A letter in Scotland on Sunday accurately describes the smoking ban imposed at Scottish psychiatric hospitals as inhumane.
In 2009 the Scottish Government issued a consultation on the issue of smoking bans in mental health facilities. Freedom to Choose (Scotland) challenged the consultation because of signficant misleading information in the text, and and a clear bias in the line of questioning. Following the consultation, the Scottish Government did not legislate to remove the smoking ban exemption for psychiatric facilities, but made it clear that NHS trusts could remove smoking rooms on the sites of their psychiatric units. See this story for background.
Correspondent George McGregor points out the very long time that patients are confined to psychiatric institutions, and the extremely distressing environment generally found in them. He concludes: 'What happened to the ethos of a caring NHS? Smoking lounges should be reinstated on humanitarian grounds alone.' I agree: the provision of smoking rooms in places where people are confined for treatment should be a legal requirement, on health and safety grounds if nothing else.
Sunday, 30 December 2012
Saturday, 29 December 2012
Nicotine, the zombie antidote, by Dr Gabriela Segura
An informed view of nicotine consumption and smoking from a professional, this piece compares smoking as a health hazard with other environmental pollutants, including those found in foods. Dr Segura refers to this video, which plots over 2,000 nuclear tests that have taken place worldwide since 1945.
This, of course, is only the tip of the iceberg as far as environmental pollution is concerned, as it does not record heavy industry emissions or any other kind of pollution, but only the nuclear tests. The point being made is that the emissions from tobacco smoke, and even the risks of primary smoking, are really without significance in the face of all the other environmental hazards that people face daily.
In 2000, George Monbiot addressed pollution and its link with cancer in his book Captive State. He describes how the research agenda has been led away from investigating links between corporate industry, pollution and morbidity:
Dr Segura's piece also claims:
You can enjoy this article for yourself. It sets out the view that smoking should not be used as a scapegoat for modern health problems: not only does it have benefits, but the hazardous ingredients in mass-market tobacco are found in consumer items everywhere.
This, of course, is only the tip of the iceberg as far as environmental pollution is concerned, as it does not record heavy industry emissions or any other kind of pollution, but only the nuclear tests. The point being made is that the emissions from tobacco smoke, and even the risks of primary smoking, are really without significance in the face of all the other environmental hazards that people face daily.
In 2000, George Monbiot addressed pollution and its link with cancer in his book Captive State. He describes how the research agenda has been led away from investigating links between corporate industry, pollution and morbidity:
As big business infiltrates the research agenda, ever wider zones of public enquiry are placed off limits. In 1999, the government published a White Paper on public health called Saving Lives: Our Healthier Nation. The only atmospheric pollution named in the report is radon. It also happens to be one of the only pollutants in Britain which does not result from the activities of large corporations: it is naturally occurring. The report warns us about the dangers of cancer resulting from 'exposure to radon gas in certain homes or excessive sunlight', but nuclear power stations are not mentioned, and nor are any other chemicals, even though the paper concedes that 'Pollutants in the atmosphere may cause cancer if inhaled or swallowed'. The language in which this warning is given is interesting: it creates the impression that breathing or ingesting pollution is something we can avoid. The paper informs us that the government hosted 'the largest ever Ministerial conference on environment and health in 1999. It fails to tell us that the links between cancer and industrial pollution were dropped from the agenda soon after the meeting began. [link added]Except in the case of tobacco, universities are usually happy to accept corporate funding for research purposes. In the case of tobacco, but in no other case, universities are expected to refuse it on the grounds that it is 'not disinterested', but how can corporate funding ever be disinterested?
