Hospital smoking bans, Public Health England and Stoptober

I'll be on BBC Kent on Monday discussing the decision by yet another hospital to ban smoking throughout its grounds.

It's noticeable that more and more hospitals in England are falling into line with an NHS 'tobacco-free' campaign launched by Public Health England earlier this year.

At the time I described it as a "gross over-reaction" and told the the BBC, "It won't stop people smoking. It will simply force people to smoke further away, which will discriminate against those who are physically infirm or in a wheelchair.

Last week however a hospital in Hackney, north London, announced that it was planning 'a total smoking ban on its premises – and in patients’ homes – by the end of the year.'

The local paper has the story here. You'll find full details of the 'consultation' here (closing date September 4) but you could be forgiven for thinking that implementation of the policy has already been agreed.

Although the 'engagement document' is aimed at staff, "service users" and the local community, Forest will submit something, if only to express our disgust.

I might include some of the 300 words I wrote for the Scottish Sun while I was on holiday. See Smokers to face steep fines if caught lighting up within 15m of Scots NHS hospitals – here are both sides of the argument (Scottish Sun).

I know some of you think responding to consultations is a waste of time, and sometimes you're probably right, but if we sit back and do nothing we can't complain if our arguments are ignored.

It's not as if we never win any battles. Remember the Brighton Council consultation on smoking in parks and beaches in 2015?

Likewise I've heard nothing more about the proposal by Birmingham Children's Hospital to extend an outdoor smoking ban to nearby streets.

It was exactly a year ago (August 2016) when the hospital trust announced plans "to make the streets around it a smoke-free zone - asking people not to light up in nearby roads":

Signs and security patrols would highlight the new zone under the proposals, the trust said.

According to the BBC the plan was subject to a six-week consultation. Not only did Forest condemn the proposal, we submitted a response and encouraged others to do so too (see Action alert – hospital wants to extend smoking ban to nearby streets).

On the closing date I wrote a second post (Why 'smoke-free' consultation should be declared null and void) and released a further statement (along similar lines) to the local media.

To the best of my knowledge the trust has made no further comment about the consultation nor has it implemented its plan to ban smoking in 'nearby streets'.

Frankly I've no idea what the outcome of the consultation was or what the current policy is so this morning I emailed the communications team as follows:

In August 2016 you launched a consultation that included questions concerning a possible 'smoke-free zone' in the streets around the hospital.

Has a report on the consultation been published? If so, I would be grateful if you could send me a copy. If not, can you nevertheless let me know what the outcome of the consultation was?

Can you also confirm (a) what your current policy on smoking outside the hospital is, and (b) whether there there any plans to extend it to nearby streets?

Meanwhile, following up a previous enquiry about Stoptober 2016 that was only partially answered (see Stoptober celebrities feeling the pinch), I've written again to Public Health England:

Further to our correspondence last year re Stoptober 2016 and your response of 18th November 2016 (your ref 03/11/lh/400), I would be grateful if you could provide answers to the following:

1. A full evaluation of the outcome of Stoptober 2016 as mentioned in your response. (According to your response a full evaluation was due to be published in February 2017.)

2. Please confirm final costs (including media costs) for Stoptober 2016.

3. Please confirm the projected costs for Stoptober 2017 including the total media spend.

4. Can you confirm whether you are hiring any celebrities to promote Stoptober 2017, who they are, and what they will be paid (in total) for their work on the Stoptober 2017 campaign?

5. Finally, can you confirm how much you are spending on third party agencies (PR, advertising and marketing) to promote Stoptober 2017, and who they are?

If I get a response to any of these queries I'll let you know.

Meanwhile, tune in to BBC Radio Kent. It may be a Bank Holiday Monday but some of us will be working!

Smoke signals

The Worshipful Company of Tobacco Pipe Makers & Tobacco Blenders was founded in 1619.

Dissolved twice and re-formed in 1954, the Company is associated with "all aspects of the UK tobacco trade, including leaf growers, merchants and blenders; tobacco and paper manufacturers; pipe makers; snuff blenders; cigar importers and retail tobacconists."

