S5
SMOKE FREE POLICY
INDEX
1 Introduction
2 Scope & Definitions
3 Regulations
West London Mental Health NHS Trust________________________________________________________1
Policy Date: March 2006 May be disclosed to patients
1 INTRODUCTION
1.1 The public health white paper, Choosing Health, makes a clear commitment to a
smoke free NHS by the end of 2006. Section 2(2) of the Health and Safety at Work
Act 1974 places a duty on employers to:
‘...provide and maintain a safe working environment which is, so far as is reasonably
practical, safe, without risks to health and adequate as regards facilities and
arrangements for their welfare at work.’
1.2 Several European Union directives relating to health and safety in the workplace
have come into force since 1 January 1993. These include the Management of
Health and Safety at Work Regulations 1999 which, under General Principles of
Prevention, include:
Avoiding risks
Combating risks at source
Replacing the dangerous by the non-dangerous or the less dangerous
Giving collective protective measures priority over individual protective measures.
1.3 Secondhand smoke (breathing other people’s tobacco smoke) has now been shown
to cause lung cancer and heart disease in non-smokers, as well as many other
illnesses and minor conditions. West London Mental Health Trust acknowledges that
breathing other people’s smoke is both a public health hazard and a welfare issue.
Therefore, the following Policy has been adopted concerning smoking.
1.4 The Healthcare Commission (HCC) has issued new targets for 2006/07 which
include targets for a smoke-free NHS, recording of smoking status and reducing
smoking: Reducing adult smoking rates (from 26% in 2002) to 21% or less by 2010,
with a reduction in prevalence among routine and manual groups from (31% in 2002)
to 26% or less. Part 1. Trusts to demonstrate smoke-free policy in place or i) Commit
to the policy, ii) Create the policy, iii) Ensure NHS stop smoking support is widely
available and accessible, iv) communicate the policy. Part 2. Recording smoking
status in adult inpatients. Part 3. Reducing smoking in adult inpatients.
1.5 The aims of this Policy are to:
Protect and improve the physical and mental health of staff, service users,
visitors and contractors.
Protect both smokers and non-smokers from the danger to their health of
exposure to secondhand smoke.
Encourage an environment conducive to giving up smoking, which provides that
staff and service users who want to give up are fully supported.
Contribute to the overall management of fire risk in Trust premises.
West London Mental Health NHS Trust________________________________________________________2
Policy Date: March 2006 May be disclosed to patients
2 SCOPE & DEFINITIONS
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The Trust acknowledges the challenges posed by a smoke free policy and whilst the desire
is to move towards a smoke free environment on as many sites as possible, implementation
will vary from site to site and case to case.
2.1 This policy applies to all staff, service users, visitors, contractors and other persons
who enter West London Mental Health Trust owned or rented premises for any
purpose.
2.2 Where the policy relates to ‘staff’ this includes locum, bank, agency, volunteer and
seconded staff on either temporary or permanent contracts.
2.3 The policy applies throughout Trust premises, whether used by service users or not.
Premises includes buildings, their entrances and exits.
2.4 The policy applies to all Trust owned or leased vehicles at all times.
2.5 All outpatient and community settings will be entirely ‘smoke free’; this means that
smoking will not be allowed for staff, service users, contractors or visitors.
2.6 Staff are not allowed to smoke at any time while on duty. They may not use smoking
facilities that are provided for service users.
2.7 Staff should not smoke whilst on duty on any third party sites, e.g. whilst at a PCT or
Social Services site.
2.8 In-patients settings will be smoke free. In line with Department of Health guidance,
exemptions may be allowed on an individually assessed basis, as outlined in more
detail in section 3 of this policy.
2.9 Staff have the right to ask service users not to smoke whilst they are on home visits
to minimise the effects of passive smoking.
West London Mental Health NHS Trust________________________________________________________3
Policy Date: March 2006 May be disclosed to patients
3 REGULATIONS
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3.1 Service users
3.1.1 The Trust recognises that the circumstances of some service users will require that
the multidisciplinary team make an assessment of whether they will be permitted to
smoke on a Trust site.
3.1.2 Permission to grant an exception will rest with the multidisciplinary team as part of
care planning and will be formally recorded in the care plan. In all cases where an
exception has been made there should be demonstrable evidence that smoking
cessation has been considered as part of the care plan, in conjunction with the
service user.
3.1.3 In cases where service users cannot go outside to smoke, a smoking room will be
provided to an agreed specification that ensures a smoke free environment for
others.
3.1.4 Staff need to be sensitive when approaching the topic of smoking cessation,
especially when a service user has just been admitted to an inpatient service.
However all service users who smoke should be offered advice and support
3.1.5 The decision of whether to smoke or not ultimately rests with the service user,
however if they want to attempt to stop smoking then a care plan will be put in place.
When a service user is discharged from the inpatient service the care plan will be
clearly communicated to the new service and the service user’s GP to ensure
continuity of care.
3.1.6 Tobacco use may lower blood levels of certain medications used in psychiatry.
Smoking cessation may therefore result in increased drug levels. The Trust
pharmacist should be contacted for specific advice on interactions between tobacco
and psychiatric medication.
3.1.7 Cigarettes or tobacco related products must not be used as a reward for good
behaviour or as an incentive to diffuse an aggressive situation.
3.2 Staff
3.2.1 The Trust recognises that smoking is an addiction and adherence to this smoke free
policy will be a challenge for some members of staff. Staff will be offered smoking
cessation support and the support of occupational health.
3.2.2 If staff want to smoke during their working hours they can only leave the Trust
buildings or grounds to smoke during break times. Therefore the following applies;
Under the European Working Time Directive, where staff work for longer than
six hours they are entitled to a break of a minimum of 20 minutes. All staff are
encouraged to take a break.
Staff are not entitled to any additional smoking breaks over and above their
West London Mental Health NHS Trust________________________________________________________4
Policy Date: March 2006 May be disclosed to patients
entitlement under the European Working Time Directive.
In most health and social care workplaces, breaks are taken in a manner
consistent with maintaining minimum staff levels and managing risk.
Managers therefore need to plan effectively for staff that leave the premises
on breaks for any reason.
3.2.3 If staff breach the policy then in the first instance managers should discuss the issue
with them and ensure they fully understand the smoke free policy. If staff continue to
breach the policy then formal disciplinary action may be taken.
3.3 Visitors and contractors
3.3.1 The staff member inviting visitors and contractors on to Trust premises should make
them aware of the Trust’s smoke free policy.
3.3.2 If staff observe a visitor smoking on Trust premises, they should make the visitor
aware of the Trust’s smoke free policy and ask them to stop smoking. If the visitor
does not comply with the policy they should be asked to leave the premises.
3.3.3 If staff observe a contractor smoking on Trust premises, they should make the
contractor aware of the Trust’s smoke free policy and ask them to stop smoking. If
the contractor does not comply they should report the contractor to the estates and
facilities department.
3.3.4 Staff safety must always be paramount. Under no circumstances should any member
of staff be encouraged to enforce the policy if they believe they would be at risk in
doing so.
Policy Developed by: Smoking Review Committee, chaired by Ann Chapman,
Non-Executive Director and led by Dr Elizabeth Fellow-
Smith, Medical Director.
Policy approved by Board: March 2006
Next Review: December 2007
West London Mental Health NHS Trust________________________________________________________5
Policy Date: March 2006 May be disclosed to patients