As promised, here's my foreword to the Forest report, Prejudice and Prohibition: Results of a study of smoking and vaping policies on NHS hospital trusts in England.
If you’re in any doubt about Forest’s position, read on ...
At Hull Royal Infirmary they used to have a smoking shelter. Regrettably it was demolished and replaced with a stark ‘No Smoking’ sign. Today patients are forced to go off site to smoke. “It’s humiliating having to stand at a bus stop,” a 21-year-old woman wearing a nightgown and a catheter told BBC Look North. “It’s like being punished for smoking.”
The same report featured another patient ambling slowly off site with the aid of crutches. Walking alongside her was a “stop smoking specialist” who could be heard saying, “I was wondering if you’d like to take this opportunity to stop smoking.” Was he helping or harassing her? Either way, it looked and felt wrong. Last year a hospital in West Yorkshire installed a public address system that at the press of a button plays messages to ‘shame’ smokers to stub out their cigarettes. Elsewhere a local radio presenter, no fan of smoking, has described how his terminally ill father was denied the ‘pleasure’ of a cigarette while he was in hospital because smoking was prohibited throughout the site.
Equally distressing scenarios are being enacted across the country. Banning smoking on hospital grounds may seem reasonable to many people but the policy demonstrates a staggering lack of empathy and compassion, targeting, as it does, people who may be feeling particularly vulnerable – stressed, upset and in some cases in need of a comforting cigarette. I would go further and argue that it’s cruel and a shocking indictment of our ‘caring’ NHS. Where’s the compassion in forcing someone to go off site before they can light up? They may be infirm, physically and mentally. It could be dark, late at night and they might be alone. No-one who is already suffering from ill health or may be recovering from an accident or serious operation should be treated in such a callous fashion.
Yes, it can be unsightly if a group of people are smoking directly outside a hospital entrance, but this is one of many unintended consequences of the workplace smoking ban. Unable to light up indoors in a dedicated smoking room, smokers are forced to stand outside. Understandably they prefer to remain close to the entrance under a canopy that provides shelter from bad weather. If the powers that be don’t want people to smoke next to the entrance incentivise them to move further away by providing a comfortable smoking shelter. Don’t ban smoking everywhere on site because that’s disproportionate to the problem. Some people may not like the smell of tobacco smoke but there’s no evidence that smoking in the open air is a health risk to anyone other than the smoker.
Even in these difficult financial times a smoking shelter represents money well spent. Enforcing outdoor smoking bans means CCTV cameras, public address systems and tobacco control wardens ordering smokers to ‘Put that cigarette out!’. What a waste of public money and scarce resources. The public appear to agree. According to polls conducted by Populus for Forest, tackling smoking has consistently been considered the least important in a list of ten priorities for the NHS. The most important issues were investing in new doctors and nurses, addressing response times at A&E, and improving general waiting times.
Tobacco, lest we forget, is a legal product. Despite this anti-smoking campaigners justify the constant war on smokers by estimating that the cost of treating smoking-related illnesses is £2.7 billion a year in the UK. To put this in perspective, smokers contribute a staggering £12 billion to the Treasury annually through a combination of tobacco duty and VAT. In short, using a discredited financial argument to justify further discrimination against smokers is not only wrong, it’s unjust.
If there is some good news it’s the fact that an increasing number of NHS trusts are adopting a more relaxed attitude to vaping. The overwhelming majority of vapers are ex-smokers or smokers who wish to cut down or quit smoking altogether so banning the use of e-cigarettes on hospital premises never made any sense. It’s encouraging therefore to see more trusts amending their policies to allow vaping on site and even in hospital buildings.
Adopting a more sensible approach to vaping does not however justify further restrictions on smoking. Hospitals can be stressful places and for some smokers – patients, visitors and even staff – a cigarette provides comfort at a difficult time. The NHS has a duty of care to protect people’s health but that doesn’t include the right to nag, cajole or bully smokers to quit or switch to a state approved e-cigarette.
Just as bad is the despicable threat to punish staff who enable patients to smoke outside hospital buildings. In theory this could result in a member of staff, with years of dedicated service to their name, being disciplined because, with the best of intentions, they assisted or turned a blind eye to a patient who wanted to smoke and whose immediate mental well-being may have been helped by being allowed to have a cigarette.
The level of pettiness is such that smoking is not only prohibited outside the majority of hospital buildings but even in hospital car parks and private vehicles while they are on NHS sites. Common sense and decency are being sacrificed on the altar of ‘public’ health. Increasingly, it seems, hospitals are in the hands of tick-boxing bureaucrats with little empathy and no compassion for those who don’t conform to today’s anti-smoking orthodoxy.
To download the full report click here.
Update: I have just taken a call from BBC Look North. From today, No Smoking Day, Hull Royal Infirmary will ‘strictly enforce’ its no smoking policy.
Smokers are being escorted off the grounds to public roads and in one case, according to the BBC, the police were called to escort somebody off the premises.
Think about that for a moment. As if the police have nothing better to do, someone working for our caring, compassionate NHS has called the boys in blue even though it is not illegal to smoke on hospital grounds.