Smoking liaison officer for NHS Tayside abused at work

I would not like to be in the shoes of anyone who is on the wrong end of abuse at work. But really, what is NHS Tayside doing, appointing somebody called a Smoking Liaison Officer to ensure that no one smokes on its sites in the face of reports that staff smoking on hospital sites is increasing?

Other hospitals have acknowledged that they can't prevent on-site smoking.

Workers who continue to smoke at work now risk committing the aggravated offence of being insolent to somebody who appears to have been appointed simply in order to ensure that they comply with a restriction on smoking in the open air, and to start disciplinary proceedings against any who refuse to do so.

Mr Marr added: ''Please note that the use of abusive language will not be tolerated, will be deemed as unacceptable behaviour, could be viewed as gross misconduct and will be addressed in accordance with the Dignity at Work Policy."

Where is any concern for the dignity of health care workers who like to smoke during the working day? Where were the unions when all this was being discussed? How does management get away with making such an inroad on terms and conditions of employment, imposed unilaterally?

All this could be avoided with the use of comfortable and well ventilated indoor smoking areas. But oh, no. We can't be seen to condone smoking. We prefer focus our resources on disciplining smokers.

Lebanese restauranteurs plan sit-in over smoking ban

Way to go!

Source of photograph (not that I can read the placards)

Lebanon ban, verdict unclear

Lebanon's ban in bars is fairly new, and has had mixed reactions.

Another article is written in a more defiant tone, entitled 'How will one get around the smoking ban?' It describes low-key protests. Tobacco smoking can be conducted outdoors as generally happens in Europe but a line seems to have been crossed with the banning of hookah.

The cigarette problem can be solved this way in Lebanon too, but what about the hookah (water pipe) which has become part and parcel of Arab culture despite its Persian roots? 

Does the government have the right to stop those who enjoy making bubbles in a bottle, listening to the sound they make, and savoring the taste in a glass-fronted cafe, whose titillating mixture of privacy and exposure would have kept Freud busy for years. 

How will the creative Lebanese people deal with this new reality? Will we witness a new legal innovation in the same vein as the “Murr extra floor”? [A twist in the law, introduced by ex-minister Michel Murr, which allowed people to add a floor to their buildings against regulations.]

There are several ideas and designs being discussed by hookah smokers on the internet. But they are still in the design stage. So, stay tuned and we will bring you the latest news on this hot topic. 

Certainly worth seeing how this develops. There is a clear sense that the Lebanese will find ways of doing what they want to do.

Unleaderlike

I won't say the editorial from the Scotsman (scroll down) on the Australian court decision was disappointing because these days it is hard to expect anything better from the media.

Does anyone really doubt that the way cigarettes are marketed – the packaging’s colour, texture, design and branding – are designed to add an attractive patina of glamour to the product? And does anyone really doubt that this glamour is part of smoking’s attraction, especially for the young and impressionable?

That is the way any packaging is designed.

If so, what possible justification can there be for allowing cigarettes to benefit from this? Advertising and sponsorship by the tobacco industry has already been severely curtailed for precisely this reason.

And tobacco has remained popular regardless, and the anti-smokers need to blame something beyond the fact that people have been smoking for millennia.

What rationale – beyond special pleading by vested interests or a woefully misplaced argument about freedom of expression – can there be for allowing this to continue? 

That we don't particularly want governments to exercise the authority to prevent people and businesses from using their branding because they perceive it to be unhelpful to their policy objectives. This is not 'woefully misplaced' concern. If government deprives anyone of assets, they should provide compensation. Brand packaging exists to protect both consumers and manufacturers from cheap imitations. Sometimes vested interests are good sources of insight.

 Smoking’s social acceptability has declined markedly over the past two decades. When the ban on smoking in public places was first introduced in Scotland, there were those who said it would never work. Does anyone now regret that historic step? Or the ban on cigarette vending machines (where many a young teenager obtained their first furtive pack)? Or any of the other curbs designed to protect public health?

You can just see the point here – anyone not agreeing with this programme can't love children and has probably got shares in tobacco companies.

This is a poor excuse for a leader article. Not even the pretence of an attempt at even-handedness.

Support for Pell from certain quarters (less from others)

Less than wholehearted support from this quarter.