To highlight its work and activities it publishes a quarterly newsletter, Smoke Signals, and I'm pleased to say the latest issue features an article about Forest.

Here's a taste:

Simon believes Forest may be unique in the world, and puts its staying power down to being professionally run. “Other smokers’ groups have come and gone,” he says. “A similar group in the USA found it hard to achieve a significant presence in the media

"Smokepeace, a loose association of smokers’ rights groups in Europe, most of them run by volunteers, ultimately collapsed. Our professional staff enable us to sustain fast responses, professional media visibility, and our 38-year history gives us credibility.”

And Forest is now spreading its wings further. It has launched a chapter in Brussels, Forest EU, to give smokers a voice in the European Union and to put consumers at the heart of the EU legislative debate.

Guillaume Périgois, Director of Forest EU, says it will arm consumers with information and resources for engaging with politicians and regulators. Like Forest in the UK, the EU chapter acknowledges the health risks, but says:

“If adults choose to smoke that’s a matter for them and no-one else. It is not a public health issue; it’s a private health issue. We need a liberal and pragmatic approach to tobacco that puts empathy above dogma and takes account of the views of ordinary citizens.”

You can read the full article here.

What a palava

Breaking news.

Shortly before I went on holiday I posted an update concerning my dispute with Indigo, the parking management company.

Having rejected my initial appeal against an undeserved fine, the original penalty of £60 had jumped to £175 after Indigo instructed a debt collection agency to get involved.

I was narked because I had informed Indigo that I had taken the matter up with POPLA, the independent appeals body, and the least they could do - or so I thought - was wait for that process to run its course.

Also, two weeks after registering my appeal with POPLA (which they acknowledged via email), I had a bizarre conversation with one of their staff who advised me they had no record of my appeal. Instead I was asked to resubmit it.

I didn't, as it happens, because it was a day or two before I went on holiday and I was too busy. Despite that I have now received an email that reads:

Dear Simon Clark

Thank you for submitting your parking charge Appeal to POPLA.

An Appeal has been opened with the reference xxxx.

Indigo Solutions have told us they do not wish to contest the Appeal. This means that your Appeal is successful and you do not need to pay the parking charge.

Yours sincerely

POPLA Team

Thank you, POPLA team. All's well that ends well. But what a palava.

New York: summer in the city

My first visit to New York twelve years ago left me hot and bothered.

I enjoyed visiting Ellis Island, in New York Harbor. Described as "the nation's busiest immigrant inspection station for over 60 years from 1892 until 1954", the main building – built in 1900 – is now a fascinating immigration museum.

Other landmarks – the Empire State Building, for example – left me a little cold. Even the view from the observation gallery on the 86th floor couldn't make up for the fact that it seemed of secondary importance to the gift shop.

My bête noire was the traditional yellow taxi. However large they appeared from the outside, inside they felt intimidatingly dark and cramped. It didn't help that passengers were separated from the driver by what appeared to be a thick bullet-proof shield or that the drivers – even if they spoke English – were largely monosyllabic.

The biggest problem however was the heat. I went there in July and it was like being in a blast furnace. When I wandered into Central Park there was almost no-one there. It was too damn hot.

Instead there was a notice explaining that the open air theatre (similar to the one in London's Regent Park) would be closed for the summer because of the temperature and humidity. 

I vowed that if I returned it would be in the spring or autumn. Hence last week's visit – in August.

Thankfully the weather was warm but not excessively hot, and far less humid. Instead we got a mixture of sun, cloud and the occasional shower. As a result:

We spent an afternoon in Central Park without being burned alive.

We navigated the High Line, a 1.5 mile urban park developed on an elevated section of a disused railroad.

We comfortably walked 20 blocks at a time without undue discomfort.

And we were able to eat al fresco, most notably on a superb rooftop terrace in the up-and-coming Meatpackaging District. (That was before we moved to ground level for dessert at the aptly named Sugar Factory.)

