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Child Item

why can't Hospitals enforce the 'no smoking' areas outside?

Andy From Sligo

I wonder why hospitals cannot enforce the no smoking rules they have in place once and for all successfully.

I was outside our local hospital (temporary entrance) waiting to be picked up on Friday and a Sign on the wall (well signs) "This is a no Smoking Campus" - No smoking allowed in any area of the hospital and its grounds .... and opposite the sign People standing around smoking. On the floor a load of discarded cigarette butts . Even the signs had "CCTV camera's are in operation" underneath the bit that said No Smoking.

Earlier on I was waiting to go into the ED department, (the Ambulances park up there now at the old Main entrance) whilst I was waiting to go in a young female paramedic lit up a fag and smoked it whilst her colleagues stood around chatting ... near the "No Smoking in this area" sign - she even turned the cigarette into her hands like 'hiding it' as if to try and say "I am not smoking honestly!" as the smell of smoke wafted over to the ED doors.

Once in the ED waiting rooms people/patients popping out for smokes (rollies and cigarettes) right by the ED waiting room doors and windows, coming back into the waiting room reeking of stale cigarette smoke and then coughing their guts up as they come back into the ED wailing room with smelly fag breath

how comes things like that can be well signposted , a plan put in place but never can be enforced properly? - makes you wonder if the plan in the first place is needed if people are just going to blatantly not take any notice and do what they want.

I suppose its the same all across the country with other hospitals or has anyone come across a hospital where it says no smoking allowed and its actually enforced?

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Comments

Goldengirl

https://www.boards.ie/discussion/comment/120865534#Comment_120865534

Oh I agree. Fair dues for getting off the fags but am glad you see it is not kicking the addiction vaping but its a step down.

There is however a lot of evidence that vaping is causing many lung issues if not cancer, as yet.. Popcorn lung, spontaneous collapsed lung, lipid pneumonia to name some.

https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-does-vaping-do-to-your-lungs

On another point you do have to register on Quit. ie to get free NRT? Is Champix not on the list?

https://www.hse.ie/eng/services/news/media/pressrel/hse-announces-free-nicotine-replacement-therapies-for-anyone-who-wants-to-quit-smoking.html

[Deleted User]

https://www.boards.ie/discussion/comment/120867605#Comment_120867605

It wouldn’t be because it’s not NRT. Also the tablets are prescription only & absolutely riddled with violent side effects to boot.

most GP’s would advise absolutely anything else before Champix and in my experience will only give to people who’ve little prospect of quitting otherwise.

NRT’s would be the nicorette products mainly, patches, gums, inhalers etc

[Deleted User]

I tried to quit using Champix in one of my first attempts. The side effects were known to be risky - even linked to depression and suicides.

I was only on it for about 10 days before I had to stop taking it. I felt really bad, and my blood pressure went from typically low /normal, to sky high. It took a long time to get it back under control.

[Deleted User]

https://www.boards.ie/discussion/comment/120868322#Comment_120868322

Same as myself, I couldn’t describe how I felt but it was absolutely horrible. Sick to my stomach, but also just feeling so rundown.

my aunt had great success with them and the side effects weren’t too bad for her but I couldn’t stomach them

Grayson

https://www.boards.ie/discussion/comment/120868574#Comment_120868574

The side effects can be rough. Just so everyone is aware the tablets were originally developed as a anti depressant. But they discovered everyone who took them gave up smoking.

The stomach thing really affected me. I'd feel sick whenever I took them. Taking after food helps. I'd get incredibly vivid dreams. Not nasty, just really vivid. I could have a dream where I was walking down the street and wake up thinking "That was a really intense walk down a street". At first it's entertaining. Almost like an adventure everytime you sleep. After a few months you get tired of it.

I had friends who got panic attacks when they took it. So I was lucky with my side effects.

The dosages are designed to be really small at first so if you get bad side effects, you stop taking them immediately.

The thing is it works. Everytime I took it, I stopped smoking within 2 weeks. I just didn't want a smoke. The reason I'm not on it now is because I've been highly stressed and experiencing anxiety recently and I don't want to risk taking it. So I'll keep vaping for now.

https://www.boards.ie/discussion/comment/120867605#Comment_120867605

The chemicals listed there are all illegal to add in the EU. I believe that they're also not added in the US anymore which makes me think that article is a few years old. The popcorn lung that people were experiencing in the US was caused by vitamin e added to illegal marijuana vapes. It's not added to vapes for nicotine. I've done plenty of research, including talking to my lung specialist in Dublin. He says that yes, I shouldn't vape and should give it up sometime but it's far, far healthier than smoking.

