In 2015, we wrote about how the NHS as a body was appearing to be ignoring sound advice in failing to cater for vaping. We asked: “what is it that prevents the NHS from adopting evidence-based tobacco control programmes?”
The answer, we wondered, was whether or not the financial incentives being offered by pharmaceutical companies to doctors might be playing a part. News broke that sweeteners worth up to £15,000 were being handed out to medical professionals (just for a doctor to attend a meeting), in a “perks for NHS orders’ exposé”.
While vaping offered a healthier solution to using nicotine, and was being touted by experts as holding at least a 95% reduction in harm potential, most Trusts were giving out highly cautious or negative advice like Southern Health.
It took Scotland to lead the way, as the year came to a close. “Hospitals should encourage the use of free e-cigarettes on hospital grounds to improve the health of patients and the wider public,” said David Shaw at the announcement that all bar one Scottish health board were going to implement a total vape ban. “Permitting e-cigarette use on hospital grounds would provide much more positive role modeling for children than seeing pregnant women and patients with cancer smoking conventional cigarettes in sub-zero temperatures at the main entrance to hospitals.”
This single Trust stated: “This review of evidence asserts that a harm reduction approach is the most appropriate strategy going forward. If e-cigarette use was permitted within hospital grounds, inpatients being supported by acute and mental health smokefree services could proactively support use of e-cigarettes as part of their quit attempts. Based on the emergence of new evidence, a review of the NHSGGC Smoke Free Policy position on e-cigarettes is timely and would improve consistency between the use of e-cigarettes within NHS grounds and the e-cig friendly approach being recommended for cessation services."
It would have been nice to think that all NHS Trusts could have got on board with evidenced decisions and harm reduction, now almost two and a half years later. Not so, unfortunately.
NTHFT is re-launching its smoke free agenda. Inpatients will be asked if they smoke, upon being admitted. Then they will be offered a range of NRT products and referral to a community stop smoking service.
But if they want to vape inside or outside any Trust property? Not a hope.
Rather than take a strong lead and make a decision for the public good, based on the sound and ample evidence available and the experiences of other forward-thinking Trusts, NTHFT are entrusting the decision to allow vaping in special shelters to the largely ignorant and misinformed general public.
Clare Henry, a NTHFT specialist alcohol and tobacco nurse adviser said, “We have started a questionnaire to find out both patient and staff opinions on smoke free hospital sites, including whether or not people support the idea of designated outdoor areas for people to use E-cigarettes.”
“Initial patient feedback comments say it is not tolerable to see people who are clearly unwell with drip stands and oxygen standing outside the main entrances and exits of a hospital. The impaired air quality when walking past a group of smokers can exacerbate existing respiratory issues for some patients, which is unacceptable.”
Maybe The North Tees and Hartlepool NHS Foundation Trust can get on board by 2021?