Smoke Free Hospitals: Frequently Asked Questions

1. Why do we have a Smoke Free Policy?
2. Who does the policy apply to?
3. Can I vape on NHS Dumfries and Galloway hospital grounds?
4. What will happen if someone smokes within 15 metres of a hospital building?
5. Where can people smoke and not breach the smoke free policy?
6. Can NHS Dumfries and Galloway install smoking shelters?
7. Whose responsibility is it to approach people who smoke on hospital grounds and remind them of our policy?
8. What should I do if I encounter a difficult situation in which someone has been asked not to smoke on the hospital grounds?
9. I am a staff member who smokes. What do I need to do during my workday to comply with this policy?
10. What support is available to help staff stop smoking?
11. How can I support patients to comply with the policy?
12. What should I do if a patient wants me to take them out for a cigarette?
13. Are there any exemptions for mental health wards?
14. How will visitors be supported to comply with the policy?
15. Will all staff receive training on the policy?
16. I’m a line manager, what should I do to support the smoke free grounds policy?
17. Who is responsible for cleaning smoking litter on hospital sites?
18. How can staff members, patients or visitors make a complaint about smoking?

1. Why do we have a smoke free hospital policy?

The NHS Dumfries and Galloway Smoke Free Policy is a way to reduce smoking in the general population, improve the health of smokers and non-smokers, and make it harder for people to become addicted to tobacco use in the first place. The policy also helps the health board comply with several national laws and regulations which prohibit smoking on hospital grounds. The latest of these regulations, which came into force in September 2022, makes anyone smoking within 15 metres of a hospital building liable for a £50 fine.

2. Whom does the policy apply to?

There are no exemptions to our smoke free policy. All NHS Dumfries and Galloway staff, patients, visitors, contractors, and other people who work within NHS Dumfries and Galloway premises or on NHS Dumfries and Galloway grounds (such as students, staff on placement, voluntary workers, workers from other organisations to whom the buildings are leased, contractors, or personnel with honorary contracts) should respect our smoke free hospital status.

3. Can I vape on NHS Dumfries and Galloway hospital grounds?

To protect everyone’s long-term health, NHS Dumfries and Galloway does not allow vaping either inside or within 15 metres of a hospital building.

4. What will happen if someone smokes within 15m of a hospital building?

If a member of staff sees an individual smoking anywhere on our hospital grounds, they should politely ask the individual to proceed to the nearest public area to smoke and help us improve the hospital environment for our staff and patients.

If someone is smoking within 15 metres of a hospital building, their actions can have more severe consequences for public health. Spaces such as these have an enhanced legal protection. So, a person refusing to comply with our smoke free regulations within 15 metres of a hospital building may be issued with a £50 fixed penalty notice by an Environmental Health Officer, employed by the local council.

5. Where can people smoke and not breach the smoke free policy?

You can smoke anywhere outside of the hospital grounds. We understand that it can be confusing to determine just how far the hospital grounds extend. This is why we have created some maps highlighting the nearest public areas where smoking is not prohibited near each hospital.

6. Can NHS Dumfries and Galloway install smoking shelters?

No.

All smoking shelters have been removed from our hospital grounds to comply with our hospital smoke free policy. The hospital can be fined if it is not adhering to the laws which prohibit smoking in this space.

7. Whose responsibility is it to approach people who smoke on hospital grounds and remind them of our policy?

Our smoke free policy states that NHS Dumfries and Galloway staff should encourage people not to smoke anywhere on our hospital grounds. The only way to eradicate smoking from our hospitals in the long term is to have comprehensive support for the policy from all staff groups. Staff should approach people who are smoking if they feel confident enough to have a quick, factual, and positive intervention to raise awareness of our smoke free hospital policy. Please also refer to our policy training video for some useful tips when deciding whether to approach someone smoking or not.

Overall, the message is that our smoke free policy is not about forcing people to stop smoking, but about protecting people from the harms of second-hand smoking by restricting where smoking takes place in an environment that should always be about health protection and promotion.

8. What should I do if I encounter a difficult situation if someone has been asked not to smoke on the hospital grounds?

Research across several countries has found few instances of staff being challenged when raising the issue of not smoking on hospital grounds.

However, it is imperative that staff asses any potential approach and never engage in a conversation with a person or group which you fear might respond in a threatening manner. Your safety is paramount, if someone does not respond well to your request please walk away.

If you have encountered a difficult situation when approaching someone smoking on hospital grounds please talk to your line manager in the first instance.

However remember to be sensitive about why they may be visiting our premises and if they become angry it is important not to take their reactions personally.