Dr Segura's piece also claims:
Outdoor air contains some of the nastiest cocktails of pollutants. Most people tend to think of air pollution as having effects on the lungs, but exposure to road traffic and air pollution may also trigger heart attacks6. But people are right: air pollution does cause lung cancer. A much-anticipated government study of more than 12,000 miners has found that exposure to diesel engine exhaust significantly increases the risk of lung cancer. For NON-smokers, the risk was seven times higher. The authors of the study say "we also observed an interaction between smoking and 15-year lagged cumulative REC [marker for estimation of diesel exhaust exposure] such that the effect of each of these exposures was attenuated in the presence of high levels of the other.7" What does that mean? It means that research suggests that people who smoke are less vulnerable to the toxic effects of inhalation of diesel fumes than people who don't smoke. [Emphasis in original]Says Dr Segura: 'You have no idea how many times we have found again and again the protective properties of tobacco smoking.' She gives more examples.
You can enjoy this article for yourself. It sets out the view that smoking should not be used as a scapegoat for modern health problems: not only does it have benefits, but the hazardous ingredients in mass-market tobacco are found in consumer items everywhere.
Yes, tobacco has its pollutants, but they are found in the water we drink, the air we breathe, in baby food, you name it, in even higher concentrations. A conservative estimate is that over 80,000 new chemicals have been introduced into society since the 1800s, only a few hundred of which have been tested for safety; this doesn't even take into consideration nanotechnology and GMOs, which are already pervasive in the food chain. According to the U.S. Environmental Protection Agency, about 2.5 billion pounds of toxic chemicals are released annually by large industrial facilities. And the authorities are worried about a plant that produces the learning and memory-enhancing, natural chemical nicotine? It really is laughable. You see what mainstreamAs a lay person it always astonishes me that studies are done to determine that tobacco makes people ill, without taking any trouble to exclude other forms of pollution beyond the crudest use of non-smokers as a comparison. Surely any honest attempt to discover why people get sick should take all factors into consideration without prejudice, rather than by accepting funding that is dedicated to show that tobacco is responsible for most modern ailments.educationindoctrination does to your brain? You breathe thousands of chemicals every time you inhale air, whether you like it or not, and whether or not you are sitting next to a smoker.
Wednesday, 5 December 2012
Health Minister's written answers on smoking in hospitals
SOURCE
Written answers on hospital smoke-free policies
Richard Simpson (Mid Scotland and Fife) (Scottish Labour): To ask the Scottish Government what steps it has taken in the last three years to ensure that there is no smoking in the grounds of all hospitals other than psychiatric hospitals. (S4W-11310)
Michael Matheson: Smoking is prohibited by law only in wholly or substantially enclosed public places. Areas in the open air, such as hospital grounds and car parks, are not covered by this legislation. The Scottish Government issued guidance on smoking policies for the NHS, local authorities, and care providers in December 2005 to support the implementation of the smoking ban.
This encouraged NHS boards and other service providers, to demonstrate leadership in implementing smoking policies and promoting smoke-free lifestyles. It also highlighted the benefits of going further than the strict parameters of the law and working towards completely smoke-free policies to maximise health gain. This was subsequently reinforced in the chief executive letter Health Promoting Health Service: HPHS CEL (01) 2012.
While the decision to move to smoke-free hospital grounds is currently a matter for individual boards to determine the Scottish Government is currently developing a new tobacco control strategy, which we intend to publish early next year, and we will consider smoking within NHS grounds as part of that work.
Richard Simpson (Mid Scotland and Fife) (Scottish Labour): To ask the Scottish Government what steps it has taken in the last three years to introduce a ban on smoking in psychiatric hospitals. (S4W-11311)
Michael Matheson: Smoking has been banned in public places in Scotland since 2006 by virtue of the Smoking, Health and Social Care (Scotland) Act 2005. However, the law includes an exemption for residential mental health institutions and permits smoking in designated indoor rooms in such settings. During 2009 the Scottish Government consulted with stakeholders, service users and the public on the best way to achieve smoke-free mental health services in Scotland. The smoke-free mental health services in Scotland implementation guidance was issued by NHS Health Scotland on behalf of the Scottish Government in March 2011.
The guidance clearly articulates the benefits behind the drive for a change to smoke-free and the expectation that NHS boards will implement smoke-free policies in mental health services at a pace which suits the services’ particular needs and circumstances. For example, with the support of the guidance, the state hospital, Carstairs has managed a successful transition to its current smoke-free status.
