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

5 Overcoming Likely Challenges and Obstacles

The smoke-free legislation protects the health of employees, patients, residents, clients and visitors. It is comprehensive and mandatory. Yet there may still be those who are unhappy about its implementation. This section provides some of the counter measures that can used to help people overcome their opposition. If the introduction of the smoke-free law is being used as an opportunity to develop a comprehensive tobacco control policy then addressing the issues below should be an important element of the policy development process. It is important for policy development and implementation to be approached in a sensitive and supportive manner including, as covered in section 6, signposting support which is available for those who wish to quit as a result of the introduction of smoke-free policies.

Despite widespread public support for smoke-free legislation ²², some employees and managers, may resist any restrictions on their ability to smoke during the working day.

Keeping them fully aware of the developmental process, providing opportunities during that process for consultation and involvement can all help. Of particular importance is that when an employee puts forward an opinion or point of view, this is acknowledged and followed up. The member of staff should be given feedback on what action has been taken in response or why their view has not been acted on, or if they were asking a question, an answer should be given.

Staff representatives should be fully involved in the developmental process, and equally involved in any consultation. Consultation should not only be through or with the staff representatives. It should include all staff, and communication channels, such as the intranet and staff newsletter, which can help greatly in this context.

Ultimately all staff must accept that the organisation is adopting this new approach to tobacco because it has a statutory responsibility to do so, and that in going beyond the legal requirements it is seeking to protect and promote the health and wellbeing of people associated with it.

So far as these groups are concerned the key to overcoming any resistance is communication, communication, communication.

Investing in good communication practice with these groups during the development phase, prior to and following the launch of the new approach, is central to its success.

While posters and signs have an important role to play, it is better to correspond and engage directly with these groups. The key opinion formers need to be approached, briefed and asked to support the move to smoke-free. Once their support has been gained it should be given a high profile.

Second-hand smoke, and the substances it contains, including more than forty carcinogens, cannot be controlled by ventilation, air cleaning, or by positioning smokers as far away as possible from non-smokers. Ventilation is a solution promoted by the tobacco industry but there are many studies which show that ventilation does not remove the harmful substances... as one expert states, ventilation would need to achieve "tornado like levels of air flow" to achieve a minimal risk ²³.

Ventilation is not the solution so far as second-hand smoke is concerned. It does remove the smell and the colour of the smoke; it does not fully remove the harmful substances it contains ²⁴. So while the air in a ventilated room may look and smell good, in reality it isn't harmless.

Given the evidence, which indicates that harmful substances remain in a ventilated room, does ventilation have any role to play? The answer is a cautious 'Yes'. In residential care settings, ventilation can be used in a completely independent smoking area, properly separated by air tight doors to 'pull' air through the room and then to the exterior. As has been indicated previously, the external vent needs to be carefully positioned to ensure that the air containing smoke is not able to drift into other rooms in the building through open windows or doors. Under no circumstances should air containing smoke be allowed to enter common ventilation ducts i.e. ducts which are used to circulate or carry air to other rooms in the building. It must be remembered that even though the air passing through the room is colourless and to a large extent odourless, it is not safe.

People will be committing an offence if they are smoking in no smoking premises, and those in control of the premises will also be committing an offence of allowing that person to smoke. It is important that the consequences of breaking the law are clearly communicated and understood.

Smokers in breach of the law will be subject to a fixed penalty notice and those permitting smoking on their premises may be subject to prosecution. There will be a national compliance phone line to support the legislation, to which complaints may be made about people smoking in no smoking premises and all complaints will be investigated.

There is public support for the move to greater smoking restriction in the workplace and in public places. Trades unions are supportive and in surveys undertaken among workers and the general public, support remains consistently high.

It is important to be clear with people that the legislation and associated workplace and public place restrictions on smoking do not call into question an adult's right to buy and smoke tobacco. Instead, in line with policies about drug and alcohol use, they make clear the circumstances in which tobacco may not be used.

Restricting the times and places where smoking is permitted is necessary because smoking produces a toxic substance, which is damaging to health. The key issue is not whether a person smokes, but when and where they do so and the impact this has on other people.