9. I am a staff member who smokes. What do I need to do during my workday to comply with this policy?

NHS Dumfries and Galloway recognises the addictive nature of tobacco and wishes to support staff to comply with the policy. The smoke free policy aims to protect people from the harms of passive smoking by restricting where smoking takes place and is not about forcing people to stop smoking.

If you wish to smoke during your break, there are two actions you need to take to comply with our smoke free policy:

1. Change out of uniform and remove any NHS Dumfries and Galloway recognisable items.
2. Walk to the nearest public area where smoking is not prohibited.

10. What support is available to help staff stop smoking?

If you are considering stopping smoking, there is support available for you at the hospital. Quit Your Way is a free NHS service to help smokers stop. Specialist practitioners can provide advice and support, as well as information about stop smoking medications. You can access behavioural support from a Quit Your Way practitioner during your workday and receive free nicotine replacement treatment. Anyone who wants to stop smoking can access information on NHS Inform https://www.nhsinform.scot/healthy-living/how-to-stop-smoking/ or can contact our local service directly on 01556 505 713 or dg.quityourway@nhs.scot.

11. How can I support patients to comply with the policy?

Upon referral, admission, or attendance at hospital you should assess patients for their smoking status and have it recorded in their clinical notes.  Please ensure that your patient is in receipt of a Patient Information Leaflet which will be provided for all wards.

All patients who smoke should be offered nicotine replacement therapy within 24hrs of admission to manage withdrawal symptoms and ensure a comfortable hospital stay. We have created a tobacco and nicotine addiction treatment pathway as a guide for clinical staff in both the Acute and Mental Health settings.  This pathway will be made available to all staff via senior management teams.

Patients should also be aware that staff cannot assist them to smoke and that a note will be recorded in their patient record that they are leaving against medical advice if they leave the ward for this reason.

If a patient expresses an interest to quit smoking, staff should refer them to Quit Your Way. This is a free NHS service where specialist practitioners will provide information and support to help your patients quit. To make a referral, staff can refer via Cortix or send an email with the patient’s name, CHI and ward to dg.quityourway@nhs.scot.  Please highlight if the patient would like support on the ward or on discharge if possible.

12. Are mental health wards exempted from smoke free hospital rules?

There are no exemptions to the smoke free hospital rules regarding specific patient groups.  In exceptional circumstances and where there is recognised risk that not smoking impacts prescribed treatment, clinical exemption may be applied by the lead clinician in the prescribed care.  This must be recorded within the patient’s clinical notes.

13. How will visitors be supported to comply with the policy?

You should make ward visitors aware that they should not smoke within the hospital site and that there is a risk of a £50 fine if they smoke within 15 metres of the hospital building (including awnings and canopies). If they need to smoke, direct them to the nearest public area where smoking is not prohibited.

14. Will all staff receive training on the policy?

NHS Dumfries and Galloway has a series of extensive communications about our smoke free policy to all staff. In addition, we also encourage staff to access the Smoke Free Hospitals training on Beacon to

• become familiar with the NHS Dumfries and Galloway Smoke Free Grounds policy,
• and learn how to implement the policy as part of their role at NHS Dumfries and Galloway.

15. I’m a line manager; what should I do to support the smoke free grounds policy?

As a manager you should ensure your team are aware of the smoke free policy and have read it and understood their responsibilities. When further on-line training on Understanding Tobacco and Nicotine Addiction is available from the Quit Your Way Service, we would encourage you and your staff to attend this via the link that will be provided.

Overall, managers are responsible for ensuring staff compliance with the policy and ensuring any non-compliance is dealt with in a fair and supportive manner. If a staff member has breached the policy, the first response should always be to discuss the implications of smoking in uniform and/or on hospital grounds and remind them that it is not permitted for staff to be seen smoking while recognisable as an NHS Dumfries and Galloway member of staff either within or outside official hospital grounds (this applies to all staff, regardless of whether they wear an assigned uniform). You should also signpost them to support to stop smoking should they wish.

If a staff member repeatedly breaches the smoke free policy and has previously been reminded of their responsibilities under the policy, please contact HR for further advice or visit NHSScotland Workforce Policies for information on the conduct policy and investigation process.

16. Who is responsible for cleaning smoking litter on hospital sites?

Local NHS Dumfries and Galloway Estate and Facilities teams are responsible for the general upkeep of our hospital environment, which includes the management and removal of smoking detritus.

17. How can staff members, patients or visitors make a complaint about smoking? 

Complaints should be directed to the Patient Experience Team on 01387 272733 or email dg.patientservices@nhs.scot.

Alternatively, you can also provide anonymous feedback using the Care Opinion website which is a public facing platform for collecting feedback.