The Scottish Government is committed to developing a new tobacco control strategy for publication early next year. As part of that work we will consider whether there is a need to review progress in this area.
Written answers on second-hand smoke exposure in prisons
Richard Simpson (Mid Scotland and Fife) (Scottish Labour): To ask the Scottish Government what steps it has taken since 2006 to ensure that non-smoking prisoners are not exposed to second-hand smoke in (a) their cells, (b) communal areas and (c) workshops. (S4W-11312)
Kenny MacAskill: I have asked Colin McConnell, chief executive of the Scottish prison service, to respond. His response is as follows:
“Since 26 March 2006 prisoners have not been permitted to smoke in communal areas and workshops within Scottish prison service establishments. Prisoners are allowed to smoke in cells as long as the governor has not designated the cell as a non-smoking cell in accordance with the prison rules. On admission to custody and when moving cells prisoners are asked for their smoking preference to minimise, wherever practicable non-smokers sharing cells with smokers.”
Richard Simpson (Mid Scotland and Fife) (Scottish Labour): To ask the Scottish Government how many complaints the Scottish prison service has received from prisoners regarding passive smoking since 2006.(S4W-11313)
Kenny MacAskill: I have asked Colin McConnell, chief executive of the Scottish prison service, to respond. His response is as follows: “The Scottish prison service does not centrally classify or record complaints specifically regarding passive smoking.”
You have to admire their priorities.
Written answers on hospital smoke-free policies
Richard Simpson (Mid Scotland and Fife) (Scottish Labour): To ask the Scottish Government what steps it has taken in the last three years to ensure that there is no smoking in the grounds of all hospitals other than psychiatric hospitals. (S4W-11310)
Michael Matheson: Smoking is prohibited by law only in wholly or substantially enclosed public places. Areas in the open air, such as hospital grounds and car parks, are not covered by this legislation. The Scottish Government issued guidance on smoking policies for the NHS, local authorities, and care providers in December 2005 to support the implementation of the smoking ban.
This encouraged NHS boards and other service providers, to demonstrate leadership in implementing smoking policies and promoting smoke-free lifestyles. It also highlighted the benefits of going further than the strict parameters of the law and working towards completely smoke-free policies to maximise health gain. This was subsequently reinforced in the chief executive letter Health Promoting Health Service: HPHS CEL (01) 2012.
While the decision to move to smoke-free hospital grounds is currently a matter for individual boards to determine the Scottish Government is currently developing a new tobacco control strategy, which we intend to publish early next year, and we will consider smoking within NHS grounds as part of that work.
Richard Simpson (Mid Scotland and Fife) (Scottish Labour): To ask the Scottish Government what steps it has taken in the last three years to introduce a ban on smoking in psychiatric hospitals. (S4W-11311)
Michael Matheson: Smoking has been banned in public places in Scotland since 2006 by virtue of the Smoking, Health and Social Care (Scotland) Act 2005. However, the law includes an exemption for residential mental health institutions and permits smoking in designated indoor rooms in such settings. During 2009 the Scottish Government consulted with stakeholders, service users and the public on the best way to achieve smoke-free mental health services in Scotland. The smoke-free mental health services in Scotland implementation guidance was issued by NHS Health Scotland on behalf of the Scottish Government in March 2011.
The guidance clearly articulates the benefits behind the drive for a change to smoke-free and the expectation that NHS boards will implement smoke-free policies in mental health services at a pace which suits the services’ particular needs and circumstances. For example, with the support of the guidance, the state hospital, Carstairs has managed a successful transition to its current smoke-free status.
The Scottish Government is committed to developing a new tobacco control strategy for publication early next year. As part of that work we will consider whether there is a need to review progress in this area.
