The NHS and Vaping

The NHS and vaping - how does the British healthcare system treat vapers?

Britain’s National Health Service is unquestionably the most popular institution the country has. Founded in 1945, it offers all kinds of healthcare free at the point of use to anyone in the country who needs it.

The British Government has also been at the forefront of encouraging smokers to switch to less harmful products like vapes or nicotine pouches. The Department of Health, backed by medical doctors at the Royal College of Physicians, regularly tells smokers that they’d be far better off if they vaped, and that vaping is 95% less harmful than smoking.

But how does the NHS itself - the hospitals and other healthcare facilities that fall within the remit of this huge national treasure - deal with vaping in the real world?

We decided to find out.

Do NHS doctors encourage smokers to switch?

Doctors in England tend to be better informed about vaping than in many other places in the word due to the stance the British government has taken on them - actively encouraging their use by smokers. And the NHS is no exception.

The NHS website has useful advice for patients hoping they can switch to vaping. A long article on the subject answers a lot of the questions smokers have about switching to vape juice, like “how safe is vaping?”, “do they pose a fire risk?” and “is e-cigarette vapour harmful to others?”. The site even advises smokers to seek advice from local vape shops as well as stop smoking services.

Doctors organisations in the UK - whose members will all work in the NHS in some capacity - are also keen to encourage smokers to vape. The largest and most respected Doctors body in the Country, the Royal College of Physicians, said in a seminal publication “Nicotine Without Smoke”, that “in the interests of public health it is important to promote the use of e-cigarettes, NRT and other non-tobacco nicotine products as widely as possible as a substitute for smoking in the UK.

Can you vape on NHS hospital grounds?

Duncan Selbie, the former Chief Executive of Public Health England, once complained that “it is more acceptable in some hospitals to smoke at the front door than it is at a pub…One in four hospital beds are occupied by a smoker, and most of them are trying to quit. It is time for the NHS to stop smoking within its hospital grounds”.

But what about vaping?

This depends where in the United Kingdom you are; and in some cases, hospitals in the same area can have different views on the topic. While it’s pretty much a universal rule that smoking is banned within hospital buildings, there are a lot of interesting different approaches to vaping outside while on hospital grounds that mean it’s possible to vape, but not smoke, in hospitals from Glasgow to Devon.

The NHS in Greater Glasgow and Clyde says on its website that while smoking is banned, vape kits can be used anywhere on NHS grounds by patients, visitors as staff save for the entrances and exits to hospitals and other healthcare facilities. They even offer advice for charging and storing vaping products on site!

This policy is increasingly common in British hospitals. A freedom of information act showed that around half of hospitals allowed vaping on their grounds in 2019, and at the time, 14% said they were in the process of reviewing their policies so as to permit vapes outside.

One of those mulling a change was Derriford hospital, one among many which decided to allow vaping on hospital grounds in 2020 - indicating that since the Freedom of Information Request was made, many more NHS facilities have probably taken a more enlightened view of vaping within their grounds. Derriford also renamed their policy “tobacco free” instead of “smoke free” to help avoid confusion, and placed helpful signs showing where the designated vaping areas are around its site.

Inpatients using British mental health services are more likely to smoke or use nicotine, so it’s also interesting to take a closer look at mental health facilities, which house some of the country’s most vulnerable patients. A survey of 45 NHS Mental Health Trusts from Action on Smoking and Health found that:

  • 91% of the mental health trusts that responded allowed some or all inpatients to vape
  • 47% of the trusts allowed people to use all types of vape kits
  • 31% of the trusts only allowed the use of disposable vapes, presumably for safety reasons
  • 42% of the trusts provided free vapes to their patients
  • All but one trust restricted where people could vape
  • 44% of the trusts allowed the use of vape juice indoors
  • 76% of the trusts allowed the use of vape pens in ward courtyards

The British Government even gives advice to mental health facilities on the best way to help patients access vapes instead of cigarettes.

Can you get more vapes in the NHS hospital shop?

Two hospitals in the West Midlands - both of which have steep £50 fines for smoking on hospital grounds but do allow vaping - have gone even further and allowed vape shops to open inside the hospital buildings themselves.

In 2019, The Guardian reported on two vape stores opening inside West Midlands hospitals, the first in West Bromwich’s Sandwell Hospital, and a second in Birmingham City hospital.

The NHS Trust in charge of those hospitals wants to eliminate passive smoking on its sites and encourage those who still light up to look at alternatives. “Every alternative is available and we ask visitors and patients to work with us to enforce these changes,”said Dr David Carruthers, the Trust’s clinical director. Giving up smoking saves you money and saves your health”.

Another group of hospitals are giving vapes away for free! As part of a trial undertaken by the University of East Anglia, four hospitals in England and one in Scotland are giving away free starter kits.

The 1,000 smokers who take part will be randomly assigned to receive either smoking advice during their emergency department wait, an e-cigarette starter kit and referral to local stop smoking services, or just written information about locally available stop smoking services. Both groups will be asked if they are still smoking one, three and six months after they attended hospital.

Professor Caitlin Notley, from UEA’s Norwich Medical School, said: “Many people who smoke want to quit, but find it difficult to succeed in the long term.

“Electronic cigarettes…can be an attractive option for helping people switch from smoking, even if they have tried and failed in the past.

“We know that they are much less harmful than smoking tobacco, and that they have been shown to help smokers quit.”

The NHS helping smokers make better choices

NHS doctors, nurses and staff know that their patients will be better off without cigarettes. Many part of the NHS have embraced vaping for that reason - it’s a viable alternative to smoking for their patients.