Chief medical officer for England Professor Sir Liam Donaldson has urged managers to make their views felt if they want to see stronger action on smoking than is currently proposed.

His advice to shout now came at the NHS Confederation conference session on the health of the public last Thursday when he said managers should send a 'forceful message' to the government - and said tobacco should be eradicated like polio had been.

On Monday the government launched consultation on proposals to ban smoking in enclosed public places - except for pubs and bars that do not serve food. But indications are emerging that the new health secretary is prepared to go further than her predecessor.

Department of Health sources have suggested that the government is most likely to go for a total ban if the hospitality industry says implementing a partial ban is too complex.

Launching the consultation, public health minister Caroline Flint stressed: 'Government wants to hear from groups, particularly businesses, on the practicalities of the proposals, so we end up with workable, consensus measures which become law.' At the NHS Confederation conference, Sir Liam made his points after North and East Yorkshire and Northern Lincolnshire strategic health authority chief executive David Johnson had suggested that the appointment of a new health secretary in Patricia Hewitt could provide a window of opportunity to extend the proposals.

And Sir Liam told delegates:

'There is a consultation on the draft legislation about to be launched.

That does open an opportunity for a forceful message to be sent to the government that we would like them to go further.' He urged delegates: 'I would encourage you to make that message clear.' Earlier he said that England could not match the success of California in cutting smoking rates without a full ban on smoking in public places. He compared the 15 per cent smoking prevalence achieved in the US state of California - which has strict anti-smoking laws - with the current English figure of 25 per cent.

Sir Liam sent a stark warning:

'Until we get a complete grip on the issue of smoking in public places we will not hit the California rate - and people will continue to die from smoke-related diseases.' Last week Ms Hewitt told HSJ that she would look at proposed ban 'in some detail' during the consultation process. And a group of Labour MPs are understood to be considering an amendment to the draft legislation which would see the age at which one could purchase cigarettes raised from 16 to 18.

The consultation document covers issues including the definition of 'enclosed' public places; the definitions of 'prepare and serve food';

exemptions in general; placing of signage; and enforcement and penalties attached to new laws. The consultation closes on 5 September.