Gone up in smoke..

As Wales seeks to further consolidate its own identity, it is today announced that the last NHS Trust in the Principality has signed up to the NHS no smoking policy which has been adopted elsewhere. In a bid to standardise policy, patients are now banned from smoking in any hospitals in Wales.

On the face of it, this is fair enough. There are basic flaws though. The first is that I've never yet known any ban to work. Drive home tonight and observe the people having a smoke in the entrance door of the local pub. That is a reasonably public place. Ban the playing of a song on Radio 1. Ban electronic cigarettes in school. The list goes on but the point is made. The problem with bans is not so much their intention but rather their enforcement. Go to any hospital you like in Wales or anywhere else and I guarantee you will see patients smoking at the entrance. The Welsh Assembly has a solution though. They will offer nicotine patches to all those caught smoking within the grounds of the hospitals. They can indeed offer but they are on a sticky wicket ethically speaking. If somebody chooses to smoke, that is a matter for them. The problem is that smoking is an addiction and it is not as easy as giving someone a nicotine patch because, believe it or not, if it were that easy, it would already have been done and there would be no tobacco kiosks. You can of course physically remove the lit cigarette from the person smoking it. By the same logic, they can then light another one. And so it goes on.

You can't force people to do things. You can advise them until you're blue in the face. You can offer patches, pills, cognitive behavioural therapy, counselling and all the other solutions but it does not follow that people have to comply. That is the aspiration but they are entitled to the choice they make. I don't for a minute condone smoking because the harm it does is so well documented. I do respect the right of everybody to make informed decisions about the way they choose to live their lives even if that choice exerts a massive drain on NHS resources.

Just last week, a report found that the British are a nation of addicts. Its just possible that the report was right. But then, aren't we all addicted to something? If what I read is correct, a worrying number of us are addicted to alcohol to various degrees yet I don't see the Welsh Assembly seeking to ban alcohol consumption or its effects on NHS sites. Go to any Accident and Emergency department on a Friday or Saturday night and feast your eyes on the rather more unpleasant aspects of alcohol. Yet the Welsh NHS appears to do little to address this. Of course, the list of illicit drugs seems to grow by the day as factories in China churn out another concoction aimed at achieving an even newer form of high. Again,no bans on these of which I'm aware. Having a ban on anything is relatively futile but being selective about those things you choose to ban is a bit hypocritical. Given recent stories about the drinking habits of various members of the Welsh Assembly, this is perhaps unsurprising.

So really, rather than banning the smoking of cigarettes in and around Welsh hospitals, laudable though it is, the Welsh Assembly would surely do better to invest more resources in tackling addiction. Clearly, they will never win with every case of addiction but they can at least have the intention to try. The money spent at the beginning of the pipeline will be chicken feed compared to the money needed at the other end if the addiction is allowed to grow and exert its ill effects on that person's health. It seems as though there is a good deal of fire fighting going on without any obvious desire to question where the fire is coming from. This, I would suggest, would be a far more constructive place for the Welsh NHS to begin its crusade against smokers and the like. Although it is highly irritating to be faced with a blast of smoke when entering a hospital, we need to be more pragmatic about it. The person smoking that cigarette may have been doing so for decades so it is a trifle unrealistic to expect them to suddenly stop after having extracted so much tax out of them for the privilege. Addiction is no laughing matter and many such people would love to stop if it were so simple. Banning it ignores the root cause. Progress will only be achieved when the root causes are addressed.