The yellow taxicabs (and their drivers) were as bad as ever but help is at hand – Uber! Yes, I lost my Uber virginity in New York and I think I'm smitten.

We stayed in two hotels – the Hilton Millennium in Downtown Manhattan, and the Renwick Hotel, close to Grand Central Station in Midtown Manhattan.

The latter was far more to our taste (we were in a loft style room on the eleventh of 17 floors) but the view from our room at the Hilton was extraordinary.

Not only was it on the 52nd floor, it overlooked Ground Zero and the new Freedom Tower (aka One World Trade Center), "the tallest tower in the Western hemisphere".

It's impossible, of course, to visit the US at the moment and not mention the President, so here are my Trump tales.

In Halifax, Nova Scotia, I got talking to an American from Indiana who was on another ship. He seemed certain the US was about to go to war with North Korea but praised Trump for standing up to the "little fat man" as he called Kim Jong-un.

Indiana, I was led to believe, has plenty of underground bunkers in case of a nuclear strike. Whether this is true I've no idea, but when he asked me where I was from and I replied, "the UK", he was quizzical. "UK? Is that Ukraine?" Make of that what you will.

The next American I spoke to was a porter at the New York cruise port. He looked and sounded just like Sylvester Stallone and his first question was not "Can I carry your luggage for a large tip?" but "What do you think of Donald Trump?"

Before I had a chance to respond he was impressing on me just how much he supported the president.

Of course there were others, notably the lady on an adjacent table at a posh Mexican restaurant who chose, unsolicited, to apologise to me – a complete stranger – for America's choice of president, but the message I took home was that support for Trump from white, blue collar workers and Southern conservatives remains strong.

By coincidence, when we left Central Park it was late afternoon and we were one block down from Trump Tower, which overlooks the park.

Trump was travelling to New York that very evening and protesters were already gathering on 5th Avenue awaiting his arrival. The police were there too and they were controlling the traffic and restricting access to streets and sidewalks.

Suddenly we found ourselves trapped and had to take refuge (I kid you not) in the flagship store of Tiffany & Co, the world famous jewellers.

It was almost as if my wife planned it.

Above: view from our 52nd floor room at the Hilton Millennium Hotel in Downtown Manhattan. Below: the Freedom Tower (centre).

All at sea

Apologies for the lack of posts these past few weeks. 

Towards the end of July I was extremely busy. Since then I've been on holiday.

Specifically I spent eight days aboard Queen Mary 2, crossing the Atlantic to New York with a single stop at Halifax, Nova Scotia. My wife and I then spent five days in Manhattan.

Our first transatlantic cruise was to mark our 25th wedding anniversary. But we didn't go alone. Accompanying us were our friends Bill and Patty, who got married a few weeks before us; and Gary and Helen, who married a year earlier in 1991.

I've known Gary since we were at university in Aberdeen and I've known Bill even longer. We were at the same primary school in Wormit, north Fife, and later went to the same secondary school, Madras College, in St Andrews.

(By coincidence, someone who was in my English class at Aberdeen responded to a photo I posted on Facebook by declaring, "Good grief. We must have passed you in Southampton. Just got off yesterday morning!" Small world.)

Anyway, I've been on several cruises in recent years – to the Baltics, Iceland/Norway, East and West Mediterranean – and this was certainly different.

On a 'normal' cruise you spend almost as much time off the ship as you do on board. Or it certainly feels like that. Every other day (sometimes daily) you arrive in yet another port and have five or six hours to eat, drink and wander around, but always with an eye on the clock.

I've lost count of the number of places we've visited (the list includes Tallin, Helsinki, Stockholm, St Petersburg, Reykjavík, Seville, Rome, Cannes, Dubrovnik and Santorini) but apart from a handful of memories there's little to say because we weren't there long enough.

Instead, on every one of those cruises the announcement I craved most was, 'Tomorrow is a day at sea'.

