They have the highest smoking rates, worst lung cancer record and lowest life expectancy anywhere in western Europe. Now Scots are choking on their cigarettes as they contemplate a ban on smoking in public places.
The Scottish Executive is shortly to consider outlawing smoking in restaurants, pubs and indoor spaces such as shopping centres. The signals are that it wants to follow New York, now eight months into a city-wide ban, and Ireland, where smoking in pubs will be banned from February.
The Scottish proposal is included in the devolved Executive's tobacco action plan, to be published within two weeks. Scots are to be consulted on the legislation. Health ministers say they want to take the public with them on the issue rather than impose an unenforceable law. It is a bold move by the Scottish Executive, and another example of how the devolved government has shown a willingness to take controversial action in contrast to political prevarication south of the border.
Last month in Westminster the Health minister, Melanie Johnson, ruled out the prospect of a ban. But the Government's chief medical officer, Professor Sir Liam Donaldson, wants legislation, saying that would lead to a dramatic fall in deaths from lung cancer and heart disease. The heads of 18 royal medical colleges, the British Medical Association and the respected journal The Lancet have all called for a ban in the past year.
The Prime Minister is hedging his bets. Launching Labour's "Big Conversation" consultation exercise in November, Mr Blair called for a discussion on a ban, but refused to come down on either side.
Now the Scottish Executive has stepped in where Westminster fears to tread. The Health minister, Malcolm Chisholm, said: "A smoke-free Scotland may be a long-term vision but it is a vision that demands our action."
The Executive does not have the power to outlaw smoking in the workplace - that requires UK legislation - but it can ban it in restaurants, pubs and public areas such as shopping centres, clubs and leisure facilities.
A spokesman for the Executive added: "We want to see what people think of smoking in public places, and passive smoking, and one of the options could be legislation bringing in a ban. But we can decide where we want to go only after we've taken everyone's views into account."
Ministers know voters may not take kindly to the outlawing of tobacco in anywhere except their own homes, but they are determined to act on an issue which is making Scots the sick men - and women - of Europe.
Scotland has one of the highest smoking rates in the EU, with 34 per cent of men and 32 per cent of women hooked on the habit. In the most deprived areas of the country, 49 per cent of men and 43 per cent of women smoke. A quarter of Scottish women smoke during pregnancy, and the country has much lower rates of giving up than south of the border.
In comparison, 28 per cent of men and 26 per cent of women in England smoke. English teenagers are similar to those in Scotland, with one in five smoking, but the numbers who smoke south of the border are declining much faster.
The grim statistics are casting a black shadow over the lungs and life expectancy of Scottish adults. More than 13,000 deaths a year are attributed to smoking, with lung cancer and heart disease the biggest killers.
Scottish women have the lowest life expectancy of all the countries in Western Europe, with death rates in the 15 to 74 age group at their highest since the 1950s. Male life expectancy in Scotland is the second worst in western Europe, after Portugal.
What worries health experts most is that despite decades of expensive publicity campaigns, school lessons and cigarette pack warnings, children are still ignoring the message that smoking kills. One in five 15-year-olds and more than 10 per cent of 13-year-olds smoke, the Scottish schools adolescent lifestyle and substance abuse survey showed last month.
And this is not simply a case of the odd illicit fag behind the bike-sheds; the average Scottish 15-year-old started smoking at 12 and now has a 40-a-week habit. Scotland's heavy smoking habit does not just hit the pockets of its cigarette addicts hard. The NHS in Scotland spends £140m a year treating heart disease, cancer and strokes, all related to smoking.
Public support for a ban on smoking has increased as people have seen the success of legislation in New York and more than 100 other American cities. Norway is to bring in a similar law in the summer and public smoking in New Zealand will be illegal from late 2004. Canada, Italy, Greece and Japan have also brought in legislation. Baroness Finlay of Llanaff, a cancer specialist, launched a Bill in the House of Lords this month which would allow the Welsh Assembly to ban smoking in public places.
In a recent survey, three-quarters of people said they believed smoking was now less socially acceptable than it was a year ago. With public opinion shifting, Tony Blair may wait to see how such a law goes down in Scotland before deciding whether to bring in similar legislation here.
But the flame of opposition to a ban is far from extinguished. Months ago, Scotland implemented a voluntary system, asking food and drink outlets to set up smoke-free zones; so far only 11 per cent of businesses have done so. That reluctance gives an indication of the fight ministers may have on their hands when it comes to imposing legislation. Alistair Don, president of the Scottish Licensed Trade Association, said: "This would have a major impact on the trade. We will lose a lot of customers. Cigarettes are not an illegal substance and that's the problem with this."
To ban or not to ban? In England, the decision lies with Scots-born John Reid, the Secretary of State for Health, who was named Scotland's champion smoker in 1999 by the pro-tobacco group Forest. Since taking the health portfolio in April, he has kicked the habit and become an eloquent speaker on smoking cessation. But from champion smoker to tobacco's prohibiter may be a long journey.
How devolution has made a difference
While the debate drags on in England over hunting with dogs, it has been outlawed in Scotland.
The Scottish ban, introduced in August 2002, outlaws fox-hunting, fox-baiting and hare-coursing. Despite warnings that it would destroy a centuries-old culture, only one of Scotland's 10 hunting packs has disappeared, with the others surviving in some form.
One of the most contentious issues for Westminster MPs was easily decided by the Executive - it scrapped tuition fees for Scottish students at Scottish universities in 2001.
It has also ruled out introducing the "top-up" fees being brought in south of the border, which could see some universities charge an extra £3,000 for courses.
When a Royal Commission concluded in 2000 that the NHS should provide free, long-term care for elderly people, the Labour Government refused to implement the recommendations.
Scotland, however, decided to fund the proposals in full, meaning that the elderly north of the border are not means-tested for a range of services.Reuse content