The government’s decision to opt out of a full smoking ban in England and Wales will mean a handful of workers will die each year, the health secretary, John Reid, has admitted.

He defended his decision to stop short of a full smoking ban as he gave evidence on the public health white paper to the Commons health select committee yesterday afternoon.

Mr Reid conceded he had gone completely against the advice of the chief medical officer, Sir Liam Donaldson, in deciding not to follow Ireland and Scotland in opting for an outright smoking ban.

But the health secretary said he had sought to get a balance which best reflected the results of a public consultation exercise carried out ahead of the white paper’s publication last autumn.

He admitted that the exemption of private clubs and pubs that only serve cold food from the ban meant a fifth of drinking outlets could remain smoke-filled zones, with bar staff failing to receive the same protection from passive smoking as other citizens.

But the health secretary said many staff who were smokers might opt to work in these environments, while maintaining that the impact on non-smoking staff would prove “statistically insignificant”.

“We are not talking about thousands of deaths, or even hundreds”, Mr Reid said. “We are talking about the potential of an estimated four to five deaths a year. That estimation will have to be reduced further because we are taking into account we are protecting the bar area from the effects of passive smoking.”

People had expressed a clear reluctance to be dictated to by the government on their lifestyle choices, but did welcome better advice and support to make their lifestyle decisions, backed by extra resources, he said.

They also wanted protection from other people’s damaging lifestyle choices - with passive smoking being an obvious candidate.

The ban outlined in the white paper will effectively mean that 97% of enclosed public places will be smoke-free.

“It is a matter of good balance between what we thought was reasonably achievable - and not just on smoking, but across a whole array of areas,” he said. “The fully engaged scenario would require a degree of government direction in your life that was not acceptable in Britain, in my view.”

Mr Reid said another consideration had been the experience of the one-year-old smoking ban imposed in all confined public places in Ireland, which had seen around 15% of people who had previously gone to the pub to smoke now lighting up in the home and around their families. “But that wasn’t my primary reason.” he said. “I reached the decision I did because I thought we had achieved the balance between protecting the public who did not smoke.

“The legislation was introduced to protect the public not to force you to follow a certain lifestyle. Because if you do that you start to move onto serious questions such as why should we allow you to box and then get treated on the NHS?

“Every single person, whether they smoke or do not smoke will be in a better position, where they are far better protected from passive smoking than beforehand.”

Higher taxation on cigarettes and “horrible” messages on cigarette packets, backed by a greater range of provision for those who wanted to stop, was a better way of persuading people to stop smoking than imposing an outright smoking ban, Mr Reid suggested. “We are going to make greater efforts to persuade you not to smoke,” he said.

Referring directly to the previous comments he controversially made in which he opined that smoking is a potential sense of pleasure for disaffected people from deprived backgrounds, Mr Reid said: “If you want to change people’s behaviour on smoking, make them middle class ... if you want to help people change you have to help them change their social circumstances.”