On a transatlantic cruise almost every day is a 'day at sea'. The one exception was Halifax where we got off, hopped on an ancient Routemaster bus and enjoyed a 90-minute tour of the city.

(I recommend bus tours. Instead of wandering round aimlessly you see something of the city and if there's something that takes your fancy – like a brewery or an enticing waterside bar or restaurant – you can go back to it, if there's time.)

Anyway, after six days at sea I appreciated Halifax more than I might have done had we been getting on and off every day or so.

I was happy though to return to the ship because if there's one thing cruising does to you it's this: you become a little institutionalised. 

Notwithstanding the well-known fact that a week on board a cruise ship can add at least half a stone to your weight unless you exercise some discipline, you are inexorably drawn to yet another cream tea followed (a few hours later) by cocktails, three-course dinner and several (shared) bottles of wine.

That night, lying in your 'stateroom' feeling bloated and a little queasy, you convince yourself that tomorrow you'll eat and drink less.

It makes no difference. Come morning you're back in the restaurant eating blueberry pancakes (with gallons of maple syprup) followed by kippers and a full English (or American).

The former includes bacon, eggs, black pudding and Cumberland sausage, the latter hash browns and corn beef.

Soon it will be time for lunch, and the cycle continues.

Although it's larger and can carry more passengers (2,620) than the Queen Victoria (2,014), another Cunard ship we've been on, the QM2 is significantly smaller than the latest generation of cruise ships, most of which resemble floating hotels with the largest carrying 6,780 passengers.

It's built though to be far more stable on a transatlantic cruise. 

Funnily enough, at a tobacco event in London a couple of years ago one of the speakers was discussing smoking on the great cruise liners of the past and he mentioned that the original Queen Mary was renowned for 'rolling', which caused a lot of seasickness.

That was the norm, apparently, and passengers just had to accept it. In the Thirties, of course, there was no alternative if you wanted to travel from Europe to America, or vice versa – unless you went by airship.

Airships were the Concorde of their day. They were significantly faster than ocean liners, saving several days' travel, and were therefore popular with businessmen.

Airships were also pretty safe, until the Hindenberg disaster altered people's perceptions. (Even then the majority of the 100 passengers and crew escaped the blazing inferno.)

In order to keep the weight down however facilities were relatively spartan. Cabins were more like the compartments you'd find on a sleeper train and there were no theatres or ballrooms. Obviously.

Contrast that with a ship like the Queen Mary where, bouts of seasickness aside, first class passengers in particular could travel in enormous comfort.

As it happens we didn't encounter any seriously bad weather on our trip. Some days it was overcast or foggy but the sea was never more than mildly choppy and often very calm. Only once were we warned not to walk on the outside decks.

Talking of which, and in line with most of today's cruise ships, smoking is now banned almost everywhere on the QM2 with the exception of "designated areas of the open deck on the aft of Deck 7".

To be fair there were seats, tables and even deckchairs in the 'smoking area', which offered a good view of the ocean beyond, but how long before those God awful joggers start to complain that 'their' air is being polluted?

In my experience the entertainment on cruise ships is a mixed bag. There are no shortage of things to do but I prefer to find a quiet spot (with a waiter close at hand) where I can read without interruption whilst drinking coffee or something a little stronger.

Shows in the ship's theatre tend to err on the side of cheesy but they're rarely more than 45 minutes.

Daytime entertainment will include a guest speaker who will give two or three presentations in return (I assume) for a complimentary holiday and a suitable fee.

Last year (aboard the Queen Victoria) it was Baroness Wheatcroft, the former business and city editor of The Times, who later became editor of the Sunday Telegraph.

This year the QM2 events team chose to book Lord Paddick, the retired police officer who stood as the Lib Dem candidate in the London mayoral elections of 2008 and 2012. Oddly enough, the American passengers who attended his lectures seemed to love him.

However the daytime programme was dominated by a series of very well-attended events featuring American veterans of World War II, including a sprightly 93-year-old who took part in the D-Day landings.

Day after day one veteran after another received a standing ovation. Quite what the German passengers on board made of it I really don't know.

