Smokers flout ban at ‘smoke-free’ Southmead Hospital - forcing bosses to come up with a new plan

So many smokers are flouting rules at Southmead Hospital that bosses have come up with a new plan - introduce vaping areas.

Southmead Hospital in north Bristol is a designated ‘smoke-free’ site, in line with NHS guidelines, but many people ignore the ban.

In 2017, North Bristol NHS Trust, which runs the hospital, bowed to public pressure and introduced two smoking shelters outside the main entrance and maternity ward.

Now it has admitted its ‘smoke-free’ policy is not working, and has said it is re-thinking its approach, with the possible introduction of designated outdoor areas where people can smoke e-cigarettes and the sale or provision of vapes on site.

Kathryn Hamilton, a public health registrar at the trust, said a multidisciplinary working group at the trust was reviewing its smoke-free policy in an effort to make the hospital grounds “more truly smoke-free”.

“Options that we’re considering will include designated outdoor vaping areas, selling e-cigarettes commercially, looking at [behavioural] signs, nudges, and crucially, underpinning that with training for staff in very brief [quit] advice and conversations around smoking,” she told a meeting of Bristol health leaders on October 20.

She said the extent to which people ignored the current smoke-free policy was revealed in a survey of more than 500 hospital staff, visitors and patients over summer.

Some 70 per cent of respondents said they saw people smoking at the hospital “most days or every day”, members of the Bristol health and wellbeing board heard.

“What we found is that overwhelmingly people know that we’re a smoke-free site,” she said. “That’s not the problem. The problem is that we actually do have people smoking on site and most people most days see people not following the policy.

“In our consultation, we brought out hotspots where this is happening and this wasn’t a particular surprise to those people who work at the trust and knew about these.”

The consultation survey found around two-thirds of respondents backed the introduction of designated outdoor vaping areas, but the idea of the hospital selling or providing vapes was more contentious.

Some non-smokers were “very vehemently” opposed to vaping on hospital grounds, seeing it as unhealthy, members heard.

But Dr Hamilton said: “We’ve got a lot of evolving evidence that e-cigarettes or vaping is a really powerful tool to help quit smoking, and we’ve got more and more evidence that it’s dramatically safer than smoking and also seems to really work for people trying to quit.”

The survey also found good support for other changes the trust is thinking of making to its smoke-free policy, such as better signage, she said.

Tim Keen, associate director of strategy at the trust, said smoking was a “very polarising” issue and some of the existing non-smoking signs at the hospital were “terrible” and “quite aggressive”.

He said one with the slogan “Put your fag out or we’ll put you out” had “really got people’s backs up”.

The trust is holding focus groups to work out “how we get those messages right”, Mr Keen said.

“There’s lots of things we can learn and change our approach on,” he said. “This is about treating people who’ve got a dependency and helping reduce harms.”

Dr Hamilton added the trust was also planning training for staff in how to avoid conflict when having difficult conversations with patients or visitors about smoking.

The initiative is part of a long-term plan by the NHS to treat smoking addiction by identifying smokers in hospitals and helping them to quit.

Such are the damaging health effects of smoking that it’s estimated that a quarter of hospital inpatients are smokers, according to information presented to the meeting.

In Bristol, an estimated 66,500 people smoke (roughly 18 per cent of residents) and almost 600 pregnant women smoke (10 per cent).