The right to breathe smoke-free air in one's own home - opinion

Comment on the current Supreme Court case (1416/21)

 No smoking sign at Canary Wharf (photo credit: Wikimedia Commons)
No smoking sign at Canary Wharf
(photo credit: Wikimedia Commons)

On January 26, 2022, the supreme court heard case 1416/21, an administrative case brought by the Clean Air Organization (Avir Naki) against the Ministry of the Environment, the Ministry of Health, and the Ministry of Home Security (the police). The petition was brought because of failure to protect residents against tobacco smoke penetration into their own homes. The Court indicated that a problem indeed exists and requested that the Ministries work to find a resolution within 90 days; the deadline was subsequently extended to August 28, 2022.  In the event that the Ministries do not find a solution, the Court may intervene.

The case touches on issues central to governance and life in a liberal democracy such as Israel: To what extent should the government interfere in private matters? Does the right of smokers to smoke in their homes and porches supersede the right of neighbors to breathe smoke-free air in their homes?  Does primary responsibility for protection against such penetration depend on the smoker (for example, by refraining from smoking on the porch or near open windows), the neighbor who is affected by the smoke infiltration (for example, by closing windows, perhaps for most times of the day), the government, or no one? And isn't this a minor issue anyway, an irritation of no real or lasting health importance? 

The last question is perhaps the easiest to answer. Scientific evidence shows unequivocally that individuals exposed to tobacco smoke are at higher risk for illness, disability, and premature death. Tobacco smoke exposure (not active smoking) accounts for about 1% of deaths worldwide and 0.7% of illness, with a heavy financial burden. In Israel, tobacco smoke exposure causes about 800 deaths per year – more than suicides and traffic accidents combined. Even short exposure can lead to health consequences such as heart attacks and asthma attacks, and regular exposure increases the risk of heart disease by 30% and the risk of lung cancer by about 20%. Children bear a disproportionate burden of illness: tobacco smoke exposure doubles the risk of sudden infant death syndrome and increases the chances of bronchitis, ear infections, and lung problems. According to the World Health Organization, there is no safe level of exposure to tobacco smoke. 

Prof. Leah (Laura) Rosen (Credit: Debbi Cooper)Prof. Leah (Laura) Rosen (Credit: Debbi Cooper)

Some people, even those who are aware that tobacco smoke exposure is harmful, mistakenly believe that the smoke from neighboring residential units doesn't actually reach other units in sufficient quantity, or for long enough, to constitute a problem. This position is incorrect, and the consequences may be deadly.   First, emissions from even a few cigarettes can be substantial:  3 lit cigarettes, smoked in succession, can produce toxic emissions up to 10-fold that of an idling diesel engine. Second, smoke travels from one place to another rapidly and usually invisibly. Outdoor tobacco smoke from a single smoked cigarette is detectable at a distance of 9 meters. Within multi-unit housing, penetration occurs as tobacco smoke drifts into neighboring apartments through doors, windows, air conditioners, or areas between floors or walls or doors. The risk is greater when residential units are in greater proximity, whether within a single multi-unit building or in adjacent buildings. 

 Israel is one of the most densely populated countries in the developed world. Three-quarters of the population live in multi-unit housing, with proximity between units, creating a high-risk opportunity for tobacco smoke penetration.  Indeed, tobacco smoke infiltration is common in Israel: a study conducted last year by Dr. Mina Tzemach showed that about 50% of adult Israelis -- nearly three million individuals – experience tobacco smoke penetration into their homes. Among those exposed at least monthly, 84% -- over two million individuals – reported being troubled by the exposure. 

Given these facts, should the government intervene? In liberal democracies such as Israel, individuals generally can behave as they please – on the condition that their behavior does not harm others. Damaging behavior is regulated in order to protect the innocent. Tobacco smoke penetration is ubiquitous, it is harmful to health (and property), and the problem has not been resolved for millions of individuals. Breathing clean air is a fundamental human right, as defined by the World Health Organization. It is incumbent on the government to take immediate action to protect the public: the victims are often captive passive smokers in their own homes, where they should be most protected. The rights of Israelis to breathe smoke-free air supersedes the rights of smokers to smoke anyplace in their apartment. Bold action – whether through a Supreme Court ruling or new legislation – on this issue will set the stage for the protection of millions of Israelis from the effects of tobacco smoke infiltration, help pave the way to a deeper societal understanding of tobacco smoke exposure, denormalize smoking around others, and promote health and prevent disease among Israelis.  

 Prof. Rosen is Chair of the Dept. of Health Promotion in the School of Public Health at Tel Aviv University. She is a leading tobacco control researcher with a focus on tobacco smoke exposure, teaches and mentors many students, and has taken part in various international and national committees, including The Israel National Plan to Decrease Smoking and its Damages. She submitted an Expert Opinion to the Supreme Court in Feb. 2021 and an Update to that opinion in Jan. 2022 regarding the current case. Both the original Opinion and the Update were accepted by the Court. Prof. Rosen is participating in discussions to help find a resolution to this problem.