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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.


My week

Quick recap on the week.

It kicked off on Sunday with a call by the All Party Parliamentary Group on Smoking and Health - run by ASH - for an increase in the legal age for purchasing tobacco from 18 to 21.

We came late to the story - I think it must have been given to the Observer as an exclusive - but Forest’s reaction was subsequently picked up by the Press Association which led to us being quoted by the Daily Mail, Metro and a number of local papers online including the Manchester Evening News, Belfast Telegraph and several more.

It was then reported that the Scottish Government is to consider the same measure, conjuring up images of a race between Westminster and Holyrood although, to be fair, the UK Government has so far shown no appetite to introduce the policy.

Anyway, I was subsequently interviewed on BBC Radio Scotland alongside Deborah Arnott of ASH and quoted by The Times (Scotland), the Herald, Scotsman and Scottish Daily Mail.

There was also a story in Dundee about Ninewells Hospital using children's voices to ‘encourage’ people not to smoke outside the hospital entrance. The children concerned are aged 9, 10, and 12.

My reaction - I described the initiative as “Orwellian” and “emotional blackmail” - was reported by the Scottish Daily Mail and Dundee Evening Telegraph.

While all this has been going on we have been busy disseminating a new report.

I can’t say more because it’s under embargo but it’s a substantial document that has taken the best part of six months to put together. I’ll reveal all on Monday.

Meanwhile, here's that report in The Times.


Double standards and the futility of making personal attacks on journalists

The Telegraph has just published a series of articles attacking e-cigarettes.

All bar one is behind a paywall but the headlines tell you all you need to know.

On Friday one read 'Instagram promoting vape products to children as young as 13, Telegraph investigation finds'. 

Another reported 'Children as young as 14 are becoming addicted to e-cigarettes, head of Britain’s biggest addiction clinic says'.

On Saturday the paper ran two further reports. One was headlined 'Tobacco companies are using e-cigarettes as a 'Trojan Horse', experts warn'.

The second ('E-cigarettes are creating a generation of nicotine addicts, top scientists warn') started reasonably but then took a more propagandist turn:

E-cigarettes are hotly debated by health experts, with some viewing them as an effective quit smoking device while others are concerned that they have become a popular accessory for young people.

PHE has thrown its weight behind vaping and maintains that it is “95 per cent” less harmful than smoking, a position it took in 2015.

But academics have told the Daily Telegraph that this figure is “simply not credible”, as they say that “very clear picture is emerging” about the dangers that e-cigarettes pose, particularly for young people.

The ‘top scientists/academics’ quoted by the paper were ‘prominent tobacco control activist’ Prof Stanton Glantz, director of the Center for Tobacco Control Research and Education at California University; Prof Simon Capewell, ‘an expert in public health’ at Liverpool University; Prof Martin McKee, ‘an expert in European public health’ at the London School of Hygiene and Tropical Medicine; Prof John Ashton, former president of the Faculty of Public Health; Dr Gabriel Scally, president of epidemiology and public health at the Royal Society of Medicine; and Mike Daube, emeritus professor of health policy at Curtin University in Perth, Australia.

All these names will be familiar to anyone who has followed the war on smoking for the past two decades. The irony is that I don’t recall many (if any) of the current cheerleaders for vaping criticising them for their repeated fearmongering about the dangers of smoking.

As I have stated many times, I accept that on current evidence the health risks of smoking and vaping are miles apart. Nevertheless, if Glantz, Capewell, McKee, Scally etc can be so wrong about vaping, surely that should prompt a review of some of their more exaggerated claims about smoking, the dangers of 'passive' smoking in particular?

Apparently not.

The same people who are castigating these 'top scientists' for their views on vaping are quite happy it seems to accept without quibble all their claims about smoking.

Double standards?

Meanwhile, another story that broke on Saturday evening was first posted on the Guardian website. Written by Observer journalist Jamie Doward, a regular conduit for ASH-inspired stories, it was headlined 'MPs call for legal smoking age to be raised to 21', and began as follows:

Smokers will be banned from buying cigarettes until they are 21 as part of measures to improve public health being considered by the government.

