Smoke-free Scotland - Guidance on smoking policies for the NHS, local authorities and care service providers

4 Going Forward - The Case for Completely Smoke-Free

Much of this document has been devoted to explaining the implications of the legal requirements created by the smoke-free legislation. Prior to the introduction of the law, NHS organisations, local authorities and care service providers should inform their staff, service users, patients, visitors and clients that as of the 26th March 2006, the organisation's enclosed premises will be smoke-free. In addition it needs to display signs, brief managers and ensure that 'all reasonable precautions' are taken to comply with the legislation.

To maximise the health and economic benefits to the organisation, compliance should be supported by the development of a comprehensive written workplace tobacco policy, which goes beyond the legal requirements and carries the organisation towards the goal of being completely smoke-free.

Such a policy has at its core the concept of supporting smokers to stop smoking, not by compulsion or under threat, but rather by providing information, advice and support, which enables and encourages them to appreciate the health and other benefits, which accrue when someone stops smoking.

The development of such policies is underpinned by an organisational commitment to effective communication and consultation. This in turn means that measures implemented have the support of the staff, and levels of compliance will be even higher.

The health and business cases for going completely smoke-free are set out in full in Appendix 2, but key points include:

The Health Case

• Second-hand smoke has been labelled carcinogenic to humans ¹⁵ it represents a substantial public health hazard and no infant, child or adult should be exposed to it ¹⁶
• Every year up to 1000 lifelong non-smokers die in Scotland as a result of exposure to second- hand smoke ¹⁷
• Exposure to second-hand smoke is a cause of lung cancer and heart disease ¹⁸
• Reducing people's exposure to tobacco smoke will reduce the disease burden on adults and children. In addition the introduction of smoke-free public places has been linked with a reduction in smoking prevalence - people use the move to smoke-free as an opportunity to quit, and consequently derive all the benefits to health that quitting smoking brings ¹¹
• So far as the workplace is concerned, tobacco has an impact on employees health and fitness for work. Tobacco will cause the premature death of half of all regular smokers, and of these a half will die in mid life, that is between the ages of 45 and 69 ¹⁹. Of those smokers who are not killed by their habit, many will experience tobacco related disease. This means that organisations are at risk of losing valuable and experienced employees at a time when pressure on the labour market is increasing due to the ageing of the working population. Helping smokers quit the habit and becoming a truly 'smoke-free organisation', reduces this pressure on the labour force.

The Business Case

• At the macro economic level the introduction of a smoking ban in Scotland has been estimated over a thirty year period to be a positive, net present value gain of around £4620 million pounds (the mid point of a range from £55 million to £7395 million) ²⁰
• The economic impact of smoking on the workplace is well documented with factors influencing costs including time away from the workplace in order to smoke a cigarette, and increased costs due to higher levels of sickness absence and lost productivity ²¹
• Having a comprehensive smoke-free policy which has been developed through consultation and in partnership with the workforce results in the employer being seen in the wider community as 'caring', and this is recognised as being important in terms of both recruitment and retention.