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Last Updated: Thursday, 10 July, 2003, 23:11 GMT 00:11 UK
Row over smoke-free hospitals
Royal Victoria Hospital Belfast
The Royal Victoria Hospital has spent thousands on smoking rooms
A row has ignited over whether smokers should be allowed to light up in and around NHS hospitals.

A letter in this week's British Medical Journal (BMJ) suggests that banning smoking completely in hospitals is unethical.

Dr Stephen Head, a GP in Newark, said forcing people out of smoking rooms and onto the street was adding to the suffering of terminally-ill patients and their relatives.

His comments come just weeks after executives at one NHS trust came under fire for creating smoking rooms in their new 46m building.

They have approved four smoking rooms in the new Royal Victoria Hospital in Belfast at a cost of 390,000.


Dr Head backed the move. He suggested smoke free hospitals were unfair for patients.

"When patients have no prospect of benefit from smoking cessation and enforced abstention aggravates their existing distress, they are being managed unethically.

Hospitals should provide limited and controlled smoking facilities for patient
William McKee,
Royal Victoria Hospital, Belfast

"Their best interests as a patients are being subjugated to a broader policy that does them harm."

Dr Head said he had recently been asked to prescribe nicotine replacement therapy to a terminally-ill patient who was stuck in a smoke-free hospital.

He said another patient who was also terminally ill declined to be admitted to hospital, where they would have received round-the-clock nursing care and access to pain relief medicine, because he would have to give up "his one remaining pleasure".

"Both patients were dying of smoking related disease," Dr Head said.

"But making their last days more distressing than they would otherwise have been reflects an uncritical policy enforcement that adds a cruel and condescending twist to how doctors and health managers as much as the international tobacco industry are able to create smoking-related suffering."

William McKee, chief executive of the Royal Victoria Hospital, also wrote to the BMJ to defend his decision to create smoking-rooms in the new building.

"We aspire to achieve a smoke-free hospital but we also have to recognise that patients don't leave their cigarettes and matches at home," he said.

"For safety reasons, we are unwilling to insist that patients who wish to smoke should leave the hospital building.

"Neither do we want smoking to take place in uncontrolled areas, which will expose others to second-hand smoke and increase the risk of fire.

"We also recognise the distress of terminally ill patients and relatives who may be smokers.

"In these circumstances, acute hospitals should provide limited and controlled smoking facilities for patients."

Split views

Amanda Sandford of anti-smoking group ASH acknowledged that the issue was "a tricky one".

"Maybe there is an argument for existing hospitals to have smoking rooms but I think new hospitals should not make provision for smoking," she told BBC News Online.

"It is a backward step. New hospitals should be smoke free."

Simon Clark, director of the smokers' group Forest, said hospitals should provide smoking rooms.

"It is nonsense to ban smoking completely in hospitals," he told BBC News Online.

"It makes much more sense for hospitals to take a practical approach to this and to have designated smoking areas for patients and staff."

Smoking room plans criticised
16 Apr 03  |  Northern Ireland
Patients face total smoking ban
24 Oct 02  |  England

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