Get well soon if you are dying to have a smoke

By FRANCESCA MOLD and MARTIN JOHNSTON

Lawrence Tai defies the no-smoking signs outside Auckland Hospital - and the advice of his doctor.

The 54-year-old heart and lung patient from Glen Innes, who is also awaiting a hernia operation, said yesterday that he was not supposed to smoke, so he nipped out the front for a drag rather than going to the patients' smoking room.

"It's a wonder they don't refuse to treat me," said Mr Tai, who added that he had cut down since he went to hospital on Friday after a mild heart attack.

"It's the only pleasure I have got now," said Mr Tai, a smoker since he was 15 and an invalid beneficiary since a car accident in 1995.

Nicotine-addicted patients can still light up at "smokefree" public hospitals, but the squeeze is going on the places where they can indulge.

Hospitals are acutely aware of their status as health icons, and some are cracking down on tobacco smoking, a leading cause of disease and death.

"It is our responsibility to discourage smoking wherever possible and to set an example to our community," says Stephen McKernan, the chief executive of the state-owned Hutt Valley Health company.

Staff and visitors are not allowed to smoke in Hutt Hospital's building or grounds or at any of the company's other facilities.

They also must not smoke anywhere if they are on company business or wearing company identification.

Smoking areas have been retained for patients - a room in the hospital and a courtyard in the mental health unit.

Under the Smokefree Environments Act, hospitals and rest-homes must let patients or residents smoke in smokefree areas if they are so incapacitated they cannot be moved easily.

Public hospital smokefree policies in the central and upper North Island generally allow smoking outdoors, although one will ban it soon.

Smoking areas - usually outside - are often provided, at least for patients.

Tairawhiti Healthcare Smoking is already banned indoors and in company cars. The ban will be extended to include hospital grounds from July 1.

Gisborne Hospital's designated outdoor smoking area will be abolished then, but patient smoking areas will be retained at mental health facilities.

The company subsidises quit-smoking products for staff.

Auckland Healthcare Smoking is forbidden throughout all buildings and in vehicles, although Auckland Hospital has a smoking room for patients.

People are discouraged from smoking outside the main entrance - a concern at many hospitals - but the policy does not ban smoking outdoors on company land.

Waitemata Health Smoking is banned in vehicles and buildings, apart from patient smoking rooms - one in North Shore Hospital and in each secure mental-health unit, but not at Waitakere Hospital.

The North Shore room is only for patients so ill they cannot be taken outside in a wheelchair. Staff smokers must use a designated outdoor area.

Smoking patients are offered nicotine patches to inhibit their desire for tobacco.

South Auckland Health Smoking is allowed in the grounds, but not in vehicles and "internal facilities, including foyers, balconies and entrances."

But Middlemore Hospital managers say they "don't make an issue" of patients smoking in a hospital foyer. They don't want to overburden people already anxious about illness by forcing them to stop smoking at hospital, "despite the irony."

Health Waikato Smoking is not allowed in buildings, within 10m of buildings or in company cars. The company has designated outdoor smoking areas.

Pacific Health Smoking is allowed in the grounds of Tauranga and Whakatane Hospitals but not in buildings.

Staff smoking areas are provided, and Whakatane Hospital has a sheltered and paved outdoor smoking area.

Tauranga Hospital is planning an area for visitors and patients who want to smoke, to deter people from smoking at the entrance.

Lakeland Health Smoking has been banned in all buildings, including Rotorua Hospital, since 1995, but is permitted in hospital grounds.

The company discourages staff from smoking in public when they are wearing company identification as it "doesn't project a healthy image."

Hospitals display Quitline posters, and encourage staff to call the number if they want to give up.

Northland Health A staff committee is reviewing the policy, but from July 1 staff will not be allowed to smoke on company premises.

The company wants to extend the policy to patients and visitors, but this is still being discussed.