An influential cross-party group of MPs has proposed raising the minimum smoking age and introducing a levy on big tobacco companies to fund measures to encourage people to quit and to prevent youngsters taking up the habit.

The parliamentary group on smoking and health, backed by 17 health charities and medical organisations, also wants to tighten the rules on showing smoking on TV and in films.

I came late to the story because I was away but I subsequently sent a quote to the Press Association that was picked up by a number of newspapers online including the Daily Mail:

“These proposals infantilise young adults. If you’re 18 and old enough to vote, drive a car and join the army you’re old enough to make an informed decision to smoke.”

(For Forest’s full response click here.)

Needless to say there has been barely a peep about the APPG’s proposals from vaping advocates, most of whom are so deeply aligned with today's anti-smoking agenda that they fail to see that every tobacco control policy will, sooner or later, be used to combat the use of e-cigarettes.

Anyway, back to the Telegraph. The common link between those anti-vaping reports was education editor Camilla Turner, not science editor Sarah Knapton who has been the subject of repeated abuse from vapers and vaping advocates on social media.

I’m not defending Knapton but attacking journalists is rarely the way to win friends and allies. As I wrote here (Rough guide to dealing with the media):

I know what it is to metaphorically bang your head against a brick wall. It's incredibly frustrating when reports are published that appear one-sided, factually incorrect or both. I've experienced this for many, many years. No-one, I believe, has more experience of the futility of engaging with certain journalists who are deaf to the likes of you and me. Nevertheless it must be done and my advice is that abusing individual journalists, often directly, on social media is wholly counter-productive.

Yes, it will make them aware of the extent of your anger and frustration but you can do that privately. It makes little sense to set the dogs on them, which is effectively what you're doing by encouraging others to steam in with similar comments of their own. Human nature is such that if people feel they are being bullied by a mob they will react negatively. The idea that they will suddenly choose to see your point of view is naive.

I'm not saying it's right that journalists don't check the facts or chase contrary viewpoints but it's no use taking it out on individual correspondents. Whatever the rights and wrongs of the report that offended the vaping community earlier this year, for example, some of the subsequent attacks on the Daily Telegraph's science editor Sarah Knapton were deplorable.

I'm not a conspiracy theorist so it's hard to say whether the persistent criticism of Sarah Knapton precipitated the recent flurry of anti-vaping reports in the Telegraph, but I can't imagine it helped.

If I was advising the vaping industry the first thing I would do is suggest a meeting with Knapton and Turner. I'd invite them to visit an R&D facility and they would be top of my list of potential guests to attend the UK Vaping Industry Forum in May.

In the meantime I'd advise the vaping community to stop making personal attacks on journalists. Human nature being what it is, it rarely ends well.


Hockney: “I just need a cup of tea and a cigarette”

Early start (4.00am) to drive my daughter to Heathrow to catch a flight to New Orleans.

Returning home I listened to David Hockney being interviewed by James Naughtie for the Today programme.

They were in Amsterdam for the opening of an exhibition featuring the works of Britain’s greatest living artist and Vincent Van Gogh.

As luck would have it, Hockney and Naughtie were in a group of ten people who got stuck in a lift in an Amsterdam hotel before the opening of the exhibition.

According to the Guardian:

The incident happened when the 81-year-old artist was heading for a cigarette, before being interviewed for the BBC Radio 4 Today programme.

Too many people tried to get into the lift at Amsterdam’s Conservatorium hotel – not helped by some journalists who were carrying heavy cameras and microphones – which then became stuck ...

After about 30 minutes, Hockney and the others, who told jokes to keep spirits up, were released.

Hockney – cigarette in hand and desperate for a smoke – cheerfully posed for photographs with his rescuers afterwards. He also asked for a cup of tea.

The report also referred to ‘the next chapter in his life beginning this weekend’:

“I’m just going to Normandy because we’ve got a house there,” he said. “It is surrounded by trees, it is going to be marvellous for me because I’ve got a new location and I’ll draw it.

“I can’t think of anything better in life than watching the spring happen in Normandy in 2019, I mean what better thing can I do? I can’t think of anything. Van Gogh would love it.”