Support from the great and the good in the Scottish Parliament:

*S4M-02252 Richard Simpson: Smoking Ban Reduces Premature Birth Rate— That the Parliament welcomes the report by the Centre for Population and Health Sciences suggesting that there has been a 10% reduction in the country’s premature birth rate; notes that the report has associated this with the introduction of Scotland’s ban on smoking in public places, which was introduced in 2006; understands that the study was based on data collected over 14 years from more than 700,000 women; notes that the report comes at the same time as information claiming that, since the successful introduction of the smoking ban in public places, there has also been a reduction in hospital admissions arising from acute heart attacks; looks forward to the implementation of the further tobacco control measures that the Parliament has passed to discourage smoking, and believes that significant inequalities remain in the distribution of those still smoking, which it believes to be a major public health challenge for Scotland.

Supported by: Hugh Henry*, Patricia Ferguson*, James Kelly*, Sarah Boyack*, Jackson Carlaw*, Jean Urquhart*, Helen Eadie*, Stewart Maxwell*, John Park*, Malcolm Chisholm*, Anne McTaggart*, Paul Martin*, David Torrance*, Patrick Harvie*, John Mason*

It is surely inaccurate to describe the difference between 55 and 65 premature births per thousand live births as 10 per cent. A decline from 65 to 55 births may have taken place in the period Pell examined but they don't support her case – partly because the drop is already under way before the ban is introduced. This represents a decline in the numbers affected by about one-tenth but Dr Simpson categorically states that the premature birth rate has declined by 10 per cent. (This of course might help to explain how Pell achieved her 17 per cent drop in heart attack admissions.)

Source

This piece from BBC Scotland in 2009 is also relevant because it states that the premature birth rate was increasing up to 2005: a change associated with a growing number of expectant mothers with diabetes. It does not deal with the post-2006 period. It also records the rates in the 1980s as around 54 per 1000, which means that the peak of 62/3 was not typical of the pre-smoking ban premature birth rate. In any case the variation between 54 and 62 per thousand is very small in percentage terms.

Bid for court hearing on smoking ban: Chris Carter appeal

Chris Carter has been fighting to bring the smoking ban before the courts for many years now. Last week he was denied a hearing before the Supreme Court. The story is here, and Pat Nurse has more.

Chris's case is complex and involved citing some powerful witnesses. The courts have denied him the opportunity to present it.

If you wish to assist him to minimise his impending gaol term, please go here. Fines and costs added up to £1,250. Cheques can be made payable to P & P Productions, and sent to P & P Productions at 37 Windley Road, Leicester LE2 6QX.

Stop press: the target has now been reached.

Eddie's interview, Leith FM, 2010

Eddie Douthwaite, until recently Chairman of Freedom to Choose (Scotland), gave the following interview to Leith FM nearly two years ago – when the skies were full of volcanic ash from Iceland. Eddie gave the interviewers some enlightening new angles on the smoking ban issue, and the switchboards lit up. Listen below.

                                      
   Click To Play
Eddie Douthwaite on Radio Leith FM

Eddie – the ferret – an exemplary interview and one we will build on. Thanks for all you've done.

No smoking at Carstairs

A smoking ban at The State Hospital, Carstairs, Scotland's unit for treating violent offenders, will be implemented from 1 December this year.

The issue was covered last year in the Daily Record. The two accounts present different estimates of the numbers currently smoking at Carstairs. Marcello Mega in the Record refers to the ruling in favour of the smoking ban by a two to one majority, against two prisoners who had challenged it on human rights grounds. The judge who dissented, Justice Keane, felt that Parliament had not agreed in principle that certain categories of people should be prevented from smoking entirely as a consequence of smoking bans, and that this was not an outcome intended by the legislation (quoted here).

The Record records concern about a violent reaction from prisoners. The Scotsman's treatment is much lower profile, no staff byline, and does not appear to have interviewed anyone in connection with the story. It states that the ban was imposed following a consultation (not even a wide consultation). This is not reassuring.

Liberal Vision revisited, again

This time, a discussion of the relevance of libertarianism to the smoking ban, for the benefit of people who think of themselves as libertarian but still believe that the issue is about dirty air caused by smoking ('The right to swing my fist ends where the other man’s nose begins'), rather than an invasion of personal autonomy, and the right of individuals and businesses to decide their own rules of engagement.

