Hospitals bring in more staff to tackle smokers

Smokers outside the hospital. Picture: Toby Williams

These pictures reveal signs are being routinely ignored at the Edinburgh Royal Infirmary despite the crackdown by the Scottish government which declared all hospitals smoke-free from April 1.

It is not currently a statutory offence to smoke in hospital grounds, although some health boards, such as NHS Greater Glasgow and Clyde, have introduced wardens to enforce the ban – something NHS Lothian has refused to do.

With the rules being openly ignored, the health board has now pledged to bring in extra stop-smoking advisors to help people quit or to provide support while they are in hospital.

Professor Alison McCallum, director of public health and health policy at NHS Lothian, said: “We are grateful to the Evening News for highlighting this, enabling us to bring in additional support such as increasing the number of smoking cessation advisers and deploying in these areas over the coming days and weeks.

“We would ask all those who smoke to respect our policy and refrain from smoking on our grounds and are grateful to all those who have.”

The policy’s introduction will be “challenging”, she admitted, but she said it was important to change the attitudes of staff, patients and visitors towards smoking.

The health board has spent £600,000 cleaning up discarded cigarette butts at the ERI in recent years, and complaints have also been made about smoke wafting into wards from smokers standing near the hospital doors.

Prof McCallum said: “We are confident that people will understand that as a health organisation, it is right for us to remove smoking from our sites and that they will respect the health of others by following the new rules.

“We encourage staff, patients and visitors who would like to quit smoking to access help and support through our stop smoking service.”

However, calls have been made for a tougher approach to the ban as the “light-touch approach” is failing to force smokers to stub it out.

Alison Johnstone, Lothian Green MSP, said: “The ban on smoking at NHS hospitals hardly needs explained, it’s there for a reason and if the light-touch approach to enforcement isn’t working then NHS Lothian should consider the more direct approaches taken by other health boards.

“Anyone visiting a hospital, be it staff, patient or visitor, shouldn’t have to pass through a haze of cigarette smoke on their way inside.”

Enforcing the ban could put extra strain on stretched resources said Sheila Duffy, chief executive of health charity ASH Scotland, who said the new rules were about changing people’s attitudes towards smoking.

She said: “I think the policy is about trying to change the way we think about smoking.

“Cigarettes are often the very reason many of these patients are being treated in hospital and it is right the ban is in place.

“For the next generation we want to put cigarettes out of mind, out of sight and out of fashion.

“They have no place in a health establishment.”

NHS Lothian is the only health board which allows electronic cigarettes to be used in the grounds but not inside hospital buildings.

The move – which has been introduced as part of plan to create a tobacco-free generation by 2034 – also bans patients and staff from smoking in their cars on hospital property.

Ms Duffy said: “We want people to understand why the policy is there in the first place. At the moment, seeing smokers is a part of life but that is changing.

“It is not a habit that smokers want for their children.

“The aim is to put it out of fashion for the next generation and send a clear message that smoking is incompatible with health.”

NHS Lothian has been offering staff help to ditch cigarettes through their stop-smoking service, which provides support and subsidised products.

Employees or patients who do not wish to quit are being encouraged to use Nicotine Replacement Therapy –  including patches, gum and nasal sprays – to keep  their nicotine withdrawal symptoms under control while at work.

Scottish Conservative health spokesman Jackson Carlaw said: “It was always dubious how this would be policed and enforced.

“No-one wants to enter hospital through a plume of smoke.

“But at the same time, people are free to smoke and it’s surely not unreasonable for them to do so in secluded parts of the grounds.”

The Scottish government has consulted on making it a statutory offence to smoke in hospital grounds, as a possible measure to be included in the forthcoming Public Health Bill.

Public Health Minister Maureen Watt, who announced the bill earlier this month, said: “Hospitals are places where people go for rest, recuperation and recovery and it’s quite right that they should be smoke-free.

“I welcome all the hard work that has been put in by NHS boards around the country to lead by example and make this a reality.”

She added: “Tobacco remains the biggest cause of preventable death in Scotland, which is why we want to create a tobacco-free generation by 2034.

“Measures like smoke-free hospital grounds play their part in creating a culture change on tobacco, and discouraging people from taking up the habit in the first place.”

Trained help is on hand

NHS Lothian has a team of specially-trained smoking cessation advisers to help people kick the habit.

Smokers are four times more likely to quit with help from the NHS than by going it alone.

The staff are on hand across NHS Lothian to offer one-to-one guidance, as well as group sessions.

Advisers can also provide e-mail, text and telephone support to anyone who needs a morale boost.

They are not hired to pro-actively approach smokers but to provide support when smokers ask for it, according to an NHS Lothian spokesperson.

As well as advice, the staff can provide information on quitting aids like Nicotine Replacement Therapy (NRT), Zyban and Champix as well as free products which can be prescribed without needing to visit a GP.

Some staff members and patients may need NRT products to help them while they are working, whereas others can seek help to give up altogether.

NHS Lothian cessation advisers also provide specialist services for young people and expecting mothers.

Enforcing the ban

HOSPITALS are bringing in wardens, staff training sessions and blaring out loud tannoy messages to try to ensure all visitors abide by rules to keep their grounds smoke-free.

One of the only health boards to introduce enforcers is NHS Greater Glasgow and Clyde, who will have smoke-free wardens patrolling hospital grounds as well as giving advice on quitting.

Staff training sessions to advise managers how to approach smokers and give them guidance have been brought in by various health boards including NHS Ayrshire and Arran and NHS Dumfries and Galloway.

NHS Ayrshire and Arran has improved its signage to make the ban clear to all visitors along with NHS Fife and NHS Lanarkshire.

Extra smoking cessation advisers have been brought on site at NHS Grampian to dole out advice and support to smokers.

The smoking ban has been in place in all hospital grounds across NHS Tayside since 2006.

The health board has used wardens in the past but no longers needs to, according to a spokeswoman.

Some of NHS Tayside’s institut-ions, including Ninewells Hospital in Dundee, have tannoy messages played throughout the day reminding staff and visitors that it is forbidden to smoke on site.