Hockney returned to his adopted home city of Los Angeles after several years painting the Yorkshire Wolds. Asked if he might return to paint Britain, he was dismissive. “I’ve no plans. Not at the moment. I think France is a lot more smoker-friendly … I take that into consideration as well.”

The Daily Mail, whose editor Geordie Greg was credited by the Guardian as the man who got the hotel to call firefighters to release the group, devoted the whole of page three to the incident.

Hockney, the paper noted, seemed none the worse for his ordeal:

He was offered a glass of whisky to help him recover but simply said: “No, no, a nice cup of Yorkshire tea would be perfect. I feel fine, I just need a cigarette.”

He’s not alone.

Update: Just published, Smoking with David Hockney. Some great quotes.


Travel sickness

I am currently at Geneva airport waiting for my flight to Gatwick.

I’m keeping my fingers crossed because on my two previous visits to Geneva last year my return flights were both delayed by two to three hours.

On each occasion EasyJet was the culprit and this time I was going to go with British Airways until I compared the prices - £160 with EasyJet, £500 with BA.

How ironic then that Alex Deane, who I bumped into in a pub in Geneva on Monday evening, should have had the following experience a few hours later, and all thanks to BA and its contracted airline Stobart Air.

Alex posted the full story on Facebook and I hope he won’t mind me reprinting it here:

Tonight, even boarding the flight from Geneva to London (9pm Geneva time, 8pm UK time) was delayed by over an hour; once on the plane we sat in it on the tarmac for another half an hour.

In that time, I learned that the lady in front of me dealt with her fear of flying by vomiting copiously into a series of paper bags. She was both tidy and extraordinarily productive in this regard. The smell was overpowering. The flight was overheated. The little blower thingies overhead didn’t work.

This was whilst we were still on the ground. Only once we were belatedly airborne, 90 minutes late for a 90 minute flight, was it revealed that there was no alcohol onboard.

The significant delay in departing meant that the pilot and crew knew we wouldn’t possibly make it to London City before it closed (at 10pm UK time), but they still kept up the charade that we’d make it and didn’t say we’d been diverted until just before we landed - at London Southend.

It was announced that we weren’t to worry; there would be transport outside the terminal for us to go into town. Then it was announced that there wouldn’t be transport for us, but that we should get the train into town and claim the cost back. The last train, it was announced, would leave at 11.15pm.

We got off the aircraft at 10.50 and entered a customs queue to end all customs queues. To say that there was no chance of getting a train is to state the obvious. To say that the tempers in this absurd queue were short is generous. But it moved at a better than expected pace and no fights broke out. Not to spoil things but this good old hardy spirit of the Brits no matter how late it is and how much vomit we’ve smelt is the highlight moment of the account.

So thereafter, in hope of a cab, I queued again, this time in the dark outside Southend airport at some time after 11.30pm, two hours after I was supposed to be home, waiting on a process which seemed wholly dependent on, controlled by, and significantly slowed down due to, a maniacal high vis vest wearing clipboard wielder who, when I ultimately had my audience with him, insisted on me taking a big taxi and the family of four with a pushchair in front of me getting into a diddy one because that was the order in which we had presented ourselves. There was no arguing with him and that’s how it was.

And so, for the merest fixed price of £140, I find myself rattling towards home in a cab-cum-removals van as it nears midnight. Home is yet some way off.

Compared to that tale of woe a two or three hour wait is nothing to complain about. Indeed, in terms of flight delays and the knock-on effect, I’ve lived a fairly charmed life.

I do remember a six-hour delay at Bologna in 2015 which was annoying because the Ryanair flight was due to leave at 6.30am and we’d arrived at the airport two hours in advance.

I recall too an eight-hour delay caused by a combination of snow and ice at Heathrow. My flight to Glasgow was due to take off at 2.30pm but we didn’t board until 8.30 because of the weather and a backlog of aircraft waiting to take off.

Even then we sat on the plane for the best part of two hours while ground staff ‘de-iced’ it, a practice that seemed to involve a man with a broom vigorously brushing the top of each wing.

