Dr Max Pemberton: Banning smoking in pub gardens will NOT save the NHS

There are many things that affect health, causing people to have a poor quality of life or dramatically shorten their lives.

I’m going to stick my neck out and say that smoking in a pub garden is not one of them. Smoking, yes, absolutely, but doing it in a pub garden is not what is going to cause the problems.

So why on earth is Keir Starmer considering wasting time and energy banning smoking in outdoor spaces, including those outside pubs and restaurants? It has been described as ‘madness’ and as a psychiatrist it is hard to disagree with that diagnosis. Madness describes a belief that has no basis in reality, and that seems to fit with the idea that this plan will save lives and help the NHS.

Starmer is facing a backlash and a backbench revolt over his plans, which also include a smoking ban in small parks and open-air stadiums.

This was one of my fears about a Labour government: the tendency to meddle in people’s lives, to descend into authoritarianism and to trample on people’s rights and responsibilities. I find this kind of finger-pointing approach to legislation chilling. I think it’s low-hanging fruit when the real problems facing the country are so big and complex. It’s easier to pick and choose things to ban to make them feel like they’re ‘doing something’.

To be clear, I detest smoking. It destroys lives and causes premature death and disability. An estimated 76,000 deaths a year are due to smoking.

I used to smoke, but now I wish I hadn’t. For years I told myself I loved it, but once I quit I saw that I was addicted, that smoking was a waste of money, and that I was playing Russian roulette with my health. You don’t have to tell me why it’s bad for you.

But what people choose to do with their health is their business. I spend a lot of time teaching my patients personal responsibility, telling them that while I can advise them, they—and they alone—are responsible for their health, and that they must deal with the consequences of their decisions. This level of responsibility can be scary—but it’s also the essence of adulthood.

Starmer has said the new law would reduce avoidable deaths and help the NHS, but I find that really hard to believe and I think it sends out completely the wrong message: that the state will always step in and save you from yourself.

I was a smoker in 2007 when the indoor smoking ban was introduced and I resented it because I felt it was an unwanted government intrusion into my life. Of course I knew smoking was bad for me, but it was my choice. That said, I could understand the argument for protecting bystanders. It seemed reasonable that other people in a pub or restaurant wouldn’t have to inhale my second-hand smoke – smoking areas didn’t stop the smoke from drifting around and then there were the poor staff who had little choice but to serve me.

There is no such argument for a ban in outdoor spaces. In fact, the opposite is true. The number of deaths attributed to passive smoking is estimated at 10,700 per year and it is thought that the majority of this exposure occurs in the home. If people are not allowed to smoke outside, where do you think they are going to go?

But there is also an insidious and threatening aspect to the repeated references to protecting the NHS.

This makes me very cautious. Everything in life carries a risk. It is up to us to choose what level of risk we will tolerate. If our only motivation is to ‘protect the NHS’ then we should be banning all sorts of things that cause illness and death. Alcohol, driving, swimming in the sea – the list is virtually endless.

The NHS is there to help us when we get sick, not to be an instrument to control us. It is our servant, not our master. The idea that the government will ban things to protect the NHS shows a dangerous shift that began during Covid, from valuing the rights of individuals to valuing an institution.

Surely one of the biggest things affecting people’s health at the moment is the disastrously long waiting lists that patients have to endure to get treatment? It is estimated that 340,000 people die each year while waiting for treatment. Surely this is what voters really want the government to do, not someone smoking in the garden of their local pub?

I wish more people would follow Oasis

The Oasis reunion has led to an epic battle for tickets. It has also surprised many that the waring brothers have managed to reconcile, at least enough to get back together and perform together.

It’s one thing to compensate for the extent to which you can tolerate a civilised Christmas dinner, but it’s quite another to tour the UK.

Good for them. I’m glad they were able to bury the hatchet. As with so many sibling quarrels, it was unclear who started it, and both brothers gave different versions of what happened.

These kinds of fights are often based on long-standing hostility, and then something comes along and boom! Everything blows up. I’ve had patients stop talking to a sibling because of something as stupid as typing the wrong postcode on their birthday card. But on closer inspection, it was of course about much, much more than that.

I do believe in building bridges, especially between siblings. Yes, there are people who have really terrible ties and the smartest – and safest – thing for your long-term mental health is to cut them off. But in general, blood ties are important. You’re connected to them in a way that you never can be with a friend or a partner. Yes, they can be incredibly annoying at times (I have a sister, so I know all about this!), but they can also be a wonderful addition to your life.

I’m all for Kirstie Allsopp letting her son go interrailing at 15 after his GCSEs.

Over the years, I have seen time and again the consequences of parents who over-indulge their children and never give them the chance to be independent, stand on their own two feet, or have an adventure.

Yes, I know times are different than 20 or 30 years ago when many of us were able to roam freely with little parental input, but in many ways times are actually safer than they used to be. Technology has made it much easier to supervise children.

We are ruining a generation by our obsession with controlling their every move, isolating them from real world experiences, and protecting them from all of life’s eventualities. We are creating a generation of fearful, dependent, and insecure young people who have never had to do things for themselves and have never built resilience.

And it’s affecting them in other ways too. Figures released last week showed that more than 200,000 children in England – or 4,000 a week – waited to start treatment for anxiety alone in the past year. That’s more than 100,000 more than in 2019/20. A separate survey also published last week found that 70 per cent of people aged 18 to 24 admitted to feeling lonely at least some of the time.

This is compared to just 32 per cent of over-75s. I think this is because there’s a whole generation who have grown up in their bedrooms glued to social media rather than getting out and socialising. They should go interrailing, for Christ’s sake – much better for them than watching Tik Tok.

Finally, good news for those of us who are more owls than larks. According to new research, a weekend lie-in could save your life. The study of 90,000 adults in the UK found that catching up on sleep on a Saturday or Sunday could “significantly” reduce the risk of heart disease.

This is music to my ears. I love a weekend of sleeping in. I live for it. What could be more relaxing and pampering than lying in bed and snoozing until late in the morning? It is absolute bliss.

Dr. Max Prescribes: Bala Bars Hand Weights, £59.99

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Forget January as the perfect time to start a new workout regime. I see the back-to-school vibe of September as an opportunity to get in shape after the summer (and before Christmas).