General Policy
Medical Director
GP/S2
NHS Fife Tobacco Lead, NHS Fife Human Resource Advisor, Fife No Smoking Policy Review Group
NHS Fife Tobacco Lead, NHS Fife Human Resource Advisor, Fife No-Smoking Policy Review Group
Joy Tomlinson, Director of Public Health
01 March 2013
01 March 2025
01 March 2026
1

General Note

NHS Fife acknowledges and agrees with the importance of regular and timely review of policy statements and aims to review policies within the timescales set out. New policies will be subject to a review date of no more than 1 year from the date of the first issue.

Reviewed policies will have a review date set that is relevant to the content (advised by the author) but will be no longer than 3 years.

If a policy is past its review date, then the content will remain extant until such time as the policy review is complete and the new version published, or if national policy or legislative changes are made.

1. FUNCTION

The purpose of the policy is to inform of legislative changes following amendments of the 2006 smoke-free enclosed public spaces legislation in Scotland. It describes the implications for NHS Fife.

NHS Fife maintains a smoke-free site approach to smoking within its premises and grounds for patients, visitors, and staff; as of 05 September 2022, smoking within 15 metres of a hospital building is an offence. Smoking around hospital buildings - Smoking - gov.scot

1.1

NHS Fife recognises its duty to comply with the Smoking, Health and Social Care (Scotland) Act 2005 which bans smoking in wholly or substantially enclosed public places.

As part of the 2005 Act, with effect from 05 September 2022, NHS Fife does comply with the new regulations. An enforceable ban of smoking outside hospital buildings (defined as a 15-metre perimeter from a hospital building) is in place. A fixed penalty can be issued for breaches of this legislation by Fife Council Safer Communities enforcement officers.

In addition, NHS Fife recognises its duty to comply with the Health and Safety at Work Act 1974 Section 2 which sets out the legal obligation to maintain a working environment for all employees that is, so far as is reasonably practical, safe and without risks to health.

1.2

NHS Fife is committed to the development and implementation of more comprehensive organisational tobacco policies with which this policy contributes.

Scottish Government’s Health Promoting Health Service (HPHS) provides direction to this locally: Chief Medical Officer letters - HPHS Delivery & Reporting Support - The Knowledge Network: Scotland's source of knowledge for health and care

1.3

This policy supports the Scottish Government’s action plan - Raising Scotland's tobacco-free generation: Refreshed Tobacco Action Plan (2023) which is a five-year action plan setting out interventions and policies to help reduce the use of and associated harms from using tobacco in Scotland and contains the following action relating to smoke-free NHS grounds:

The aim is to remove the visibility of smoking from environments in which people are facing health challenges. Restrictions will help protect people – patients, visitors and staff – from the health risks associated with second hand smoke. Raising Scotland's tobacco-free generation: our tobacco control action plan 2018 - gov.scot and Tobacco and vaping framework: roadmap to 2034 - gov.scot

NHS Fife will continue to operate a whole site smoking ban, but this new legislation requires no-smoking areas directly outside hospital buildings.

1.4

Smoking remains one of the biggest single preventable causes of ill health and early death in our community and causes the premature death of 13,000 people in Scotland every year.

1.5

Active smoking poses a fire risk on NHS premises and an infection control risk with cost implications for clearing up smoking related debris within grounds/sites.

1.6

NHS Fife, as an exemplar employer, has a responsibility to set a good example in health improvement and to work towards national targets set to reduce smoking and the incidence of diseases caused by tobacco smoke. NHS Fife, as a health promoting organisation, has a responsibility to promote healthy living and non-smoking as the norm. This policy states that smoking will not be allowed within any NHS Fife premises, around entrances or buildings, within NHS Fife grounds, or within any NHS Fife vehicles.

The use of e-cigarettes and vaping devices are also prohibited by this policy.

1.7

This policy recognises:

  • Smoking is a personal choice.
  • The policy aims to create a smokefree, healthy and safe environment for staff, patients and visitors.
  • The policy ensures that smoking does not take place on NHS premises/grounds.
  • NHS Fife is committed to provide support for smokers who want assistance with giving up smoking.
  • In-patients have access to Nicotine Replacement Therapy (NRT) products whilst staying in hospital through our Temporary Abstinence programme, contact the Stop Smoking Service for further information Stop smoking service | NHS Fife.
  • No patient, visitor or staff member should be exposed to second hand smoke against their will.
  • Support and information is available - Stop smoking service | NHS Fife

1.8

There are no exceptions in respect of mental health sites.

2. LOCATION

2.1

This policy applies to:

  • All NHS Fife staff;
  • All patients, including out-patients, day-patients, in-patients and long-stay patients;
  • All other people, including visitors, contractors, students, agency staff, bank staff, voluntary staff and anyone whose work, study or personal circumstances brings them into NHS Fife premises.