[Deleted User]

https://www.boards.ie/discussion/comment/120860854#Comment_120860854

Where did they say they don't have an issue with the other stuff? This is about smoking.

Agreed OP, it's infuriating going into the hospital and all these people (always scumbags) smoking in the path of patients. So disrespectful.

Mrs OBumble

https://www.boards.ie/discussion/comment/120861098#Comment_120861098

The difference is that alcohol and food, in moderation have health benefits. Abstinence from food has serious health consequences.

Whereas smoking has only serious health consequences, for both the smoker and the innocent parties around them (the underweight disease-prone babies, spouses exposed to 2nd had smoke, etc).

Health resources are scarce. We have massive waiting lists.

I don't see any point in wasting scarce resources on people who have shown, by their actions that they don't want to get well. If people want to call that trolling, that's on them. I 100% believe in what I said.

And, I can name people who have been told (recently, in Ireland) that they won't get surgery XYZ unless they reduce their bodyweight by <<whatever>>, or quit drinking alcohol. If it can be done for food and booze, it can be done for cigs.

Purple Mountain

https://www.boards.ie/discussion/comment/120873169#Comment_120873169

I didn't think you were trolling by the way.

I was just curious to know how you felt about other areas of "abuse" to the body.

I think it's a debate that could go round in circles forever, but interesting none the less.

Grayson

https://www.boards.ie/discussion/comment/120873169#Comment_120873169

It's an addiction. It's not that people don't want to, it's that they can't. That's why it's called an addiction. Some are more addicted than others. there's plenty who can only smoke weekends and never smoke during the week. They just never feel the need to. Others are more addicted. Many will have tried and failed to quit. You are giving the impression that you think smokers want to smoke or that they could quit at any time they want to. The truth is that for many it's damn hard.

[Deleted User]

https://www.boards.ie/discussion/comment/120873591#Comment_120873591

100% this. ^^

I'm sure there have been studies done as to why some people become more addicted to certain substances than others - or not addicted at all. This could aso be applied to alcohol.

I have always been fascinated by those who say "oh I only have a cigarette while having a drink" but never touch them otherwise.

Even after 15 years, I know that if I smoked just one cigarette today, I'd most likely end up back where I was on 50 a day - and knowing that, is what has kept me smoke free.

Mrs OBumble

https://www.boards.ie/discussion/comment/120873770#Comment_120873770

So you COULD and DID give up.

Just like anybody else can, if they want to and choose to. It's mot easy, but it is possible.

[Deleted User]

https://www.boards.ie/discussion/comment/120873871#Comment_120873871

Every case is individual..

For me, it was possible. After many failed attempts.

I know many others who have gone to their graves still addicted to smoking, because they were unable to give up.

It's shows a distinct lack of understanding or any empathy, to proclaim they didn't give up because they didn't choose to, or they didn't want to.

Even actual qualified medical professionals recognise this.

Hence why they show some compassion and provide a discreet smoking room for terminal patients, in Tallaght University Hospital.

Spanish Eyes

Vaping and low/no alcohol drinks. That's the future!

Re vaping and popcorn lung etc., this scaremongering has to stop, popcorn lung was a phenomenon in the US where the additive diacetyl caused it. It is not used in (regulated) EU vapes which contain only propylene glycol, water and nicotine. Propylene glycol is also a food additive in grub we eat every day.

I have a friend who was admitted to one of our private hospitals during Covid. He vapes. He used his vape in the bathroom of his (private) room in the hospital when he felt like it. No one noticed, he was calm, all was good. I laughed when I heard his stories of being locked in the jacks and the consultant on rounds knocking on the door asking him to come out. No one noticed the vaping. In fact the HSE (copied from NHS) while it does not advocate vaping, it certainly does not denigrate it completely as a stop smoking (tobacco) aid. They do of course push for nicotine replacement therapies like gum and patches etc., which do not work as well as vapes which are also NRTs. I think they should ban disposables and encourage tobacco smokers to use vapes instead. No more frighteners on those who have successfully quit tobacco with vapes is my view. They are far more acceptable than cigarette smoke.

