The Ban on Smoking on Hospital Grounds

1. Questions to the First Minister – in the Senedd at on 1 October 2024.

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Photo of Julie Morgan Julie Morgan Labour

(Translated)

3. What assessment has the First Minister made of the impact of the ban on smoking on hospital grounds? OQ61625

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 1:49, 1 October 2024

Smoke-free legislation making it illegal to smoke on hospital grounds came into force on 1 March 2021. We published guidance to support implementation and continue to work closely with health boards and local authorities to support compliance with the law.

Photo of Julie Morgan Julie Morgan Labour

(Translated)

Thank you for the response. 

Photo of Julie Morgan Julie Morgan Labour

I'm very supportive of this policy to ban smoking on hospital grounds and its obvious health benefits. But is the First Minister aware of some of the consequences in secure mental health units, for example, where staff often have to deal with increased levels of anxiety, agitation, and sometimes aggression, when patients are told they’re no longer able to smoke? And typically, patients may have used the opportunity to go out for a smoke to get away from stressful situations. The Government’s policy is the right policy, but what more can we do to help staff and patients to adjust to this new development?

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 1:50, 1 October 2024

Thanks very much, Julie, and I remember this was drawn to my attention on a visit to north Wales, where they were explaining to me the stress that many mental health patients endured, and how having a cigarette was their release, and, actually, not being able to do that close to the building meant that they had to release patients. So, I understood that that could create an unintended consequence, as you say, but I think you’re right, I think the policy is absolutely right. But, while the law prevents smoking inside, a unit's manager can put in place a designated smoking area for use by patients in the grounds of a mental health unit, and that’s a local decision that they can make. But I do think it’s important that we really keep on driving up that attempt to stop people from smoking in Wales. We’ve made huge strides in the past few years; I think we have an all-time smoking rate of 13 per cent, which is an all-time low. And what we’re doing is we’re rolling out the Help Me Quit programme in hospitals. I think that’s a real opportunity. But the other thing is that many people suffer withdrawal symptoms and sometimes that can be effectively managed with nicotine replacement therapy, so there’s an opportunity for that to be used as well in those mental health units.

Photo of Gareth Davies Gareth Davies Conservative 1:52, 1 October 2024

Welsh Conservatives supported the initial ban on smoking outside of hospitals, and I’m pleased that the Welsh Government has now taken enforcement of this ban seriously, as many people had continued to flout the ban since it was introduced in 2021. It’s also important, however, to promote smoking cessation tools, including NHS support to assist people to overcome their addiction. The enforcement of this ban without the requisite support to quit smoking is just punitive and unfair, and, whilst encouraging the prohibition of this habit in the vicinity of a hospital makes sense, the Welsh NHS should also provide the support to these individuals to quit. This can involve the use of vaping devices and other nicotine products, which have been stigmatised in recent years by the Welsh Government, which is counter-productive in moving Wales towards smoke-free. Keir Starmer also announced his outrageous plans for an outdoor smoking ban, with further measures in the pipeline to curb vaping indoors. Despite being widely unpopular, it is also a grotesque restriction on people’s liberties and further stigmatises smokers and users of nicotine devices. So, can the First Minister outline how the enforcement of hospital smoking bans will be complemented with smoking cessation support? I recognise you did note that in your response to Julie Morgan, but I’d be more interested to see how that will be directly implemented, and, secondly, how the Welsh Government’s smoke-free Wales plan fits with the Prime Minister’s bizarre outdoor smoking proposals. Thank you.

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 1:53, 1 October 2024

Thanks very much. One in 10 of all deaths in Wales are attributable to smoking, and that’s around 3,800 deaths in Wales per year and what we know is around seven in 10 smokers actually want to quit, and that’s why we have this free NHS service, Help Me Quit, and that is available to support smokers inside or outside of hospital, and, since 2017, that’s helped over 100,000 smokers, because we know that getting NHS support increases the success chances of giving up smoking by 300 per cent, compared to going it alone.

Now, just in terms of what health boards are doing in terms of enforcing that, well, they’re using some of the allocation, the £6.8 million prevention funding that is available to them, to employ officers to patrol hospital grounds and to speak to anyone found smoking and refer them to the cessation services.

Photo of Lesley Griffiths Lesley Griffiths Labour 1:54, 1 October 2024

There's a significant problem with smoking in the grounds of the Wrexham Maelor Hospital. For instance, if you go towards the main entrance, you’re often met with huge piles of cigarette stubs. Following representations from several constituents, I met with the health board, who, while employing a smoke-free environment officer, told me the legal responsibility for enforcement sits with the local authority, so they’re unable to take enforcement action. On the other side, Wrexham County Borough Council tell me that it’s the health board who have responsibility under the legislation to prevent smoking within its grounds. So, could the First Minister please clarify who is responsible for the enforcement of this much-needed public health legislation?

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 1:55, 1 October 2024

Well, thanks very much. When the legislation was introduced, we published detailed guidance, we provided training, we ran awareness campaigns, which included tv and radio ads, to ensure that people knew about the new rules. We know, also, that lots of hospitals have taken that innovative, local measure to communicate the requirements to hospital users. So, some of them are doing it in an innovative way, for example, using audio speakers to play a recorded message at the entrance to the hospital. As I say, some of them have enforcement patrols, and so it is a question, of course, for the health boards to make sure that they are enforcing the action outside of their hospitals, but I think persuasion is always better than landing people with a fine, if you can do that. We are talking, generally, outside hospitals, of people who are generally in a vulnerable position, so I think whilst, on the one hand, we need to be supportive of them, they also need to understand that there are rules that they need to comply with.