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« Managing the news | Main | My week »

New report: smoking and vaping policies in NHS hospital trusts

Brexit will dominate the news this week so today may not be the best moment for Forest to publish a new report.

Nonetheless the snappily-titled ‘Prejudice and Prohibition: Results of a study of smoking and vaping policies on NHS hospital trusts in England’ is topical for two reasons.

One, it’s No Smoking Day on Wednesday.

Two, on Friday (March 15) Labour MP Tracy Brabin will present the second reading of the Smoking Prohibition (National Health Service Premises) Bill.

Researched and written by Mark Tovey, Prejudice and Prohibition is based on data gathered via a series of Freedom of Information requests sent to 200 NHS trusts in England.

The 64-page report summarises the policies that regulate smoking and vaping in the 170 trusts that responded and how their policies may change in 2019.

The key findings were:


  • Three quarters (76 per cent) of the 170 responding trusts said they did not tolerate smoking anywhere on hospital grounds.
  • 94 per cent did not tolerate smoking even in their car parks.
  • Four in five (79 per cent) prohibited smoking in private vehicles on site.
  • Smoking shelters were provided by one in five trusts (78 per cent).
  • 18 trusts (10 per cent) plan to tighten restrictions on smoking in 2019 by removing smoking shelters and extending no-smoking areas.


  • The use of e-cigarettes was prohibited by 55 per cent of NHS trusts.
  • Mental health trusts were more tolerant of vaping with 65 per cent allowing the use of e-cigarettes compared with 39 per cent of acute (hospital) trusts.

  • 24 trusts (14 per cent) said they planned to amend their policies in 2019 to lift restrictions on vaping.


  • Of the 170 trusts that responded to the survey 88 per cent said they used signage to enforce smoke-free policies.
  • 34 per cent expected medics, nurses, kitchen workers and other staff to act as enforcers.

  • 32 per cent said they had installed shame-a-smoker buttons that members of the public could press to trigger anti-smoking messages to play over public address systems.
  • 18 per cent said they used security guards to do walk-arounds and provide support to other members of staff when they got into trouble confronting smokers.
  • 14 per cent said they used CCTV to monitor smokers and vapers, twelve per cent said they provided advice and nicotine withdrawal therapy to keep patients from violating their smoke-free policies.
  • 9 per cent said they used leaflets, information on patient appointment letters and welcome pack literature to spread information.
  • 8 per cent said staff could face disciplinary action if they violated their policies or assisted patients in doing so.
  • 2 per cent said they reserved the right to confiscate smoking and vaping equipment from anyone caught using combustible or electronic cigarettes.

The report concludes with these recommendations:

  • NHS hospital trusts should permit vaping in all outdoor areas.
  • The use of e-cigarettes should be allowed inside hospital buildings (including wards) at the discretion of hospital management.

  • Individual trusts should be allowed to devise policies on smoking in outdoor areas that best suit their patients, visitors and staff.

  • Options should include designated smoking areas, designated smoking shelters or no restrictions on smoking in the open air.

  • Smokers should be incentivised to smoke away from hospital entrances with the provision of comfortable smoking shelters, clearly signposted.

  • Where smoking bans are in place trusts must take steps not to discriminate against patients who are infirm or dependent on others to accompany them off site to smoke.

To read the press release click here.

To download the full report, click here.

Update: Yesterday I did a recorded interview for Global Radio, a soundbite from which may (or may not) be included in the news bulletins this morning. I shall also be talking about the issue with Nick Ferrari on LBC at 8.50.

The Press Association has covered the report so it's getting quite a lot of coverage online. See, for example, these PA-based reports on ITV News, Mail Online and Metro.

The Sun has put its own spin on the report here.

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Reader Comments (3)

Allowing vaping indoors, while insisting smokers are still forced outdoors, just shoves us more into 3rd class citzenship and supports the otherising of smokers as patients.

We should be calling for the old ventilated and segregated smoker rooms back where people can also vape - or calling for shelters outside for those who smoke and vape. As usual smokers are sacrificed to promote comfort for vapers. It is not acceptable.

Monday, March 11, 2019 at 11:18 | Unregistered Commenterpat nurse

It's time to stop the persecution of smokers and remove draconian restrictions on smoking.

Monday, March 11, 2019 at 20:04 | Unregistered CommenterVinny Gracchus

Your 'Enforcement' bullet points read like something from Nazi Germany... or East Germany, with their grass-a-smoker buttons.

It seems that the NHS isn't as cash-strapped as they like to pretend. Obviously, there's plenty of money for large metal signs everywhere, for security guards monitoring CCTV and to assist other members of staff when 'confronting' smokers, for leaflets, including literature to 'welcome' you to your temporary new home in HMP North Manchester General Hospital, or wherever.

Talking of which, "Patients are 'still scared' to go to North Manchester General Hospital warn councillors - North Manchester councillors say people are deliberately going to Central Manchester A&E to avoid their local hospital."

Elsewhere, we learn of this hospital that, "Support and advice are available to patients who would like help to quit smoking. Leaflets are available which set out the range of support available and these will be given to patients by our nursing staff."

Meanwhile, they've probably forgotten the reason you were admitted in the first place, as some of the comments on the Manchester Evening News suggest.

And smoking is 'disgusting'?

Monday, March 11, 2019 at 20:53 | Unregistered CommenterStewart Cowan

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