CardioExchange Archive

Reading a recent special article and editorial in the New England Journal of Medicine about diseases caused by smoking has reignited my resentment toward the red carpet that is rolled out for smokers in the hospital where I practice.

Following the courageous decisions made by many American mayors to ban smoking in public places, including parks, I had hoped that the management of the American Hospital of Paris would impose a smoking ban throughout its premises, including the garden.

A Special Place Just for Smokers

If you were to come visit our hospital, you’d find that, under the “Tobacco-Free Hospital” signs, there is now an arrow pointing to the “Smoking Shelter”. Unfortunately, this is not a joke!

Under alleged pressure from smokers, and despite protestations from many professionals, a glass room (much like a lovely greenhouse) has just been completed.

Is this irony or provocation? The entrance to this smoking room is adjacent to the Health Center, which is dedicated to screening for many diseases, including cardiovascular disease. The hospital is very proud of the Health Center, however, when patients walk out the doors they will now be confronted with smokers from this room dedicated entirely to smoking.

What’s more, it is a very elegant room: designer pedestal tables, teak benches, tiled floors, tinted windows, and the recent addition of a heater to ward off the winter chill, ensuring that nothing deters the people from smoking.  Will they be supplied with air conditioning in the summer? There is no harm in asking!

Setting a Good Example

Tobacco aromas escape, teasing the users of this busy corridor and encouraging people in the Visitor Restaurant who may like the idea of a quick smoke with their coffee… And why not enjoy one with the smoking healthcare professionals who are setting such a good example?

Several months ago I made a suggestion to the management via Occupational Health to provide financial support for women (who form the majority of our hospital personnel) to stop smoking by providing them with free nicotine patches.  Unfortunately, this initiative has never seen the light of day (for accounting reasons?). Subsequently, I have been pleased to see that such an initiative had been implemented in Scotland with pregnant women. So it is possible!

Taking the elevator with a caregiver, medic, or other technician whose clothes are saturated with the smell of tobacco smoke never fails to make me cringe. My personal opinion is that it is disrespectful to patients to be confronted with such an unpleasant smell. Some patients suffer from diseases caused by tobacco and struggle to quit — this confrontation is probably even harder for them to tolerate.

Despite having an expensive room reserved for their sole use, smokers also smoke in the gardens. This results in hospitalized patients witnessing the sad spectacle of the “white coats” poisoning themselves with tobacco when they look from their windows or move around the hospital.

First Step Toward a Complete Smoking Ban

We certainly cannot prevent people from smoking any more than we can ban alcohol. However, I know that drinking alcohol in the workplace is prohibited.  So why allow smoking in a health facility? Smokers have every opportunity to indulge at home.

The Director and Board of Governors, a majority of whom are American citizens, should remember the American roots of the hospital and ban any form of smoking throughout the hospital including the car parks and gardens. Shouldn’t the first decision be to hand out penalties to smokers who smoke anywhere other than the smoking room?

Pending this initial diktat(!), I am going to put pamphlets on the dangers of smoking from the American Cancer Society on the tables and benches in the smoking room.  How many regulars will read it? How long will it stay there?