I haven't considered the issue of libertarianism enough to know whether I am a libertarian. But you don' t have to be a libertarian to realise that the only way the health authorities have got away with the smoking ban so far has been by convincing enough people that secondary smoke is a killer (even though there is no evidence to support the hypothesis that isn't distorted by compounding factors). And to convince people of something so unlikely, they must have been distorting the truth for some ulterior motive – which is not acceptable to me and many readers of blogs like this one. Government needs to be reliable, truthful and keep things in proportion. It fails on all counts with this legislation.

Pubs counter denormalisation

This is right. Reuben encourages the competition for best smoking area. (Although he has his reasons for not nominating any pubs.)

Pubs that have managed to carry on creating a hospitable environment for smokers are, in a certain sense, accomodating to the ban, but they are also resisting it. This is because the ban was not really about passive smoking but, rather about making smoking a more uncomfortable experience so as to push people into stopping.

Of course, the ban was about denormalisation, and furthering a script about secondary smoke that has spread round the world. This writer is right to appreciate any effort made to undermine this effort to demonise and marginalise smokers.

I can't really disagree with any of it:

One thing you will find these days is that politicians of all stripes will profess their desire to support pubs. Doing so is good politics. It’s a nod to British tradition, and to (understandable) nostalgia for a more communitarian epoch. But we are entitled to ask what kinds of pubs they wish to support. Judged by their policy, the political class seem to approve of pubs only insofar as they don’t let anyone smoke, don’t get too noisy and don’t encourage too much drinking. In other words, pubs transmogrified into beer serving starbucks outlets are what they are willing to support. And this is hardly the kind of environnent that will induce people to pay a premium over the prices in ASDA – and so its no surprise that for all the verbal publoving from our politicians, the industry is still in decline. If we want to save our pubs and clubs then we cannot simultaneously dragoon them into being part of the public health set up.

Here is a recent contribution to the pub debate from the Green Party in Scotland entitled Local pubs and small producers are the order of the day:

Politicians certainly like sounding tough on booze culture, but that doesn't offer the solution we need. Scotland does have a problem, but we think the solution lies in small businesses taking back some control. [... ] 

However, local pubs and craft brewers, whose interest lies in quality not quantity, have a great contribution to make to our communities, our economy and to a better relationship with alcohol. We don't need to let the multinationals and the big chains keep the upper hand. It's time to celebrate the alcohol culture we should have, and return the industry to a healthy state. 

We should be keeping the pub economy rooted in communities [...]

 All this stuff about community and local control is all very well, but doesn't allow publicans any control over their own smoking policy. Because smoking, say the Greens, isn't normal. I prefer Reuben's view.

Scottish Champix widow sues Pfizer

Champix was approved for use by the Scottish Medicines Consortium in January 2007. By 2008 BBC Scotland was reporting alleged bizarre, threatening and suicidal behaviour on the part of people who took the drug, and lawsuits were beginning in the US.

Brian McLinden died just over a year ago and it's been reported that his wife Patricia will also sue Pfizer.

It's odd that stories of sudden and traumatic death, and distressing behaviour, are considered to be a price worth paying for a lower smoking rate.

It didn't take public pressure to get rid of smoking in bars. It took a government-funded pressure group. But years of documented agony (and a non-too-impressive success rate) requires hundreds of people to take legal action before this drug is properly investigated and taken off the prescription lists. People stopped smoking before this drug came on the market and they will continue to give up after it's been dumped.

One rule for them ...

'Gentleman’s agreement' polices leaders’ smoking. Most citizens don't have the option of making gentlemen's agreements. Agreements, negotiation. Discussing how it will be.

They/we are simply told how it will be. No negotiation, no participation. No flexibility.

Just leave the room if you want a cigarette and you won't even be thanked for it because you're just following orders. And you will be punished if you offend the law.

I don't know a huge amount about the law, but I understood that everyone was meant to be equal before the law. If it affronts the dignity of rulers to be subject to a law, then it affronts everyone's dignity, and the law should be reconsidered.

Scottish Labour endorses smoking ban

Scottish Labour Health Spokesperson Jackie Baillie celebrates five years of the smoking ban. A beautifully balanced piece from the STV, closely resembling Scottish Labour's announcement of the smoking ban's fifth anniversary.

Freedom to Choose (Scotland) asked Scottish Labour back in December 2010 to explain its current position regarding smoking bans in psychiatric units. Ms Baillie clearly hasn't found it easy (in spite of regular promises) to provide a proper response.