Vaping (using e-cigarettes) - HSE.ie

I can be smug as a non smoker of course, but given the choice I'd prefer if the few smokers left that I know vaped. It should be encouraged IMV.

Goldengirl

https://www.boards.ie/discussion/comment/120873941#Comment_120873941

The Irish Cancer Society , RCSI , and any material I have read from the HSE disagrees with you there . The differences between the UK NHS and HSE are very clear .

This is from the same HSE article you linked to above ...

" Risks of vaping

The risks and negative health effects linked with vaping include:

nicotine dependence
injuries - for example, from defective e-cigarette batteries
poisoning and exposure to toxins
changes to how your heart, lungs and other organs normally work

Over time these risks may cause diseases such as heart disease, lung disease and cancer.

Vaping liquid that does not contain nicotine often has other chemicals such as colours and flavourings. These chemicals can be harmful when you inhale them into your lungs.

We are still learning about the long-term risks of vaping. This is because e-cigarettes are relatively new compared to cigarettes. We need to review studies of people who use e-cigarettes over many years before we can know the health impact of vaping."

This is why its use has been banned in under 18s here and the HSE has a Quit4Youth programme underway to reduce the use in those after groups up to 25 years of age .

So no they are not " pushing it " as you say . They advocate for other NRT instead .

The NHS take a different tack completely and promote it as part of their stop smoking campaign.

Popcorn lung btw is a rare but real disease and the risk from Diacetyl was highlighted due to a study of workers exposed to it in a popcorn production factory in the US who developed the disease ..2015 .

There are cases in the US of popcorn lung damage from vaping where it is still not banned as a constituent . They also have had pneumonitis from oils used in cannabis vaping products which are allowed ( legally anyhow ) in EU .

Diacetyl has been banned as a component following on from caution as a result of the 2015 study of the popcorn factory workers in the EU and UK . However there are other constituents that may cause inflammation and damage, cardiac , arterial stiffness and other issues in the long term with who knows what risks ,like smoking tobacco initially .

There has been an increasing body of evidence since 2018 , 2019 to back this up but for some reason the UK is still recommending it as an aid to stop smoking .

There is no doubt that cigarette smoking is a lot worse . This is a fact . But to rule out so many healthcare implications for vaping just because " the data isn't there yet " is very shortsighted .

I am very surprised to read so many commenting on the harmful effects of smoking , but saying vaping is ok.

It's not .

https://www.cancer.ie/about-us/about-the-irish-cancer-society/what-we-do/cancer-advocacy/positions-and-policy-statements/e-cigarettes-and-vaping

https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.rcsi.com/dublin/news-and-events/news/news-article/2023/04/rcsi-experts-warn-of-the-dangers-of-vaping&ved=2ahUKEwiJ15ex256AAxWVhFwKHbcRCNwQFnoECCwQAQ&usg=AOvVaw1gXRBuGaw2hRCWbWu0A0FD

https://www.boards.ie/discussion/comment/120869581#Comment_120869581

Again nobody should underestimate the difficulties of treating any addiction .

It's a shame that business interests have gotten involved in what should be a straight swap out with appropriate prescribed nicotine replacement treatments , which is making it harder for those that have reached to decision to try to stop.

The vape industry is big business and the powerful tobacco lobby has gotten behind it big time in the US and it appears UK to successfully promote and push it as a 'safe ' replacement for smoking .

CDC and EU are not happy with this as conclusions so far from evidence to date is that while risks from e- cigarettes are moderate in comparison to smoking , they are substantial enough to warrant caution, and to be actively discouraged for recreational use eg in non smokers .

It is interesting to see Vape Ireland and other Irish vaping interests quoting and directing people to UK sites for information instead of Irish and EU sites .

This makes it very difficult for the average smoker to make an informed decisions about choices to help quitting .

Information about addiction and treatment should never be obtained from vested interests in industry , go to established health websites / medical professionals .

Because like any addiction , people have to accept their addiction and want to stop before any treatment can work. This is why registering to quit / going to your doctor about it is the first step in a process..

