John Reid, the Health Secretary, has come under fire from anti-smoking groups for saying that smoking is one of the few pleasures left for the poor on sink estates and in working men's clubs.

Dr Reid said that the middle classes were "obsessed" with giving instructions to working class people about how to live their lives and insisted that smoking was not one of the worst problems faced by poor people.

"I just do not think the worst problem on our sink estates by any means is smoking, but that is an obsession of the learned middle class.

"What enjoyment does a 21-year-old single mother of three living in a council sink estate get? The only enjoyment sometimes they have is to have a cigarette," the Health Secretary said.

But his remarks immediately drew the ire of anti-smoking groups. Deborah Arnott, director of Action on Smoking and Health (Ash), said: "Smoking is the single greatest cause of the large difference in life expectancy between the rich and the poor.

"If John Reid's contribution to the white paper on smoking is let the poor smoke, then his policy on obesity must be let them eat cake.

"Any Government that cares about improving public health must act to protect workers from second-hand smoke. Second-hand smoke kills more poor people than any other group in society."

Dr Reid's comments, at a Labour Big Conversation Event in South London yesterday, suggests he will be cautioning against Labour making a smoking ban in public places part of Labour's election manifesto.

They are also in stark contrast to Tony Blair's comments last week, in which he said that the Government was considering a smoking ban in public places, but hinted that such measures could be left to the discretion of local authorities.

Andrew Lansley, the Conservative Shadow Health Minister, accused Mr Reid of sending "mixed smoke signals".

"It is impossible to see how the Government can promote a consistent public health strategy when with one hand it is funding the British Heart Foundation's ad campaign against smoking and with the other John Reid makes remarks like these," he said.

"It is yet another illustration of the confusion and mixed messages which have characterised the government's public health policies, not just for smoking but also for obesity."

But Dr Reid, who gave up a 60-a-day smoking habit just 18 months ago, fears that advocates of a smoking ban are behaving as if members of the public are incapable of making their own informed decisions, The Guardian reported.

Responding to a call for a public ban on smoking during the debate, Dr Reid added: "Be very careful, that you do not patronise people because sometimes, as my mother used to say, people from those lower socio-economic backgrounds have very few pleasures and one of them is smoking.

"I worry slightly about the unanimity of the middle class professional activists on this."

Ministers are currently considering whether to ban smoking in public, to allow councils to impose suspensions, or to leave the law unchanged.

A spokesman for Dr Reid said that yesterday's debate focused "99 per cent of the time" on long-term health care and was not about smoking in public spaces. He added that no decision had been made yet on whether to ban smoking in public.