CONSULTANTS have come out strongly in favour of a ban on smoking by patients, staff and visitors at all acute hospitals across the Mid-West, which is to come into force next month.
From June 1, Limerick Regional, St John’s, the Regional Maternity, Croom Orthopaedic and Ennis and Nenagh general hospitals will all be smoke-free zones with security expected to move smokers off hospital grounds as the HSE adopts what it says will be a “zero tolerance” approach.
Regional director of cancer services Prof Rajnish Gupta has welcomed the move but would prefer if those who flouted the ban were subjected to legal penalties.
“I am delighted and pleased to see it being introduced although I regret it has taken so long, particularly when we already know so much about the effect smoking has not only on smokers but also on those around them. There are 5,500 deaths related to smoking every year and this policy will help protect the health of patients, staff and visitors,” said Prof Gupta.
He pointed to research in the UK which showed over 11,000 people a year died as a result of passive smoking.
“When you extrapolate that, it is fair to say passive smoking accounts for around 1,000 deaths a year in this country and when you think of all the attention that is given to deaths on the road, which is around 200 a year, there’s a clear need to build awareness of the dangers of passive smoking.”
A spokesperson for the HSE has confirmed that exemptions will apply in a limited number of cases – but for patients only. Psychiatric patients will remain free to light up but others will be permitted to smoke only with the express permission of their consultant. At the Mid-Western Regional Hospital, patients will have to use a swipe card to use a new outdoor smoking area which can only be accessed between 8am and 10pm.
But Prof Gupta foresees no circumstances in which he would allow a cancer patient to smoke.
“I won’t be signing any exemption forms for anybody,” he said.
“I remember being asked in my interview as registrar once how I would manage patients with lung cancer where I knew the disease was related to lifestyle and, because they knew I was so anti-smoking, how I would deal with somebody who smoked who had another illness such as breast cancer or bowel that wasn’t directly related to smoking,” said Prof Gupta.
“And I often say to patients that, ethically, I’m not allowed to not treat them because they are smokers because I could be struck off the register. But I also tell them I would like to be able to say that if I had a free choice. And that makes them think.”
Consultant obstetrician Dr Gerry Burke anticipates “only a handful of cases a year where people would genuinely need an exemption”.
“Under normal circumstances, one would say absolutely not and doctors would not give exemptions. But medicine is a complex matter and there may occasionally be some compelling mental health issue or there may be some major stress factor where somebody has just got some bad very news,” said Dr Burke.
“The idea here is to change the culture just like there was a change when the (workplace) smoking ban came in. I don’t expect there will be major difficulties and that the majority of patients and visitors will comply with it.”
While Dr Burke anticipates the introduction of the ban at the Maternity Hospital will be relatively easy to implement, he acknowledged there could be “difficulties with some people at night in A&E”.
While the HSE will take disciplinary action against any staff found smoking on hospital grounds, they confirmed there was no legal penalty that could be imposed on patients and visitors who don’t adhere to the policy. But security staff would be “enforcing the ban by asking people to leave the hospital grounds”.
“That is one disappointing element of it,” said Prof Gupta, “by introducing the ban with no penalty, there is no incentive to obey it. But I’m glad to hear the HSE saying it will be enforced.”