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Petitioning Chief Executive of Public Health England Duncan Selbie and 5 others

Don't Ban Smoking In Mental Health Facilities

We, the undersigned, call on the National Institute for Health and Care Excellence (NICE) and Public Health England (PHE) to reverse their guidance to mental health facilities regarding outdoor smoking bans. Currently these bodies are pushing for a total ban on all tobacco smoking in secure outdoor areas, leading to much distress for psychiatric in-patients and bother for staff.

We recognise the great leaps forward made in mental health care over the past three decades. Thanks to tremendous advances in medication and more humane policy, patients are often detained for less than 30 days before re-joining society and receiving care in the community. Sadly then, outdoor smoking bans will partly undo this good work because they will make mental health sufferers, the majority of whom smoke, less likely to seek treatment. Rather than seek treatment or even grudgingly accept it, the two thirds of mental health sufferers that smoke will avoid seeking help and be more resistant. Staff already have an uphill struggle trying to convince patients they are on their side, a ban is a further impediment and will make hospitals seem scary.

The ability to smoke outdoors in psychiatric hospitals is what patients want, not just because of the nicotine, but because it is a social activity. Friendships are built, staff break down barriers with patients, and all this aids recovery. Additionally the freedom to smoke assists the smooth running of the place by reducing conflict and making the experience a little less wretched.

Psychiatric in-patients should be receiving the best possible care for their mental health condition. Smoking, whilst physically an unhealthy pastime, is unrelated to mental health except to the positive extent that it can ease the stress of one's stay. Smoking is clearly in a different category to something like self-harm with a knife, so it is not the business of professionals to 'treat' it against a patient's will.

Unlike intoxicants such as alcohol or illegal drugs, tobacco use does not inhibit effective mental health treatment. Therefore it is not something a clinic should have jurisdiction over, for the same reason one doesn't go there to lose weight, become physically fit, or train for the Olympics. Just because a patient is held in a centre, it does not mean they become playthings for public health experiments, they should still be regarded as autonomous human beings. Public health officials should not take advantage of the fact of one's 'sectioning' to believe they can do what they want with a patient.

Furthermore the new bans have not been democratically discussed in Parliament, so we would like Westminster to issue a statement that NICE and PHE should not overstep their role. NICE and PHE should not be demanding policy that has no explicit consent from society.

Outdoor smoking bans have no health justification that is respectful to choice, are cruel, and are proceeding undemocratically.

Further reading: Public Health Tyrants Are Taking Over The Asylum

This petition was delivered to:
  • Chief Executive of Public Health England
    Duncan Selbie
  • Mark Baker,
  • Centre for Clinical Practice Director, NICE
    Mark Baker
  • Alexia Tonnel,
  • Communications Director, NICE
    Jane Gizbert
  • Director of Evidence Resources, NICE
    Alexia Tonnel

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