Anyway, we arrived in New York, eight days after leaving Southampton, in the early hours of Saturday, August 12.

But that's another story ...

Above: arriving in Nova Scotia, photographed from my bed! Below: Manhattan from our cabin balcony, shortly after our arrival in New York.

Good news

Last week I mentioned my dispute with Indigo UK who manage the car park at my local train station.

You can read the sorry story here - Taken for a park and ride.

Despite the fact that I have taken the matter up with the Parking On Private Land Appeal service (POPLA), and advised Indigo of that fact, the company has passed the matter on to a debt collection agency and I am now being chased for £170.

This afternoon I spoke to someone at the agency (who was very helpful) and the next stage, if I don't cough up pronto, is a letter from the legal department followed by the threat of court action.

He promised me though that as long as it doesn't go to court it shouldn't cost me more than a few hundred pounds (that I will never get back) to continue my challenge to the original penalty.

So that's good news.

I'll keep you posted.

Update: This gets better and better.

I rang POPLA this morning to check what's happening with my appeal. Incredibly, despite having received an email ten days ago confirming receipt of my appeal, they claimed to have no record of an appeal.

They asked for my verification code (the 10-digit number Indigo gave me when rejecting my original appeal) and my car registration number.

Nope, they said. My registration number doesn't tally with the number associated with the verification code Indigo gave me.

"That's because Indigo have screwed up," I said. "In the letter they sent me rejecting my appeal they referred to my 'motorcycle'.

"You'll probably find that verification number they've given me actually relates to the registration number of a motorcycle that has nothing to do with me!"

The long and the short of it is this. Despite having received and acknowledged my (second) appeal, POPLA has not progressed it one iota.

Instead they have asked me to write to them again and their IT department will look into it.

They also suggested that if I'm dissatisfied with Indigo (I am!) I should write to a third body, the British Parking Association.

My reaction wasn't very polite but can you blame me?

Observations on 'Dunkirk'

I've seen 'Dunkirk' twice now.

The first time was at my local Cineworld. I then saw it on an IMAX screen in Milton Keynes.

I won't review the film because I'm no good at reviews and there are a million out there already. (See Rotten Tomatoes.)

But I do recommend it.

The first time I went with my son. We both enjoyed it but I made the rookie mistake of reading many of the mostly superlative reviews in advance and it's hard for anything to live up to that level of hype.

The one aspect of the film that slightly disappointed us was the scale. In reality there were almost 400,000 soldiers awaiting evacuation from Dunkirk.

Over 900 vessels were involved in Operation Dynamo including over 700 'little ships', with 15 Spitfire squadrons providing air cover.

'Dunkirk', a £150m Hollywood movie, doesn't even hint at this. What we see is a few thousand extras on a largely deserted beach, one or two warships, a handful of private boats and three Spitfires.

Ironically 'Their Finest', a small budget movie about the making of a wartime propaganda film about Dunkirk, addressed this logistical issue.

Released earlier this year there's an amusing scene where the tricks of a pre-CGI age are demonstrated in all their glory.

What appears to be a beach heaving with soldiers is actually a piece of glass placed in front of the camera. It was nevertheless surprisingly effective and the audience laughed when the subterfuge was revealed.

'Dunkirk' director Christopher Nolan is having none of that. CGI too is kept to a minimum.

What we have instead is a series of relatively intimate vignettes with the emphasis on verisimilitude, and credit to him for that.

The soldiers on the beach are not computer-generated, they are real people.

The small flotilla of 'little ships' is mostly genuine too - 12 or 13 actually took part in the Dunkirk retreat.

The Spitfires are authentic working aircraft.

Compare this to the bombastic, CGI-driven nature of every other Hollywood blockbuster.

Prior to the Cineworld screening of 'Dunkirk' we sat through trailers for several forthcoming films.

One was yet another Marvel Comic movie. Another was a 'Game of Thrones' style fantasy.

A third was an unbelievable and ludicrously over the top disaster movie built on the premise that one day we'll be able to control the weather from space but what happens if it all goes horribly wrong.