Replacement with a half harmful/ 'not-sure-how-bad- longterm-it-will-be' replacement like vaping just puts the decision to quit off for longer and the person is not really giving up , just substituting one harmful habit for another albeit less harmful .

People who are not smokers btw are commenting as many of us have faced addiction or have family in our lives who have in one form or another .

When you are in crisis like in the middle of a health scare or with relatives hospitalised is not the time to be enforcing strict rules and codes of behaviour.

In fact smoking areas which are covered from the elements and accessible for all is much more humane and imo should be provided at every hospital .

I think the premise of the thread should be " How can we support people while they are in crisis and following on from this help them to kick their addiction ?" ...not knock people further when they are at their weakest point .

[Deleted User]

https://www.boards.ie/discussion/comment/120859551#Comment_120859551

Was his one leg on fire or what?

https://www.boards.ie/discussion/comment/120859527#Comment_120859527

They could certainly enforce it for their own staff, such as the paramedic mentioned by the OP. There's no reason for this, and it encourages patients and visitors to have a go too.

o1s1n

https://www.boards.ie/discussion/comment/120873921#Comment_120873921

As an ex smoker myself I always say to people that it was like trying to give up chocolate for me. After giving it up, you know it still exists, you know it still tastes delicious, that never goes away. It will always be the case too.

I absolutely loved smoking. Loved rolling my cigarettes, the act of inhaling the smoke, pairing it with wine.. absolutely gorgeous.

Decided about 5 years ago that I kind of loved living and not having lung cancer more.. so I'd to make a choice to give it up.

Don't smoke at all anymore but part of me will forever wish I could! 😥

65535

https://www.boards.ie/discussion/comment/120880624#Comment_120880624

He had the pallour of death upon him - he leg amputated due to smoking - but still smoking

Andy From Sligo

https://www.boards.ie/discussion/comment/120880634#Comment_120880634

that's a very good way of describing it. I never thought of it like that

[Deleted User]

https://www.boards.ie/discussion/comment/120873871#Comment_120873871

if they want and choose to? you have absolutely no idea what being addicted means

Spanish Eyes

@Goldengirl

Thanks for the lengthy response. Unfortunately it seems that non vaping NRTs do not work as well as vapes. I suppose it is the ritual for smokers that is replicated. I do agree with you that vaping in non smokers should not be encouraged. I feel that if people continue to spew emissions all over the place in juice guzzling cars where none of us can escape the fumes, then the steam from a vape is ok by me when passing by the vaper. Up to the vapers to read reams of stuff about the apparent dangers, but that's their issue not mine. Vaping doesn't bother me at all.

If you look up something on the HSE website much of it is lifted word for word from the NHS website. They must have an agreement with NHS to reproduce it.

By the time (if ever) it is discovered that steam and flavourings and food additive type accelerants will do you great damage, global warming from other things will mean we are all doomed anyway.

Goldengirl

https://www.boards.ie/discussion/comment/120883537#Comment_120883537

Yes , we'll most likely be either burnt to a crisp or under water :)

Would agree that its having something to do with your hands as well as the familiarity of smoking that makes vaping a preferred replacement for so many .

As regards the HSE site I would disagree because in this it is quite specifically is different in not recommending vaping as a replacement, unlike the NHS site .

I suppose most health info sites are similar but depending on the country you happen to be in the advise may differ with certain drugs and meds .

By the way I have no problem with vapers or smokers either as per my post. I think this whole thread is overblown out of all proportion and in the end of the day nobody's business really if grown adults choose to smoke outside in the open or vape to their hearts content ( or not as some of the research may indicate !) The fact that it may happen on the street outside a hospital is just looking for a reason to give out about either these people or the beleaguered healthcare workers all of whom have more on their minds than chasing people and fighting with them outside the hospital .

The reply above was to Grayson's post as well so apologies for the length... it was a Twofer !

Goldengirl

https://www.boards.ie/discussion/comment/120881097#Comment_120881097

Well tbh ain't no well meaning hospital worker or paramedic going to stop him by pointing to a sign then are they? ;)

[Deleted User]

I always remember a girl I use to work with telling me when her dad was dying..good few years ago now..but she was saying I don't know how he got the cigarettes but he'd just randomly light one up in the hospital and they'd be like 'dad! You can't do that!" Lol

It was actually a thing where my grandad would take my granny out for a cigarette when she was dying in the hospital and when my mam would come to take over for him he'd say 'you make sure you take that woman out for her cigarette'.

