To be a bit unsure about the practicalities of smoke-free hospitals?

[Writerwannabe83]

I have just heard on the radio that a hospital has gone Smoke Free in the sense that neither staff or patients can smoke on hospital grounds. My initial thought was that it is a good thing but at the same time I did wonder if it was a bit unfair on the smokers?

I know it's ironic to see patients having a cigarette outside the hospital entrance and I know it's not ideal to have staff smelling of cigarettes but at the same time, smoking is an addiction and how realistic or helpful is it to make patients and staff go cold turkey?

If a nurse is working from 07.15-20.30pm then 13 hours without a cigarette may be a long time for some staff who are used to their cigarette breaks and could their craving affect their work if they feel stressed without a cigarette, I don't know?

Also, if a patient can't go outside for their usual cigarette break will having nicotine withdrawal symptoms for days on end really be beneficial to their recovery (assuming their admission isn't related to their smoking)?

Maybe I'm being naive but I just have my misgivings about it. I understand the public health reasons for doing it but I can't help but think there will be some negatives within this initiative.

I have visions of ill people not going to A&E when they perhaps need to because they would worry they would be admitted and not be able to smoke.....

And consider the patients detained in hospital under the MHA who are not even allowed off the hospital grounds to have a cigarette- ridiculous!

Yes milksmum at what is likely to be one of the most stressful times in their lives! Also I feel sorry for the poor staff who have to enforce this rule.

That's a bit facetious Surlycue, cigarettes aren't going impair a surgeon's judgment or fine motor skills in the way that alcohol would.

Ok, gambling (which i mentioned) or sex addiction, gaming addiction, porn? Should they be accommodated?

I have a very good reason to be so anti smoking. Smoking causes illness, early death and Cancer. Secondary inhilation of smoke is also dangerous. It should not be tolerated in hospitals for any reason whatsoever.

Vivienne we all know that. Stating the obvious much?

You obviously have the mind of a robot if you won't even acknowledge or empathise with why people may feel they need a cigarette.

YANBU. I am not anti-smoking but I get upset because I to walk through a cloud of smoke when I go to my local hospital. I am disabled, so walk slowly and I have a lung condition, so those 'few seconds' of smoke are very unpleasant. That said, the idea of smoke free hospital is a terrible idea. There needs to be dedicated smoking areas on hospital grounds. It needs to be away from the entrances but close enough for mobility impaired and ill people.

I'm a nurse and a smoker (yes I know, no lectures please.) However I don't smoke at work partly to limit my smoking and partly because I do think it's not particularly professional to advise patients against smoking when they can see me smoking and/or smell it on me. If it's that hard to go without, use NRT aids even if it's just during working hours.

I'm in mental health outpatients so not in a ward environment. However mental health is a complex area when it comes to smoking. 20+ years ago when I trained, one way of interacting with and calming down a patient was to say ''Come on John, lets go and have a fag together.'' The majority of patients with a long term mental health problem smoke but this coupled with unhealthy diets, lack of exercise and the fact that many antipsychotics lead to weight gain leads to many of our patients having high levels of cancer and cardio vascular and respiratory complaints and there's now a big NHS drive to tackle this with our client group.

When the smoking ban came in there were a lot of debates about how to police this on the wards, with concerns about increased aggression and increased fires (caused by secret smoking in bedroom areas.) My husband also works in mental health and there was a serious fire in his unit which was blamed indirectly on the smoking ban. There are still some mental health wards/units that have designated outside smoking areas. However, interestingly, Broadmoor brought in a smoking ban throughout the hospital and grounds. A recipe for disaster? Strangely, no. The patients just accepted it the same way as the public accepted the smoking ban in pubs. There has apparently been very little aggression or violence caused. I think many of the patients were offered free NRT. If long term, often disturbed mental health patients can manage it while they're in hospital, surely those who are only in for a few hours on a shift or a few days as a patient can, especially if NRT is routinely offered.

You are still being facetious, SurlyCue as well you know. I think the other things you mention fall into a different category because they are not physical addictions and but generally I'd say things which do not impair the ability of a person to do their job in a safe and professional way are the business of the individual and nothing to do with their employer. Viviennemary it's imposing your antismoking stance on other which I find objectionable, the risks of second hand smoke can be minimised by having outside areas where people can smoke so I don't think second hand smoke needs to be an issue.

generally I'd say things which do not impair the ability of a person to do their job in a safe and professional way are the business of the individual and nothing to do with their employer.

Indeed so there should be no obligation to the employer to facilitate them during work hours or on work property. Yes?

My hospital is smoke free but offers nicotine patches for free to staff and patients from the time it came in, as well as access to smoking cessation programmes for staff.

Treating staff like autonomous human beings who can make a choice about whether they want to have a smoke in their break is not 'facilitating' them, it's just not being deliberately awkward.

