Prohibiting smoking outside hospital buildings: consultation

Section 1 - No-smoking area

The primary aim of the hospital-related provisions in the 2016 Act is to support the de-normalisation of smoking on NHS hospital grounds in order to reduce the use of tobacco across the population.

As was made clear in the policy memorandum for the 2016 Act, the Scottish Government does not believe it would be practical to introduce a statutory ban on smoking covering the entire extent of grounds associated with NHS hospitals. Such a ban would be very hard to enforce as many hospital sites cover large areas of land. The Government also believes it would be a disproportionate response to the problem of smoking being visible and potentially harmful where it is most undesirable – around buildings and particularly near building entrances and windows.

The policy memorandum highlights that there is evidence from studies of Second Hand Smoke (“SHS”) in outdoor environments which suggest that smoke-drift from outside can lead to levels of SHS inside building entrances and windows which may be high enough to warrant concern for people inside a building. The highest risk from smoke-drift will depend on the environment, but it is reasonable to expect that a no-smoking perimeter of 10 metres could provide adequate protection while a perimeter of 15 metres would reduce risk significantly.

During the Bill process Scottish Ministers indicated that the perimeter of no-smoking areas would ideally be 10-15 metres from hospital buildings. This focuses on the busiest areas where the majority of patients, visitors and staff pass through and where the bulk of non-compliance with the current administrative ban takes place. Ministers also committed to consult with health boards on the distance of the perimeter to be applied across all NHS Hospital sites. As a result of that consultation with health boards, and as published in the Scottish Government’s Tobacco Control Action Plan 2018, a distance of 15 metres is proposed for the no-smoking area perimeter.

There will be two situations where the actual perimeter could be greater than or less than 15 metres. The no-smoking area can only cover hospital grounds. So at any point where hospital grounds do not extend to 15 metres the no-smoking area perimeter will match the distance to which the hospital grounds extend. Also, we want to make sure smoking is not allowed anywhere under canopies or overhangs. Some of these could extend out from the hospital building more than 15 metres. So the proposal is that the perimeter, where there are larger canopies or overhangs, will extend to the edge of these where they are larger than 15 metres. See question 2, below

Measuring the perimeter distance

Hospital buildings are of various age, design and construction. Many have incorporated walkways, canopies and other covered structures designed to provide protection from the elements. These structures may extend beyond the 15 metre distance.

Some hospitals, such as the new Queen Elizabeth University Hospital in Glasgow, have reported incidents where people have gathered under canopies and other structures to smoke – creating both an obstruction and air-quality hazard. To prevent instances such as this, we propose that the no-smoking area should include all the land and areas beneath such canopies or overhangs – even where they measure more than 15 metres from the side of the hospital building.