Goldengirl

https://www.boards.ie/discussion/comment/120886272#Comment_120886272

When I started nursing the person selling newspapers and snacks from trolley used to be selling packs of cigarettes too 😊 One of the big no nos was patients lighting up if on oxygen, " in case of explosion " , no mention of any other potential problems!

There was a day room on every ward that had everybody packed in smoking and the haze of smoke used to waft down the corridors where it was supplemented by smoke from the kitchen / staffroom !

I remember a vascular surgeon on ward round telling potential amputees that he was not going to looker talk to them again if they did not give up the fags never mind operate , and he was reprimanded by the hospital board 😁

What a different world we live in now...thank ..MM ?

Mrs OBumble

https://www.boards.ie/discussion/comment/120886272#Comment_120886272

If someone is dying, they should be getting palliative care and not in an acute hospital setting. It's the only place where a different approach to addictions is appropriate, and even then the health of staff and visitors needs to be considered too.

[Deleted User]

https://www.boards.ie/discussion/comment/120887991#Comment_120887991

I agree but in those situations they were in hospital for a long stay for a reason I don't know. They were sick which eventually led to them dying so that's why I said that phrase. We talk about a whole two years where my granny's health was deteriorating as her dying. I'm getting a bit sad now 😔

Andy From Sligo

https://www.boards.ie/discussion/comment/120887074#Comment_120887074

Ah yes i remember them day rooms , and all the smoking patients and visitors that went in them . i wonder if they still have the day rooms in Hospitals these days on the wards? (not the smoking in them obviously) - most probably not the space now for a Day room.

On that old "The Royal" hospital drama programme on TV the surgeon used to walk around the wards smoking a pipe . Think thats what they used to do back in the day

Grayson

https://www.boards.ie/discussion/comment/120880518#Comment_120880518

That's a wall of text with very little information.

At mentioned by one of the people you were replying to, propane glycerol is used in loads of stuff already. The same with vegetable glycerol. They're both used in both food stuffs and stuff that we inhale. The other addition is nicotine.

Vaping works and it works because the delivery system is better. Patches give a slow dribble over time and take ages to remove. Inhalators are just as bad. The gum is horrible and causes upset stomachs.

You already posted loads of facts which people here disproved like stuff about popcorn lung. So you went looking for more which are even hazier. And you've presented no studies or anything like that to back up what you're saying. You even included the risk of batteries exploding. That has happened when people use unregulated vape mods. But only a tiny number of people have done that and it's the equivalent of using a DIY phone. I haven't even seen one on sale for years. You'd have to really search that stuff to be able to buy it.

It feels that you don't like vaping. So you posted stuff and when you were proven wrong, you went looking for more information to back up your feeling rather than accepting the information and changing your mind.

[Deleted User]

https://www.boards.ie/discussion/comment/120889077#Comment_120889077

vapes other than “DIY” ones have “exploded” in people’s faces.

Goldengirl

https://www.boards.ie/discussion/comment/120889077#Comment_120889077

Just opinion from you. And a bit of unnecessary rudeness.

I didn't mention batteries exploding??

I have no agenda really but don't rate them and there is enough to warrant caution around their use.

I included enough evidence without wanting to hit peoole over the head with it

If I wanted to really go for it there is loads of evidence out there to show probable damage down the line but it is still in early stages and preferable to smoking, of course, which is basically lethal.

I have completely explained the thinking around popcorn lung in my reply to Soanish Eyes but you choose to have a go anyway. . You chose to ignore your own resp consultants' advice by your own account who did not advise continuing to vape.

So no more to say to you as waste of time really.. you don't want to hear anything negative about your chosen path. From anyone iit apoears. And from above uou get more than a little angry if someone disagrees.

Others think it preferable, but healthcare generally here and in the EU would be inclined towards other forms of replacement therapy.

I am in the latter category.

By the way about the glycols etc you do know that many fairly innocuous olis and polyols change to less than healthy constituents when heated or turned to smoke.

Even olive oil.

Nobody "proved me wrong" either.

All that others have posted here so far is their own opinions.

Which we are all entitled to.

You can vape off now as far as I am concerned.