I think we can all understand why it is not appropriate to allow smoking inside a regular hospital. I can just about remember the days when many wards had a ‘TV room’ at one end, in which smoking was permitted. The smell of cigarette smoke would permeate the ward and the surrounding corridors. Of course in those days no one really batted an eyelid but times have changed – non smokers, and especially those who may be sick and immobile, expect to be protected from breathing other people’s smoke, regardless of whether doing so is harmful or not.
More recently, many NHS trusts acting on NICE guidance have banned smoking entirely from the grounds, including the pulling down of smoking shelters. There is absolutely no evidence at all that second hand smoke outside is harmful to anyone, and so their reasoning seems to be that hospitals are healthcare establishments and as such must not do anything to encourage smoking and indeed, should do what they can to discourage it.
Let’s be clear here, no one goes to hospital out of choice. People are there because they are sick, or they are visiting a loved one who is sick. It can be an extremely stressful time for all concerned. Additionally, the vast majority of in-patients are not there even semi permanently – they’re there for no more than a few hours, days or weeks. Is that really the best time to try to force someone to give up smoking?
The NHS smoking bans are already resulting in people in pyjamas and dressing gowns standing outside hospitals holding drips. If the rules were enforceable this would see these people out by roadsides, cold and vulnerable and a long way from help if it were needed. What isn’t as visible are those people who will avoid treatment in hospital because of the bans and who may therefore be putting their health at further risk.
A far more pragmatic solution would be for the NHS to recognise that giving up smoking is not something which can be forced on people, and especially not at a time when they may have far greater things to worry about. Quitting smoking is a decision which people must come to themselves, and then help can be offered. It’s not as if smokers are unaware of the health risks of smoking. Smoking shelters placed appropriately within hospital grounds can offer people a safe place in which to smoke, whilst ensuring that smoke doesn’t enter the building via doorways or windows. Wallpaper them with NRT adverts if you must, at least you have a captive target audience.
The crux of the problem with the NHS ban is that it promotes the ideology of anti smoking above the comfort and safety of patients who smoke. Of course it is always better healthwise that someone gives up smoking as soon as possible – but the best way to help them do so is not to stigmatise them, or to place them in situations where their overall health and well being may be in danger. That is not what a caring health service does.