As the smoke clears: 20 years after the ban
Professor Kat Smith
Professor of Public Health Policy
25 March 2026
Scotland's smoking ban began as a bold experiment and became one of the country’s most effective public health interventions. Twenty years later, this story offers timely lessons on the power of purpose, preparation and delivery.
Scotland’s ban on smoking in enclosed public places may not have brought about a cultural change in itself but it did accelerate something already taking place. Twenty years on, it is easy to forget how controversial Scotland’s smoking ban once was.
Since 6am on Sunday, 26 March 2006, when the ban became law, compliance has been near universal and cancer mortality has declined since then, with particularly notable declines in smoking-related cancers such as lung cancer.
The legislation is widely seen as one of the most successful public health interventions of the devolution era. Its success offers a lesson policymakers today are in danger of forgetting: good policy intentions are not enough – implementation and delivery are everything.
So how has this success been achieved and sustained in the face of the changes wrought by a debilitating pandemic, severe financial crises and shifting political landscapes?
A clear scientific case
By the time the ban was introduced, the scientific case was already clear. The links between tobacco and cancer were well established, as was nicotine’s addictive grip. Just as importantly, the harms of passive smoking had become undeniable. Smoking was no longer seen as simply a matter of personal choice; it was a public health issue affecting entire communities.
Public attitudes were already shifting. But policy did not simply follow the people – policymakers worked to ensure a ban on smoking in public places would be widely supported.
Crucially, the legislation was not just well intentioned; it was meticulously prepared. Policymakers gave serious thought to how the ban would be implemented drawing on the expertise of health professionals and third sector organisations. Enforcement and communication were built into the policy development and I believe all this was central to its success.
With research colleagues, in 2024 I invited those who were most active in shaping the legislation to take part in a witness seminar which explored how the laws were designed and put into practice. The then First Minister, Lord McConnell, then Health Minister Andy Kerr, and Mary Cuthbert, a senior civil servant who headed tobacco control policy in the then Scottish Executive, were among those who shared their recollections. Their reflections made clear that success was far from inevitable. Early support was not unanimous. Hearts and minds still had to be won, amid opposition from a powerful tobacco lobby and a strong sense (including among some Labour Party politicians) that many people, particularly in areas of deprivation, could be robbed of a source of pleasure.
The harms of passive smoking had become undeniable. Smoking was no longer seen as simply a matter of personal choice; it was a public health issue affecting entire communities.
Protecting future generations
What carried the policy forward was a clear sense of purpose. Protecting future generations was central. That message resonated not only with health professionals, but with young people—and with many smokers themselves, who did not want others to follow the same path.
Lord McConnell put his trust in the briefings he received from Chief Medical Officer, Mac Armstrong, who told him: “This is the single biggest thing you can do for health in Scotland,” while Mary Cuthbert recalled that the late Tom McCabe, Deputy Health Minister when the proposals were introduced, was determined, encouraging and blunt in equal measure: “This is about winning! You make sure of it!”
It was flagship legislation for a flagship building, as the Scottish Parliament established itself in its new premises at Holyrood and sought to demonstrate what could be achieved under devolution. That clarity of intent, combined with careful planning, made major behaviour change possible.
Striking contrast
In many areas of public health, policy success has proved far harder to achieve. This is not always because the problems are less well understood, but because the gap between policy ambition and policy delivery has widened.
In the Strathclyde-based Scottish Health Equity Research Unit (SHERU), which I Co-Lead, we've amassed a vast range of data which proves how deeply inequality runs and a recurring theme has emerged; a gap between the intentions which policies display and their actual implementation and impact.
Separately, I'm leading a project exploring the impact of Scotland’s justice system on public health and we are finding further disparities. The Police and Fire Act of 2012 explicitly states that the primary purpose of policing in Scotland is community wellbeing, yet we know the communities that have the worst justice outcomes remain those with the worst health outcomes.
Nor is this necessarily an issue of public understanding. We recently asked members of the public what the most effective policy response to the harms of alcohol and drugs would be; their answer was reducing poverty.
These are not disconnected issues. They point to a broader challenge: policies are often well designed, grounded in evidence and developed with genuine engagement. But too often, they are not carried through with the same focus and discipline that characterised the smoking ban.
Less evaluation
There is also less systematic evaluation than there once was. When the smoking legislation was developed, significant effort went into planning how it would be delivered and assessed. Today, there is a growing tendency to see implementation as something that happens elsewhere – once the strategy has been written.
Scotland does not lack good ideas. Nor does it lack insight into the complex, interrelated problems affecting health and wellbeing. What it lacks, too often, is the sustained attention to delivery required to turn those ideas into lived reality.
The problems with society and health are complex but they are not intractable. The experience of the smoking ban shows what is possible when clear purpose, political will and practical implementation are aligned.
If we want the next 20 years to match the progress of the last, this is a lesson we cannot afford to ignore.
