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From a general hospital in the midlands of England comes a curious tale of direct action to enforce health service smoke-free regulations. The problem was as instructive as the solution. National and local medical and health organisations have been pressing for totally smoke-free health service premises for more than a quarter of a century. So, with a deadline of December, 2006 for all National Health Service premises to finally be smoke free, many would say it was long overdue.
Nevertheless, it was often a long, messy struggle to agree to and implement a ban. At the hospital in question, those resisting the move invoked the spectre of patients, some possibly elderly, lonely and in the last few months of life, whose only comfort and pleasure was smoking. Mostly, the resisters were smoking members of staff, and the price eventually paid for their agreement to the ban was the establishment of a small, former nurses’ sitting-room as a smoking area. If it was supposed to be for the benefit of the most tobacco-dependent patients, doctors soon noticed that in reality, it was only ever used by a hard core of hospital employees.
All sorts of strategies were considered to end the exemption, but the prospect of re-entering a painfully slow cycle of talks with staff representatives was just too much for one doctor. He simply visited a local hardware shop and bought a padlock and the necessary steel fittings. One night, having brought the necessary tools from home, and checked that no one was inside, he fitted the hardware to the smoking room door, clicked the padlock shut and crept away to await developments. The outcome was both remarkable and unexceptional. It was as if the room had never existed: no one said a word. The problem was solved, finally and for good.
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