Our hospital has been totally smoke-free for about 5 years. I just looked up its official policy and was interested to see that it is even forbidden to smoke inside vehicles parked in the grounds. So visitors who smoke can't even go to their cars and have a smoke, with the windows shut. This applies equally to staff, volunteers, patients and visitors. As non-smokers, we're happy to know we won't be smelling or inhaling cigarette smoke. But I have wondered how heavy smokers manage. As far as I know there aren't any 'shelters' in the grounds for this. And as a volunteer in the WRVS hospital shop for some years, I know they don't sell any type of cigarettes or tobacco there.
As other posters have said, outside the old hospital building in Norwich many years ago, you'd see smokers attached to their drips standing outside in the rain wearing pyjamas and dressing gowns, puffing for dear life. Some looked terribly ill but they still needed a cigarette!

I really hate smoking. I have also worked in smoke free hospitals where it just doesn't work. Sensible smoking shelters would be better.

Patients still smoke on the grounds as realistically who is going to stop them? The nurses and doctors are inside the wards. The lsecurity guards mention it when they are new and keen but after a few replies along the lines "I don't give a shit I've got cancer" or bursting into tears because someone had just died etc the all seem to turn a blind eye.

I have a very good reason to have needed to smoke on hospital grounds Vivienne. I was able to be considerate enough to other people that it made no difference to anyone. You don't have a reason to be against other people smoking when it doesn't affect you. It is least likely to affect you if hospitals don't give people a choice over ignoring a sign or ignoring their overpowering craving to do something that they believe might make them feel slightly better.

I loathe people who smoke outside hospital doorways. It's so fucking inconsiderate. But I really don't see why a smoking shelter can't be placed some unobtrusive so smokers can have a cigarette without bothering anyone else, in the dry, with bins for their fag butts. Seems like it would benefit everyone.

My local MH trust has just gone smoke free, so some detained clients can no longer smoke at all since they're not allowed out.

While I can understand the reasoning behind being smoke free, if I had just been admitted to a mental health unit under stressful circumstances then taking away my choice to smoke or to quit would seem unfair. It wouldn't be my fault I was ill enough to require hospital but yet a choice which other people can make for themselves would have been taken from me (alongside a variety of other liberties) + at that point in time I could probably really use a cigarette.

My local hospital is allegedly smoke free but there are still clusters of people outside both entrances, both inpatients and others and nobody seems to bat an eyelid. There is one path that leads into the grounds from the street if on foot, all the staff congregate there so it's like walking through a fog of smoke. There is a smoking shelter a very short distance away but I have never seen anyone use it.

I can't for the life of me see why smokers have to stand, often in pjs etc. outside or in a 'shelter' to smoke. In the cold, the rain, biting winds, in winter? I'm a proponent of living with the inevitable; there are smokers, tho not as many these days. That's good. So give those that do back their smoking lounges.

Smell? There are air purifiers/extractor fans, lord knows what. We live in a technologically sophisticated society these days, not impossible to do.

I've visited someone who lived v. near the local crem and I can hand on heart say that I have never once caught a whiff of burning flesh/whatever, even when there's tell-tale smoke coming out of the chimney.

So...smoking in proper designated areas in hospital for patients and staff alike, and bring back smoking in pubs too. The rest of it, shopping malls, parks, whatever, fine. Smoke free.

Non-smoker, me, btw.

I don't think the idea of the entire grounds being non-smoking but I think sometimes it's probably deemed as the best thing. At my local hospital they have smoking shelters however, people just seem to think that they are there for poor weather, so smoke anyway. It's almost impossible to police these things I think.

Our local hospital went smoke free a few years back - it didn't work and people were just smoking outside all the entrances . A couple of years ago they decided to build a smoke shelter about 100yrd from the main entrance and in the main it is well used and you don't have to walk through clouds of smoke by the door . At least by having the shelter security feel they can tell smokers to go there if they catch them smoking elsewhere whereas when the total ban was in place nobody did anything about the smokers by the entrances.

Whilst I support smoking areas for patients and families, I think staff should refrain from smoking before or during a shift. When I was in labour I had a midwife that absolutely reeked of cigarette smoke, it was awful, and I had to tell her to get away from me as I kept wanting to throw up everytime she came near me.

I've had breast cancer and have never smoked, not even tried it, (whooping cough at the age of 13 made the thought of smoking totally repulsive to me).
I used to hate going for BC appointments & having to weave through the ranks of smokers crowded around the entrance.
I think that a smoking shelter in the grounds, away from the entrance is a sensible way round the problem.

I always wonder though how safe it is for patients to be outside smoking without any medical staff with them. Afterall, the patient is ill, what if they were to collapse or something. I appreciate that staff will risk assess patients and not allow anyone off the ward who could potentially be unsafe but even so, I still find it a bit strange that patients can be released in order to go for an unsupervised cigarette even if it is just outside the entrance.

I just don't know how this can continue though if all hospital grounds are now going to be smoke free as it's a good 10 minute walk for a healthy person to leave hospital grounds let alone a patient. And surely patients shouldn't be allowed to wander off that far without anyone medical with them??

I would rather hospitals have - and enforced - smoking shelters which were well away from entrances and paths from car parks etc than having to walk through the smokers to get into the hospital on a smoke free site.

Completly smoke free just isn't practical or enforceable. Much more sensible to have a set area where smokers can go

I still find it a bit strange that patients can be released in order to go for an unsupervised cigarette even if it is just outside the entrance
That's the thing though, they're patients not prisoners. If needs be an escort will be provided but in any other case staff can't stop them