New rules designed to turn hospitals into completely smoke-free places are being openly flouted across Tayside and Fife, The Courier can reveal.
The move to achieve smoke-free status in the grounds of every hospital and health centre in Scotland is part of a national drive to create a tobacco-free generation by 2034.
But a Courier investigation has revealed that health boards are struggling to enforce measures, which were brought in earlier this month, designed to ensure the practice would be stubbed out entirely within hospital grounds.
Scores of patients, visitors and staffmembers have been spotted having a fly puff outside hospitals in recent days without being challenged.
And that has prompted suggestions that more must be done to tackle the issue, amid growing calls for laws governing the practice to be further tightened.
NHS Fife recently launched its A Place to Be Smoke-free campaign encouraging smokers to refrain from lighting up onhospital grounds.
Signs were set up across all hospital sites to remind smokers they are not permitted to light up on hospital premises across the region.
But with some people choosing just to ignore the messages, Edward Coyle, NHS Fife’s director of public health, conceded that bringing about the culture change needed to ensure fullysmoke-free hospitals is a challenge.
“NHS Fife sees every visit to our facilities as an opportunity to promote and improve people’s health,” he told The Courier.
“Our smoking policy states that smoking is not permitted at any time for staff, patients, visitors, contractors or the general public within NHS Fife premises or on our grounds.
“In recent weeks we have supported the national Green Curtain campaign, which seeks to raise awareness of the fact that NHS Scotland grounds are now smoke-free, and which was promoted nationally on TV, radio and in the press.
“In addition, NHS Fife also launched its own awareness-raising campaign to ensure that all patients and visitors are aware of our no-smoking policy before they arrive at any of our sites.
“Our A Place to be Smoke-free campaign, which launched on No Smoking Day, saw eye-catching new signage installed at all hospital sites across Fife, as well as on our vehicles and in bus shelters across thekingdom.
“The campaign was also promoted widely in the local press and on our social media channels.Furthermore, we employ a member of staff at the main entrance of our largesthospital, the Victoria Hospital, Kirkcaldy, specifically to further promote ourno-smoking message.
“The board is working hard to do what it can to change attitudes and reinforce the message that smoking on hospital grounds is unacceptable.
“We recognise that achieving such acultural change cannot be done overnight.However, the board is committed totaking every reasonable action to improve the environments for our patients, staff and visitors and we thank the public for theirsupport and cooperation as we work towards this end.”
Andrew Radley, consultant in public health pharmacy with NHS Tayside, said the health board has asked staff, patients and visitors to support its “strict” no smoking policy by refraining from smoking on NHS Tayside premises or grounds.
“In NHS Tayside there are severalmeasures in place to ensure our existing policy is followed which includes the use of clear signage around all sites informing patients, visitors and staff that NHS Tayside grounds are smoke-free areas and apre-recorded loud speaker message is played at Ninewells Hospital to reinforce this,” he added.
“As a health promoting organisation, NHS Tayside takes breach of the policy very seriously and regularly communicates reminders of the smoking policy to patients, staff and visitors through both internal and external communications.
“Staff and members of the public share the responsibility for adhering to the smoke-free ground policy at NHS Tayside.
“It aims to maintain a safe, healthy working environment and improve the health of the population of Tayside by providing smoke-free sites.
“NHS Tayside Smoke Free Services provides smokingcessation services and support to NHS staff, patients and members of the public, including the availability of Nicotine Replacement Therapy,stop smoking classes and drop-in sessions.”
The move towards smoke-free hospitals was pursued in a bid to cut down the number of smoking-related hospital admissions nationwide.
Across Scotland tobacco use is associated with around a quarter of all deaths and around 56,000 admissions every year.Move towards smoke-free nationAll hospital grounds in Scotland were supposed to be smoke-free from April 1, with patients, visitors and staff asked to leave the grounds before they light up.
Every NHS board was asked to sign up to the edict at the request of the ScottishGovernment, which is consulting on whether or not to make it a statutory offence to smoke in hospital grounds.
If the measure is included in theforthcoming Public Health Bill, ministers are said to be largely in favour of voting it through.
In the meantime, the Scottish Government hopes its drive will not only bring about smoke-free hospitals but will encourage smokers to stub out their habit altogether.
Maureen Watt, public health minister for Scotland, said on April 1: “Smoke-freehospital grounds have been an ambition of this government for a number of years and I’m pleased that this day has now arrived.
“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. “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.
“I’d appeal to all patients and visitors to respect the health of others and wait until you’ve left the grounds before lighting up.”NHS asked to ‘demonstrate leadership’A move towards smoke-free hospitals has been a central plank of the Scottish Government’s Tobacco Control Strategy entitled Creating a Tobacco-Free Generation.
Guidance was issued to NHS Scotland and local authorities in 2005 encouraging them to “demonstrate leadership” by implementing smoking policies and promoting smoke-free lifestyles.
In moving towards a Scotland where choosing not to smoke is the norm, NHS boards were urged to be “exemplars” in providing smoke-free environments, with employers told to provide training for staff, in awareness raising and enforcement skills, as well as appropriate cessation support for employees.
“NHS boards should also consider enforcement measures, exercising mandatory health and safety requirements where appropriate, and mechanisms to communicate smoke-free policies to patients and visitors,” the document added.
“This should include advice and support on managing temporary abstinence during visits to hospital grounds, as well as access to specialist smoking cessation services for those motivated to quit.”
The five-year plan said smoke-free status should be achieved by the end of March this year, and would mean the removal of any designated smoking areas in NHS board buildings or grounds.
Northern Ireland is set to follow suit by this time next year.Policy ‘has had little or no effect’A number of readers have complained to The Courier that their visits to hospital, either as patients or as relatives of those being treated inside, are regularly being spoiled by having to enter through a plume of smoke.
One of those was Bob Smart, from Arbroath, who believes smokers at Ninewells Hospital in particular should be targeted.
“Having attended Ninewells for treatment for over 10 years, I would say that the no smoking policy relating to hospital grounds has had little or no effect,” he said.
“At all entrances,particularly the main one, hardened smokers totally ignore the warnings.The sight of patients on drips and oxygen puffing away is disgusting.
“Taxi drivers and bus drivers use the drop off areas for a fly puff too.Even the monotonous audio warning falls on deaf ears.
“If the powers that be were as ruthless as the parking attendants, the grounds really would be a no smoking area.”
It is not a statutory offence to smoke in hospital grounds, although some health boards, such as NHS Greater Glasgow and Clyde, have introduced wardens to try to enforce the ScottishGovernment’s national Green Curtain campaign.