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Banning smokers from surgery is cruel and pointless, writes Dominic Lawson

I was asked to comment on two NHS/smoking-related stories last week.

The first concerned smokers being forced to take breath tests and refused non-urgent operations if they don't quit smoking before an operation. The second was about hospital smoking bans.

As I noted here, Forest wasn't alone in condemning the latest proposal to deny smokers treatment:

The Royal College of Surgeons (RCS) said the plan seemed to be "against the principles of the NHS".

Ian Eardley, senior vice president at the RCS, said losing weight or stopping smoking "should not be a condition of them [patients] receiving surgery".

"This goes against clinical guidance and leaves patients waiting long periods of time in pain and discomfort. It can even lead to worse outcomes following surgery in some cases."

See Hertfordshire NHS breath tests for smokers before surgery (BBC new).

The Telegraph (NHS provokes fury with indefinite surgery ban for smokers and obese) quoted the RCS and Joyce Robins from Patient Concern who said:

"This is absolutely disgraceful - we all pay our taxes, and the NHS should be there when we need it; we did not agree to a two-tier system."

Today the Sunday Times has a timely column by Dominic Lawson, son of Nigel and former editor of the Sunday Telegraph. Highlighting what he calls an "especially cruel" new form of discrimination, Lawson quotes the RCS's Ian Eardley before moving on to what he calls the "institutionalised terror of passive smoking":

This idea that smokers are ruining the health of innocent bystanders — especially children — has taken such a grip on our legislators that in 2014 parliament passed a completely unenforceable law to fine drivers who smoke while children are in their vehicles. But there is no statistical link between adults smoking and increased early mortality rates among their children. Research on “passive smoking” published in 1998 by the World Health Organisation suggested that the children of smokers had a lung cancer rate lower — yes, lower — than children of non-smokers.

This seemed to have come as a shock to the WHO, which initially kept back the details of its research, but its conclusion that there was no statistically significant connection between passive smoking and lung cancer has been most recently confirmed by a 2013 study of more than 76,000 American women published by the Journal of the National Cancer Institute. It said it “found no link between the disease and secondhand smoke”.

The article is behind a paywall, sadly, but worth reading if you can get a copy (Face it, doctor, smoking props up the NHS).

As for hospital smoking bans, I'm confident the issue won't go away, not simply because so many people are ignoring orders not to smoke on hospital sites, but because it is fundamentally inhumane.

Meanwhile, faced with adults openly flouting the regulations, the Scottish Government announced this week that it intends to get tough. According to the Scottish Mail on Sunday today:

Patients who smoke outside hospitals face fines of up to £1,000 under plans to extend the crackdown on tobacco.

Smoking and permitting others to smoke will be dealt with by £50 on-the-spot fines, but that could rise if offenders are taken to court.

The paper adds:

The Scottish Government also intends to ht health boards and managers with penalties of up to £2,500 if they fail to act on it.

A Scottish Government spokesman said:

"If a case is taken to court the offender could be fined up to £1,000 and those gound to have permitted others to smoke outside a hospital could be fined up to £2,500.

The threat to fine health boards could of course lead to the absurd situation whereby these taxpayer-funded institutions end up using public money to pay for fines imposed by government.

Another outcome could be long-serving NHS staff being disciplined or fined for turning a blind eye to someone having a quiet smoke outside. (To many people this is known as compassion.)

I'm quoted by the paper as follows:

"The Scottish Government is behaving like Big Brother. Smoking outside doesn't put anyone else's health at risk. As long as people are considerate and don't smoke directly outside the hospital entrance what's the problem?"

There wasn't room for the full quote that also included the comment that:

"Banning smoking on hospital grounds and threatening patients, staff and visitors with fines or other penalties is not just heavy-handed, it shows a desperate lack of compassion for those who enjoy the comfort of a cigarette in a stressful environment.

"Excessive regulation is not a legacy any government should be proud of. Ministers need to come to their senses and focus on the big issues, not someone have a quiet smoke in the open air."

This issue is definitely going to run and run.

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Reader Comments (7)

I was just on 3 counties Radio being interviewed about this. Public reactions are to follow. I suppose it will be available on the internet later for anyone who missed it.

Sunday, October 22, 2017 at 13:46 | Unregistered CommenterPat Nurse the discussion starts at 33.14 . I think most people agree this is wrong and it is discrimination.

Sunday, October 22, 2017 at 15:54 | Unregistered CommenterPat Nurse

Dominic lawson is on point with his comments. No doubt he recalls the efforts by ASH et al to suppress the results of that study...

Boffetta, et al: Multicenter Case-Control Study of Exposure to Environmental Tobacco Smoke and Lung Cancer in Europe, Journal of the National Cancer Institute, Vol. 90, No. 19, October 7, 1998: "public indoor settings did not represent an important source of ETS exposure." (This case-control study used data from the IARC. The period of enrollment of case and control subjects was from 1988 to 1994--16 years; IARC=International Agency for Research on Cancer.}

Sunday, October 22, 2017 at 20:50 | Unregistered CommenterVinny Gracchus

I don't suppose anyone has a link to the "2013 study of more than 76,000 American women published by the Journal of the National Cancer Institute" that Dominic Lawson refers to, do they? I don't think I've seen that report, or indeed any reference to it.

I find myself quite aghast at the fact that despite most studies on 'passive smoking' concluding that there is no link between exposure to ambient tobacco smoke and ill-health, the various arms of Tobacco Control continue to peddle the myth that breathing a wisp of someone's cigarette smoke is lethal.

How on earth to they continue to get away with telling barefaced lies when a huge amount of evidence to the contrary is in the public domain? And why do the politicians continue to pass laws based on this lie when they have access to the facts? And more importantly, why does the MSM continue to support the lie? Dominic Lawson is really the exception here - most journalists just follow the party line when it comes to anything tobacco related, even though they can find out the facts just as easily as Mr Lawson.

It beggars belief, it really does.

Monday, October 23, 2017 at 6:44 | Unregistered Commenternisakiman

A recent (2013) large prospective study (76,000 women) showed that while there is a strong association between smoking and lung cancer no such link has been demonstrated with second hand smoke. The direct quote is "the fact that passive smoking may not be strongly associated with lung cancer points to a need to find other risk factors for the disease [in nonsmokers].” (Peres, J, "No Clear Link Between Passive Smoking and Lung Cancer,"J Natl Cancer Inst, 2013.)

Monday, October 23, 2017 at 16:14 | Unregistered CommenterVinny Gracchus

Thanks Vinny. I found it here.

Monday, October 23, 2017 at 18:24 | Unregistered Commenternisakiman

Conservativehome article
Council anti smoking campaigns an expensive failure

Wednesday, October 25, 2017 at 11:08 | Unregistered CommenterSheila

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