Written answers on second-hand smoke exposure in prisons
Richard Simpson (Mid Scotland and Fife) (Scottish Labour): To ask the Scottish Government what steps it has taken since 2006 to ensure that non-smoking prisoners are not exposed to second-hand smoke in (a) their cells, (b) communal areas and (c) workshops. (S4W-11312)
Kenny MacAskill: I have asked Colin McConnell, chief executive of the Scottish prison service, to respond. His response is as follows:
“Since 26 March 2006 prisoners have not been permitted to smoke in communal areas and workshops within Scottish prison service establishments. Prisoners are allowed to smoke in cells as long as the governor has not designated the cell as a non-smoking cell in accordance with the prison rules. On admission to custody and when moving cells prisoners are asked for their smoking preference to minimise, wherever practicable non-smokers sharing cells with smokers.”
Richard Simpson (Mid Scotland and Fife) (Scottish Labour): To ask the Scottish Government how many complaints the Scottish prison service has received from prisoners regarding passive smoking since 2006.(S4W-11313)
Kenny MacAskill: I have asked Colin McConnell, chief executive of the Scottish prison service, to respond. His response is as follows: “The Scottish prison service does not centrally classify or record complaints specifically regarding passive smoking.”
You have to admire their priorities.
Saturday, 1 December 2012
Repeat after me: Glas-goals are working
Glasgow's Evening Times applauds Glas-goals, the city's smoking cessation project (a joint initiative of the local NHS health trust and the Evening Times) for its success in driving down smoking rates. Published two days ago, it declares that smoking rates and lung cancer rates are both down (it should have only seven paragraphs in it but at present it has fourteen: someone in the editorial department failed to notice that it has been replicated). An accompanying news report says that the Glas-goals campaign achieved double its expected quit rate.
I don't want to knock anyone's sincere efforts to give up smoking if that is what they want to do. But in the light of previous reports on smoking cessation, it is hard to escape the conclusion that the twelve thousand-plus smokers who have succeeded in quitting their habit are counted as quitters after just four weeks, because that is the common measure. The real test is after the quit programme is over and life has resumed its normal rhythm.
It is clear from the graph to the right of this blog that smoking rates in Scotland have not changed appreciably in the last 12 years. What is less well known is that against this largely unvarying decline in the smoking rate, expenditure on tobacco control as a whole has rocketed from £1.45 million in 1999 to £21.8 million in 2011, according to figures obtained from the Scottish Government in a Freedom of Information request (they even added up the totals for us!) At a bare minimum we can be sure that money distributed through health boards specifically for smoking cessation increased from £1 million in 1999 to £11.08 million in 2011. We also know that lottery money has been spent on tobacco control (the Refresh project) and that Cancer Research UK has funded tobacco control studies in Scotland. So the fifteen-fold increase in government expenditure on tobacco control, supplemented by other funding, has barely made a dint in the smoking rate.
Impressive, no?
P.S. I look forward to observing whether this additional exposure will prompt somebody from the Evening Times to read this story again and realise that they have printed it twice.
I don't want to knock anyone's sincere efforts to give up smoking if that is what they want to do. But in the light of previous reports on smoking cessation, it is hard to escape the conclusion that the twelve thousand-plus smokers who have succeeded in quitting their habit are counted as quitters after just four weeks, because that is the common measure. The real test is after the quit programme is over and life has resumed its normal rhythm.
It is clear from the graph to the right of this blog that smoking rates in Scotland have not changed appreciably in the last 12 years. What is less well known is that against this largely unvarying decline in the smoking rate, expenditure on tobacco control as a whole has rocketed from £1.45 million in 1999 to £21.8 million in 2011, according to figures obtained from the Scottish Government in a Freedom of Information request (they even added up the totals for us!) At a bare minimum we can be sure that money distributed through health boards specifically for smoking cessation increased from £1 million in 1999 to £11.08 million in 2011. We also know that lottery money has been spent on tobacco control (the Refresh project) and that Cancer Research UK has funded tobacco control studies in Scotland. So the fifteen-fold increase in government expenditure on tobacco control, supplemented by other funding, has barely made a dint in the smoking rate.
Impressive, no?
P.S. I look forward to observing whether this additional exposure will prompt somebody from the Evening Times to read this story again and realise that they have printed it twice.
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