New professor annoys publicans

A professor of socio-management newly appointed by Stirling University has annoyed some publicans by stating that the smoking ban has had no clear adverse effect on the hospitality industry. The measured tones of Mark Daniels at the Publican describe this conclusion as 'rude', while the Pub Curmudgeon does a bit of digging on the new professor showing a clear career interest in smoking restrictions. (This includes vice chairmanship of  Cancer Research UK's Tobacco Advisory Group: you need to be on message if you want any money for your research from them.)

Professor Bauld is clearly on the up in tobacco control. Apart from praising the smoking ban and hiding its deleterious effects on the nation's social economy, she has produced this magnificent document. It sets out by describing the Framework Convention on Tobacco Control. On page 7 she tells the world that it needs a 100% smoke-free environment, that it must reject any form of air filtration or ventilation, that guidance will be provided on punishing those who infringe no-smoking laws and that implementing the FCTC's requirements is not resource dependent. Any country can do it, no matter how poor. Tell that to the Japanese.

Welcome to Scotland, Linda. I'm glad that your talents are becoming more widely recognized.

Another Triblogology

1. Time to catch up with tripartite The Loneliness Triblogology from the Freedom-2-Choose (non-Scottish) blog through the medium of Frank Davis's essay by the same name (which links to all three parts). He links the smoking ban very convincingly with social disintegration, which may not be evident in busy city bars or to people whose social environment has never involved pubs or smoking. However social disintegration is necessarily a result of legislation that deliberately sets out to marginalise a culture, where social interaction is circumscribed by official standards of what is 'acceptable'. People who smoke will now be accused of 'excluding themselves' if they find themselves out on a limb.

2. Also see Leg-Iron's piece on adaptation 'The Ultimate Reality Game', (and as a quick aside, 'A Small Victory for Commonsense' from Subrosa whose conclusion is unarguable).

3. Finally Gildas the Monk writes on 'Scandal of the Care of the Elderly' (and also see 'The NHS: A True Story' from Simon Clark).

After reading all this, come back and argue that any money spent on anti-smoking groups and projects is well spent.

Spain intensifies smoking inspections

The Spanish Director of Public Health has announced plans to step up enforcements of the smoking ban, following widespread reports of floutings.

He said, 'he had received no indications that financial losses, claimed by businesses as a result of the smoking ban in enclosed public spaces, were generalised, and asked for time to make "relevant evaluations."  "No other country has suffered economic losses after applying a law like this," he concluded.' [emphasis added]

I have to say that surprises me.

And in by the back door ...

I'm travelling soon so many preparations to make but here in the meantime (reported from Malta) is a story of how smoking rooms are returning. (For some.)

Even as Spain prepares to ring in the New Year with a smoking ban in bars, renegade nightspots in Paris and Berlin are bucking the European trend, opening designer smoking rooms, complete with pianos, pool tables and cigar lockers.

Enjoy.

Stopping smoking makes you wealthier

So says the latest ASH Scotland press release (by inference). They really seem to believe that the best way to tackle what is widely termed 'health inequalities', much lolly has to be thrown in the direction of tobacco control.

'Research in Scotland has found that smoking is a greater source of health inequality than social class. This can no longer be ignored.' Is that really so? What is a 'health inequality'? Is it more than a fancy term for simple 'inequality' (a term which carries the implication that those on the lower end of the scale are worse off than those at the top end)? Or does it mean 'unequal health outcomes'?

Laurence Gruer, of NHS Health Scotland, Glasgow tries to help us out in his address: How does smoking cause health inequalities. 'Contrary to popular belief, recent research shows clearly that low-income non-smokers live longer than high-income smokers.' Is that so? I'll suspend disbelief temporarily. But it gets more incredible yet:

Over the past 60 years, smoking rates have declined much faster in higher than lower socio-economic groups. This may now account for as much as 80% of the differences in death rates between higher and lower socio-economic groups in the UK.' 

Eighty per cent? Er ... okay, although this looks like a very simplified view of the range of problems to which less affluent people are exposed (and it may be that their problems are about to get worse, especially if winters continue as bitter as this year). To sum up, he has now decided that those people who still smoke come chiefly from the lower quartile of society and feels compelled to explain why this is:

Why do more people in lower income groups in the UK become regular smokers? Regular smoking usually starts in the teens or early twenties. Important factors include other smokers in the family, low parental supervision, friends who smoke, and lower intelligence and educational attainment. Young people not in employment, education or training have very high smoking rates, young offenders even higher. 