I assure you that, regardless of one or two minor flaws, 'Dunkirk' is a masterpiece by comparison and we should be grateful Nolan has made a film that can be watched by adults as well as teenagers.

In short, warmly recommended. Disregard the hype (difficult I know) and you'll enjoy it even more.

Most important, watch it at an IMAX cinema. The difference is significant.

The picture was clearer, the surround sound far more intense. There were moments when the seats positively trembled in sync with the permanently throbbing soundtrack and the inevitable explosions.

Oddly the paucity of soldiers, aircraft and ships seemed to matter less on the larger screen.

I think it's because the experience is so much more immersive. Rather than observing the protagonists you feel you're with them in their battle for survival.

Best of all are the airborne dogfights that really come to life on the bigger screen.

My wife, who does not as a rule enjoy war movies, preferring a quiet matinee-style film on a modest screen at the Arts Picturehouse in Cambridge, said it was one of the best films she'd ever seen.

Take it from me, that's some accolade.

PS. Interesting to note, from US reviews of the film, how little is known about the evacuation of Dunkirk in America.

The same is true, I'm sure, of us and important moments in US history.

A better appreciation of the history of our friends and foes is fundamental, in my view, to successful foreign relations.

The Foreign Office no doubt understands this which is why so many ambassadors and civil servants are accused of 'going native'.

But that's another story for another day.

PPS. Have IMAX screens got smaller? Prior to last week I'd only been to two IMAX cinemas, one in London, the other in Glasgow, the last time almost ten years ago.

The Milton Keynes screen was large but it wasn't MASSIVE in the way the London and Glasgow screens were so I may have to watch 'Dunkirk' for a third time on an even bigger screen.

Prejudice and prohibition

I couldn't help notice a tweet on the Forest timeline this morning.

It was posted by Prof Kevin Fenton, an advisor to Public Health England, retweeted by Clive Bates, former director of ASH, and 'liked' by Louise Ross, another hero of the vaping community.

It referred to a post published on the PHE blog that highlights the work of Leicestershire Partnership NHS Trust in going 'smokefree' (sic):

A core part of their service is caring for people with mental health problems, a group who are much more likely to smoke, and to smoke more heavily, than the general population, leading to poorer physical health and lower life expectancy.

Louise Ross, Stop Smoking Service Manager, said:

"The patients understood why the wards would become smokefree, but they wanted to use e-cigarettes as a way to manage their nicotine needs. Our policy was written to reflect their views, and every effort has been made to help patients, staff and visitors see this as a positive step forward.

“Vaping is allowed in the grounds, and smoking is not [my emphasis]. This helps to manage nicotine needs while at the same time giving people a chance to try a far less harmful way of using nicotine than by smoking. Nicotine replacement products are also available through the pharmacy on site."

In other words, the Trust's pro-vaping policy is based primarily on a draconian measure that prohibits smoking inside and outside the building.

Thanks to this heavy-handed (some would say authoritarian) measure vulnerable patients have just two options - to quit smoking altogether or switch to e-cigarettes that they may not like or feel comfortable using (see The Pleasure of Smoking: The Views of Confirmed Smokers).

That sounds more like coercion to me but what do you expect when the pro-vaping movement is increasingly being driven by anti-smoking campaigners, many of them current or former employees of the tobacco control industry.

Full post: How one mental health Trust in Leicestershire is using e-cigarettes as a tool to go smokefree (PHE).

Vapers In Power, a group that used to oppose outdoor smoking bans, has also retweeted Prof Fenton's approving tweet.

Either VIP has changed its policy or they didn't bother reading the small print. Either way they have effectively endorsed a ban on smoking in the grounds of mental health units.

To understand what that means to some mental health patients read this fascinating transcript.

Good to see this practical example of #e-cigs helping smokers quit --potential for other health and care settings. https://t.co/RAY8xlKkMc

— Kevin Fenton (@ProfKevinFenton) July 29, 2017