Published: 20/05/2004, Volume II4, No. 5906 Page 19
Smokers have a right to smoke. There can be few adult smokers who are not aware of the likelihood that their habit will shorten their life and may cause some horrible diseases. It is the responsibility of the health service to treat smokers and to assist them in stopping if they so wish.
The development of smoking-cessation services throughout the NHS has been a success, despite criticisms of it, and this government has made enormous strides in this area.However, there may be a few more steps to go.
There is indisputable evidence that passive smoking is bad for your health. It will increase by 30 per cent your chance of having a myocardial infarct.A stunning recent article in the British Medical Journal showed that in Montana in the US, a six-month ban on smoking in the workplace reduced admissions for myocardial infarct from 40 a month to 24 a month (BMJ, 24 April).We also know that smoking in pregnancy causes preterm birth, increased miscarriage and increased perinatal death.
It is therefore rather strange that we still insist that many of our workers have to be subjected to the effects of passive smoking.What is even more incongruous for an NHS committed to addressing health inequalities is that the workplaces where we subject workers to passive smoking are those with the lowest pay - bar staff, waiters etc. This is further compounded by the same workers becoming pregnant and having to face the dilemma of stopping working or subjecting their babies to health risks.
The effect of a smoking ban in the workplace also has an added benefit for smokers. A study in California showed that by cutting the number of cigarettes smoked while at work reduced the chances of lung cancer and heart disease, even though the smoker continued to smoke outside the workplace.
During the 1990s a campaign by Australian health workers to ban cigarette advertising was successful. There were reports of clinicians tearing down billboards advertising cigarettes near schools. Perhaps now is the time for NHS staff, many of whom enjoy working in a smoke-free environment, to call for similar benefits to be shared throughout the country.
Confidence in politics has decreased over the last decade, as much among doctors as the rest of the population. The recent influx of funds to the NHS is gradually reversing this trend. The brave step of banning workplace smoking would not only benefit the lowest paid in our society but also develop enormous credibility among clinicians in the NHS.
If there is anyone who would like to sign a petition calling for banning of smoking in the workplace please e-mail me at tom. coffey@nhs. net with the words 'I will'.
Dr Tom Coffey is a south London GP, professional executive committee chair for Wandsworth PCT and chair of the New Health Network.