Misguided, easily led, badly educated low achievers form the highest rates of smokers. In other words, the difficult-to-persuade hard core ... Dr Gruer's solution is:

Increasing the cost of cigarettes, reducing their accessibility and visibility, and enforcing laws on legal age of sale are the most likely ways discouraging disadvantaged young people from starting to smoke. A comprehensive package of new Scottish legislation has this aim and its impact on health inequalities will be evaluated.   

Is he really trying to persuade this disadvantaged hard core by raising cigarette prices and making cigarettes invisible at the point of sale? Has he even heard of the illegal market?

His logic is absurd. These people, hard-core smokers, still smoke and their health is worse as a result. Take away the temptation to smoke and they will cease to become feckless, easily-led and irresponsible and start being a good example to their children, perhaps even start working and earn themselves out of the poverty trap ...

They still haven't got it: the temptation to smoke does not come from a tobacco display or visible prompts. Not everyone in life is grabbed by superficiality, as these anti-smokers clearly are (and as they imagine that everyone else is too). Many people like smoking. But if it is associated with poverty and chaotic lifestyles there could be a reason for that too: It is calming. Poverty and chaos in the lifestyle are stressful, and probably in themselves major contributors to ill health. Of course medics will argue that the comfort from smoking is illusory, but if the illusion is comforting, why should the smoker care if he or she is just trying to get through each day? (Some people say the same of religion.) To put it simply if you want to stop poor people needing to smoke, help to eradicate their poverty, homelessness and chronic insecurity. Don't just point at the symptoms of poverty and persecute people for exhibiting them [yes I know you care about them and are just trying to help them by 'denormalising' their habit ... bampots].

ASH Scotland's press release mentions the 'widening health inequalities gap'. One is tempted to ask why the health inequalities gap is still widening after nearly six years since the smoking ban was voted through Holyrood, and why, having failed to narrow these inequalities with a smoking ban, we are still paying tobacco control advocates to come up with other fantastic schemes.

Spain bans smoking, but rebels resist

Spain will ban smoking from 2 January next year both in bars and workplaces and in some outdoor areas as well.

But although the mainstream media sings its usual song, there is another form of reporting represented by Spiked. Here we learn of a rebel group, Club Fumidores por la Tolerancia, with their slogan Prohibido Prohibir (forbidden to forbid), dating from 1995: not three publicans like we had in the UK (and Scotland didn't manage any), but an organised group with 100,000 members. I am going to add its blog to the blogroll here (my computer managed to translate it to English so it can't be difficult). The group's introduction states that they believe conflicts between groups such as smokers and non-smokers can be resolved through negotiation.

Spiked has a history of publishing anti-ban posts. This one points out that the move to ban smoking in Spain runs against the national grain: smoking is still popular with some of Spain's rulers and the smoking rate is still going up. Passive smoking, it says, can be expressed as a metaphor: smoking offends people who don't like to see the social enjoyment associated with smoking. Smoking is being banned in Spain as a political gesture, because it is expected of all countries.

Thankfully Prohibo Prohibir sets out to articulate another view. People are capable of negotiating public space and indeed such negotiation is the way ahead. You can support the group on Facebook.

David Nuttall MP rewriting history

David Nuttall MP on the vote he lost on Wednesday last week to bring the smoking ban to a vote.

I don't buy altogether his comments about Toryism at the end. The smoking ban has so many deleterious effects on the population that it is hard to see how any political party can stomach it.

The whole process of denormalising smoking is an effort to make smoking history. (They didn't succeed in making poverty history either: a far more worthwhile aim but one impossible to achieve given the asymmetric economic relations that characterise international capitalism.)

History is written by winners and smoking history is currently being written by anti-smokers: the people who make laws on the basis of meaningless statistical babbling and strong smells. At last, in Westminster, David Nuttall MP is writing the other side of the story. He is a party man but in essence he is right, an important promise was broken and localism no longer works (nor does liberty or international brotherhood, if you go for one of the other parties).

He has promised not to let us down, so let's do what we can to support his stance on the ban. As legislation it's not wanted, needed or acceptable.

What a shame no one in the corridors of power in Scotland has done this yet.