed at under-12s".
Peter Tiplady, a public health doctor from Cumbria, said that there was evidence that up to 99% of all food advertising during children's TV was for fatty or sugary foods.
"Against a background of evidence that a diet high in fat, sugar and salt is detrimental to health, this selective targeting of children by food advertisers is unwelcome, unjustified and absolutely unforgivable," he said.
· The BMA warned yesterday of a growing problem of addiction to medicines sold over the counter without any warning of the potential risk.
It gave overwhelming support to a resolution calling on the medical profession to educate patients about the addictiveness of patent products sold without prescription, including some cough medicines, headache cures and sleeping pills.
Vivienne Nathanson, the BMA's head of science and ethics, said the addictive ingredients included codeine, ephedrine that was used as a decongestant in many cough medicines, and a variety of anti-histamine used in some brands of sleeping pills.
Extracts from the letters
"I am currently dealing with a waiter who has never smoked but who has been subjected to the effects of customers' smoking and now has very advanced lung disease. He is angry and bitter that no significant steps are being taken to prevent others meeting the same fate."
"I have recently had to endure the dreadful experience of my 41-year-old brother being diagnosed with lung cancer, which has spread to his brain. He has never smoked. But he has been exposed to other people's second-hand smoke when socialising in public places."
"A teenager of my acquaintance who has asthma finds that her nights out are ruined by having to retreat to her car to take her inhalers because the smoke in her favourite nightclub makes her chest so tight she cannot dance."
