Smoking and vaping on hospital grounds in Scotland – consultation response
Monday, June 8, 2020 at 14:33 On Friday the Scottish Government published the results of a consultation concerning the ban on smoking outside hospital buildings.
You probably won’t remember but I wrote about it here.
To be honest I was a bit confused because I was under the impression that smoking had already been prohibited outside hospital buildings in Scotland - by a distance of 15 metres - so I didn’t fully understand the need for yet another consultation on the matter.
The purpose, it turned out, was to determine three things:
1. The distance from the hospital buildings that will form the perimeter of the no-smoking areas
2. The nature of the no-smoking notices
3. Exemptions for specific hospitals or buildings
The consultation also sought views on the use of 'nicotine vapour products' (NVPs) on hospital grounds and around hospital buildings.
In particular individuals and organisations were asked to respond to the proposal that:
... NHS boards should be asked to amend their smoking policies to permit the use of NVPs as an alternative to smoking on hospital grounds but only beyond the no-smoking area outside hospital buildings.
Curiously, while 'around half supported the proposal', not one vapers’ group submitted a response to the consultation, which I find quite bizarre.
The reason this matters can be found deep within the consultation report:
There were mixed views provided to Question 7 ['Do you support the proposal that the use of NVPs should be allowed as an alternative to smoking on hospital grounds but not within the no-smoking areas outside hospitals?'] – some 48% supported the proposal and 45% did not ...
Where comments were made, the main message was that vaping e-cigarettes "should be treated in the same way as tobacco" through hospital sites in Scotland – for consistency in messaging and communications about the no-smoking perimeter, and for ease of enforcement.
Those who did support the proposal included Forest and two industry groups - the UK Vaping Industry Association (UKVIA) and the Independent British Vape Trade Association (IBVTA).
(I assume the UKVIA and IBVTA supported the proposal. I haven't actually seen their submissions and neither are quoted in the consultation report but it would be a shock if they didn't.)
For the record, Forest’s submission took the view that not only should vaping be allowed beyond the no-smoking area, it should also be allowed within the no-smoking area.
NVPs should be allowed on hospital grounds but we do not support a ban on the use of NVPs within the no-smoking area outside hospital buildings. Without exception, NVPs can be classified as harm reduction products. They are widely credited with helping millions of smokers who wish to quit smoking to switch from a potentially harmful product (combustible tobacco) to a product (e-cigarettes) that is said by Publish Health England to be "95 per cent less harmful" than traditional cigarettes. What sense, therefore, does it make to prohibit within the statutory no-smoking area the use of a product that some smokers are using to quit smoking? Likewise, what good will it do to threaten to fine or penalise someone who is using an NVP, almost certainly in an attempt to stop smoking?”
This was one of three passages from our submission that made it into the consultation report. I’ll come to the others in a minute but it’s worth noting ASH Scotland’s position on vaping:
There is a clear need to be unambiguous regarding both no-smoking regulations and smoke-free policies throughout hospital grounds. These need to be consistent, easily understood, easily communicable, and straight-forward if they are to be effectively implemented. For this reason, ASH Scotland does not support the proposal [to allow vaping beyond the no-smoking area] ... and we strongly recommend that the use of tobacco and NVPs be treated the same throughout NHS Scotland hospital premises, both in relation to the no-smoking perimeter around hospital buildings, and under policies applying across hospital grounds.
... we support the approach to NVPs set out on the NHS Scotland Smoke Free Grounds website. This states that e-cigarettes are not allowed in NHS buildings, or on the majority of NHS grounds, ‘because they are not currently regulated as a tobacco product or a medicine in the UK, and we can only recommend the products that are known to be safe and effective. E-cigarettes can also mimic the look of smoking, which may make it harder for others not to smoke.’
ASH Scotland obviously takes a more puritanical view of vaping than its counterpart in England but never confuse ASH London’s strategic ‘support’ for vaping as an endorsement of vaping long-term.
ASH and ASH Scotland are peas from the same prohibitionist pod and neither will be happy until the UK is both smoke- and nicotine-free.
Anyway, the other issues where Forest’s contribution was highlighted in the consultation report concerned the impact of the smoking ban on disadvantaged groups such as the elderly and the infirm, and a point about canopies outside hospital entrances.
Under ‘Equalities’, we wrote:
We predict there will be a largely negative impact on anyone who is infirm or largely immobile without third party support. Patients who may be mobile but are attached to a drip (for example) will also be among the hardest hit. Forcing such patients away from hospital buildings and even off site will discriminate against those who have disabilities or may be recuperating in hospital following an operation and are unable to move unaided to an area where smoking is permitted.
Regarding canopies the report quoted Forest as follows:
If the canopy or overhang extends beyond 15 metres, and the area beneath it is over 50 per cent open to the elements (and therefore not an enclosed space) we do not accept that patients, some of whom may be infirm or elderly, should be forced to move even further from the hospital building if they wish to smoke. In the absence of a proper smoking shelter, we believe it is cruel and petty to deny them even a small degree of shelter under a canopy or overhang that extends beyond 15 metres from the hospital buildings.
However, what really interests me about ‘public’ consultations is the nature of the respondents. Invariably they are dominated not by ordinary members of the public but by public sector workers and organisations, and this one is no different:
The consultation received a total of 559 valid responses, of which the vast majority were from individuals (Table 2). Based on a review of the open-ended responses and/or email addresses, many of the individuals that responded to the consultation worked in the health sector in Scotland.
The consultation attracted responses from a diverse range of organisations. NHS bodies represented almost half of all organisation responses (eg NHS Boards, hospitals and health and social care partnerships), Table 3. Further, three NHS responses included the feedback and views gathered through their own consultation process which involved staff and/or patients.
It’s an ongoing problem and one that is almost impossible to counter without a costly awareness campaign.
Nevertheless I never regret taking part in any consultation. Declining to do so is to admit defeat before a ball has been bowled.
I also refuse to abandon those who need our voice, even when the odds are stacked against us.
If others choose to sit out public consultations, that's a matter for them, but it's not a strategy I would advise.
PS. The full lists of contributing organisations can be found in Appendix B of the report which you can download here.
One of the bodies is called Spectrum which is an acronym for ... well, see my tweet below (and the response!).
Reader Comments (4)
Perhaps they've all noticed that something "weird" is going on.
Somene needs to point out to Linda that Spectrum has been taken by Captain Scarlet.
SIG
The ban on outdoor smoking is barbaric. It is evident that these so-called charities have nothing better too do than find never-ending work to fund their activism. Which in this case involves the persecution of smokers based on fabricated evidence.
Designated smoking answers (indoors and outdoors) would solve any perceived discomfort experienced by antismokers.
I am very happy to report the smoking bans outside my hospital are being ignored and signs have been torn down as people sit in the old smoking area without harassment.
I would say, however, that I hope smokers use cig bins or pocket ashtrays instead of throwing cig ends on the floor to add to the non smoking related litter including the many discarded face masks and gloves that currently litter the hospital grounds.