smoking

For the last 50 years it has been known that smoking is bad for your health. Whilst smoking rates have plummeted from over 70% of the adult population to under 20% today (and less than 10% in teenagers), some people continue to smoke.

This can variably be seen as odd strange or puzzling. Yet rightly or wrongly it is legal to smoke and people are allowed to do things, which are “bad for their health”. It is likely the case that most of those who smoke do so because they actually enjoy it. Again whether they should or should not is a moot point.

It is this obstinacy in the face of good advice, which rankles some of those in public health. As the rates of smoking have declined, the fervor in seeking to stamp out smoking has actually increased.

Some moves such as banning smoking in airplanes and restaurants are actually about creating a pleasant environment for non-smokers. Due to the nature of air circulation it is not possible to keep one’s smoke to oneself. Whilst these bans have been pushed on the back of the dangers of passive smoke, the reality is that the main benefit is comfort of others.

But as with everything, banning smoking in certain places does not stop smoking, it just moves it somewhere else. Hence the entrances to airports are often smoky. As are entrances to hospitals! At first glance this may seem odd. However it is not surprising at all.

The percentage of patients in a hospital who smoke will be higher than that in the total population. This reflects that smoking is a factor in diseases, which land you in hospital such as with heart attacks, cancer and lung diseases.

It would seem logical that being in hospital with a smoking related condition might prompt people to quit. Firstly it may be that they have been admitted for a different reason. But more importantly being in hospital is stressful. The best time to quit smoking is not when you are under stress. Again, rightly or wrongly, some people smoke as stress relief. Those who do, might, but are not necessarily about to “see the light”.

One hospital is seeking to work with its local council to extend smoking bans to the hospital surrounds. With smoking banned on hospital grounds, those who want to smoke are doing so on the footpath outside. The hospital involved is a women’s hospital so includes an obstetric unit.

And for the record smoking in pregnancy is wrong.

However being admitted to hospital is not necessarily going to get someone to quit if they are not wanting to. This is why they smoke outside. Banning smoking within say 50 metres of the hospital will not stop people smoking. It will transfer the smoke a bit further down the road.

The problem with these sorts of ideas is that it is more about making the proponents feel good and like they are doing something. This proposal is couched in terms of “protecting children” and “doing something in public health”.

In reality the children of smokers will be exposed to smoke at home or on visits. Those unrelated who wander by will have their comfort temporarily affected but will not have one minute shaved off their life expectancy.

Apparently patients are offered “medical help to beat their nicotine addiction”.

I doubt they are told that the best way to quit smoking is by just quitting rather than with medical intervention.

Similar bans have been proposed at psychiatric hospitals. The percentage of people with mental health problems who smoke is also way above the population average. If you have been admitted to a psych ward, I reckon stopping smoking is not going to be your top priority at that exact moment.

Zeal is not attractive even when the cause is a good one. People in hospitals should be encouraged to quit smoking and supported in doing so.

Those who are stressed about being in hospital may not feel it is the right time to add the additional stress of quitting. This is fair enough. Forcing them further down the road will not change this nor improve their health.

Can we apply just a little common sense, please?