Are beer gardens and pub patios the next public place to be hit by a complete smoking ban?

Beer gardens and pub patios, the last refuge of the smoker, could be the next place hit by a complete smoking ban following calls by the Royal Society for Public Health.

The health body is not making the recommendation on the grounds that smoking outside directly affects health through passive inhalation but because it claims public smoking normalises the practice.

"By reducing the prominence of smoking in public locations, particularly those visited by children, we can ensure that smoking is no longer seen as a normal or safe activity," the RSPH said.

As well as ending the normalisation of smoking, the society claimed the public needed to be re-educated about the effects of nicotine and tobacco. It said people were confused about the addictive and harmful nature of tobacco and nicotine.

"Nicotine by itself is fairly harmless. Nicotine is harmful in cigarettes largely because it is combined with other damaging chemicals such as tar and arsenic.

"If smoking was banned from outside pubs and bars 50% of adults would be more likely to use these areas, and roughly one third of smokers would be more likely to use alternatives to cigarettes such as e-cigarettes," the royal society said.

The RSPH recommended smokers use electronic cigarettes instead of lighting up outside near bars and pubs. This is despite health warnings about the new devices. A study made in Oregon has concluded the chemicals used in flavouring of e-cigarettes are harmful to the respiratory system. A second study by John Hopkins University in the US has posited that the vapour lowers the immune system and may make users susceptible to lung infections.

The pro-smoking campaign group Forest said the measures would not work and may lead to pubs closing, the BBC reported.

Shirley Cramer, the chief executive of RSPH, has said in a statement: "Children are hugely receptive to the behaviour of the adults around them. The sight therefore of individuals smoking at prominent locations risks teaching them that smoking is a normal and safe habit.

"We believe that banning smoking in these locations via an exclusion zone could further denormalise smoking, ensuring that it is seen as an abnormal activity and potentially, prevent children and young people from beginning in the future."

Simon Clark, director of Forest, has said he welcomed ideas that encouraged people to use electronic cigarettes but they should not rely on "coercion and prohibition".

He said: "Banning smoking outside pubs and bars will discriminate against adults who quite legitimately prefer to smoke."