I’m a nervous flyer at the best of times so that didn’t help but having waited that long I was grateful simply to take off.

The most frustrating delay I’ve experienced took place in Toronto. I was flying to New York and checked in, as always, in good time.

Thereafter we waited, and waited, until eventually we were told that the scheduled flight was cancelled and we would have to transfer to a later flight.

The problem was, every item of luggage that had been checked in had to be sought out and reclaimed and we had to go through the whole process - including security checks - all over again.

Hours later we boarded our new flight and noticed the aircraft seemed a little hot and stuffy. Having taken our seats we were then told there was a fault with the plane and we would all have to get off.

This time we were told our luggage would be sent on to New York on the next available flight - not necessarily the one we would be flying on - and we could pick it up there, should we ever arrive.

Eventually, some eight hours after we arrived at the airport, we bid farewell to Toronto by which time I was regretting not going by train, a slow and laborious journey of eleven hours that nevertheless had the virtue of being punctual. (Thankfully our luggage was indeed waiting for us when we arrived.)

As for fellow passengers vomiting, I’ve been spared that horror - while flying, at least. One day I may write about my experience on the Scrabster-Stromness ferry that connects Scotland with the Orkney Islands. That was a truly stomach-turning experience.

But now, I’ve got a flight to catch.

PS. My daughter, who was with me in Bologna, has reminded me of the far worse delay she endured when flying home from New Orleans for Christmas 2017.

Booked on Norwegian Airlines for the second leg of her journey, a two-hour layover in Boston became a two-day ordeal that included an overnight stay and a lot of waiting. At one point we thought she might not make it back for Christmas at all.

By coincidence she is flying to New Orleans tomorrow for Mardi Gras 2019 which is on Tuesday (March 5).

I wish I was going!


Planes, trains or automobiles

Last year I commented on the state of the rail service between Peterborough and London.

Noting that it had been largely trouble free for the 19 years I had been using it, I wrote:

The current operator is Govia Thameslink Railway which runs the Thameslink, Southern and Great Northern (TSGN) rail franchise.

A few weeks ago the company introduced a new timetable and to say the service has gone downhill is an understatement. Delays and cancellations on what was previously an excellent service are now commonplace.

An interim timetable is due to be introduced in a couple of weeks while they sort out the mess but my question is: 'Why can't they revert to the old timetable which worked so well?'

Fair’s fair and I can now report that everything has settled down and the new timetable appears to be working as well as the old one - which is to say, very well indeed.

The notable difference between old and new is that during the week most trains from Peterborough no longer finish their journey at Kings Cross. Instead they stop briefly at St Pancras International before continuing their journey to Horsham in Sussex.

For those who don’t know, St Pancras is just across the road from Kings Cross so the change makes very little difference. It does however make things a lot easier if you want to travel to several destinations in south London and beyond.

A significant advantage is that one of the stations en route to Horsham is Gatwick so I can now travel direct from Huntingdon - the nearest station to where I live - to the airport.

The journey time - two hours - is the same as by car but it avoids the unpredictability of the traffic on the M25 that can add an hour, and countless grey hairs, to that time.

Anyway, I’m flying to Geneva today and with options to fly from Heathrow, Luton or Gatwick I chose Gatwick. Watch this space.

Update: The journey from Huntingdon to Gatwick via St Pancras was exactly two hours.

Better still, as it crossed London the extended route went via Farringdon, City Thameslink (close to Holborn and St Paul’s Cathedral), Blackfriars (ideal for the South Bank and Festival Hall), and London Bridge.

If you’re unfamiliar with London you won’t appreciate how good this is in terms of getting around the capital when you live in Cambridgeshire.

Hats off then to Govia Thameslink. Whatever Southern and Northern Rail commuters might say, I think you’re doing a great job!

Not such good news about Gatwick, I’m afraid.

Until the look and feel of the existing terminals are improved I can’t for the life of me understand how anyone can take seriously its long-running and hugely expensive campaign for an additional runway - unless, that is, a significant rebuilding job is part of the project.

Sort it, Gatwick! (Rant over.)


Clive Turner and me

I’ve just received a lovely email from Clive Turner.

Clive who?

According to a profile published in PR Week in 1996 shortly before his retirement:

Turner, 64, has been in the tobacco industry since 1962 when he became deputy PR manager for WD & HO Wills. Other than an 11-year stint as Texaco public affairs chief, he has been with tobacco ever since.

As well as fronting the UK industry he also carried the torch abroad, setting up international PR divisions for tobacco company Carreras Overseas and working as MD of the Hong Kong-based Asian Tobacco Council.

I first met Clive in 1989, long before I worked for Forest. I was director of the Media Monitoring Unit which monitored TV current affairs programmes for political bias and I decided to set up a side project called the Centre for Media Research and Analysis.

Clive was working for the Tobacco Advisory Council (later renamed the Tobacco Manufacturers’ Association) and was frequently on television and radio. I contacted him with the idea of writing a report about media coverage of the smoking debate.

In those pre-internet days press cuttings were delivered every morning to PR companies, NGOs and bodies like the TAC where they helped inform executives of relevant news stories and were filed for future reference.

Clive gave me access to the TAC's library of cuttings and for several weeks I worked from a small room at their office in Stag Place, Victoria, drowning slowly in a sea of paper.

Aside from popping in every day to say hello, Clive never once tried to influence me or comment on the progress of the report which was just as well because I found the process far more difficult than analysing a television current affairs programme.

‘Smoked Out' was published several months later and we've stayed in touch – intermittently – ever since despite the fact that he’s spent the last two decades in Cyprus where he moved with his wife Diane following his retirement.

Now in his eighties he writes a regular ‘Expat View’ column for the Cyprus Mail, the local English language newspaper.

One article, published in August 2017, will sound familiar to anyone who witnessed Clive’s media appearances all those years ago:

Undoubtedly there have been tens of thousands of people around the world who have been victims of tobacco, but then there are also huge numbers of even very heavy lifetime smokers who have suffered absolutely nothing at all.

This inexplicable fact infuriates the quite rabid anti-smoking brigade such as the UK’s Action On Smoking and Health – ASH – whose neurotic and extreme swivel-eyed health fascism has been a feature of the anti-smoking culture for many years.

Here in Cyprus we have one of the highest smoking incidence figures in Europe, yet one of its lowest lung cancer statistics. Nobody knows why this is. But again, it infuriates the anti-smoking activists.

“We do not attack smokers or condemn smoking,” says ASH on its website, which has to be one of the most explicit pieces of double-think imaginable.

As for those media appearances, he wrote:

I must have done hundreds of always hostile live and recorded radio, television and print media interviews. Following these, I could expect unspeakable and anonymous messages, not excluding death threats. You name them, I got them.

I can remember one interview out of town which involved the then ASH director who refused to share a cab with me back into central London “on principle”.

And on another occasion, I shared a live interview with the author of the excellent book The Easy Way To Stop Smoking. The author, Allen Carr, who later died of lung cancer, described me in the studio as “a slug, someone who should be stepped on and disposed of” – at which the interviewer invited me to respond.  

I said to Allen Carr that his book had sold millions and made him extremely wealthy, but it probably wasn’t the prime reason why smokers quit when the cost of their habit was unquestionably the deciding factor.

I added that rather than get further worked up and red faced, he might be better off having a cigarette and a lie down – which brought loud and prolonged laughter from the studio audience.

See: Smoking debate more complicated than you think (Cyprus Mail).

I was hoping he might be able to attend Forest's 40th anniversary dinner in June but he rarely visits the UK these days so we’re unlikely to see him.

Nevertheless it’s good to know he’s in fine spirits and as combative as ever!

See also ‘From the archive: Clive Turner’s Big Breakfast’.


Geoff Norcott is Taking Liberties

Conservative-leaning comedian Geoff Norcott has a new show.

It's called 'Taking Liberties'.

Tour dates will be announced next Friday.

For 48 hours' advance notice, including priority booking, register here.

Meanwhile the first episode of his new podcast, What Most People Think, is available now via iTunes.

Click here.

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