3. RESPONSIBILITY

3.1

Managers are responsible for making sure that:

  • Staff are made aware of and supported with the implementation of the policy with regards to colleagues, visitors, patients, contractors and other non-NHS staff;
  • Employees who express a desire to stop smoking are supported and signposted to Fife Stop Smoking, contact: Stop smoking service | NHS Fife;
  • Any breaches of the policy by staff will be considered in line with the NHS Scotland Workforce Polices Investigation process: Workforce Policies Investigation Process Overview | NHSScotland Careers. Alongside this process resources will be made available to support those in breach of the policy. Breaches of the policy should be reported by email to fife.smokefreefife@nhs.scot. Following the NHS Scotland Workforce Policies Investigation process, depending on the nature of the breach the matter may progress to a conduct hearing where a disciplinary sanction may be issued.
  • No smoking notices are displayed within areas of responsibility; if required updates or replacements can be requested from the Tobacco Lead, or from the stop smoking team.

3.2

All NHS Fife Staff are responsible for making sure that they:

  • Understand and fully comply with this policy and provide a suitable role model for other staff, patients and visitors.
  • Support the implementation of the policy with regards to colleagues, visitors, patients, volunteers, contractors and other non-NHS staff;
  • Raise breaches of the policy with their line manager. Where an employee finds someone who is smoking in NHS Fife premises, they inform them of the policy and ask them to extinguish their smoking material or stop using an e-cigarette/vaping device.
  • Employees are expected to use their initiative and and professional judgement in such situations and are not expected to enforce the policy other than bringing the policy to the awareness of the person who is smoking, unless they feel that by doing so, they may be putting themselves at undue risk.
  • Report breaches of the policy, i.e., smoking in the building/grounds, by ensuring that the breach is reported by email to fife.smokefreefife@nhs.scot
  • Do not smoke at any time whilst they are on duty. Staff on-call are not permitted to smoke when required to attend work as a result of a call out, or if using on-call accommodation within NHS Fife premises.
  • Do not smoke in any official NHS Fife vehicles at any time, or during journeys on NHS business.
  • Do not smoke in their own vehicles when parked on NHS grounds/sites.
  • Do not smoke in uniform/working clothes during working hours. Staff who do this should be aware that this action undermines the health improvement message of NHS Fife, which is committed to the principle of being a health promoting health service. In addition, third hand smoke on uniforms/working clothes may compromise the comfort of both patients and other colleagues.
  • Comply with other organisations’ smoking policies when working at or visiting other sites.

3.3

All Patients and Visitors:

  • Will not be permitted to smoke in NHS Fife’s buildings or grounds.
  • Will not be permitted to smoke in vehicles while these vehicles are on NHS grounds / sites.
  • Patients will be advised of NHS Fife’s Smoking Policy, and associated penalties as stipulated in https://www.gov.scot/policies/smoking/smoking-around-hospital-buildings/.
  • Patients will be advised of Stop Smoking support available prior to admission where possible, with their smoking status documented. Assistance and support should be offered on admittance, during their stay and on discharge.
  • Staff have responsibility to manage patients’ addiction whilst in our care through the temporary abstinence pathway.

4. OPERATIONAL SYSTEM

4.1

This policy is designed to:

  • Protect and improve the health of the population of Fife by providing a smoke-free environment for all, while offering support to those who smoke and would like to stop;
  • Prevent patients, visitors and staff from being exposed to tobacco smoke;
  • Promote healthy living and non-smoking as the norm. The Stop Smoking Service offers a range of support and advice to anyone wishing to stop smoking; this is promoted across NHS Fife. Information and contact details are found via Stop smoking service | NHS Fife.
  • Support health improvement by promoting change in attitudes towards smoking.
  • Promote an environment whereby people are discouraged from starting to smoke or continuing to smoke.
  • Staff are equipped with knowledge and understanding to support health improvement and promote change in attitudes towards smoking.

4.2

NHS Fife operates a whole site no-smoking policy, smoking or vaping is not permitted at any time for staff, patients, visitors, volunteers, non-NHS staff, contractors, or the general public:

  • within all NHS Fife premises or residences;
  • within 15 metres or the vicinity of entrances to NHS Fife buildings;
  • within its grounds, this includes car parks, maintenance areas, gardens, foot paths, on site bus stops, entrances or exits etc;
  • in any official NHS Fife vehicle, while on health service grounds, or whilst being used for NHS business;
  • in any vehicle on NHS Fife sites or grounds, regardless of ownership;
  • staff may not smoke while in uniform/working clothes even when outwith NHS sites;
  • staff are not permitted to smoke in privately owned vehicles while these vehicles are on NHS grounds, or while using their vehicle to carry a colleague or patient as a passenger during working hours;
  • passengers should not be exposed to second hand smoke. This will ensure that staff, patients and visitors are protected from the dangers of second-hand smoke while on NHS Fife premises and grounds.

4.3

In areas subject to the Smoking, Health and Social Care (Scotland) Act 2005 legislation-compliant signage will be displayed in order to make staff, patients and visitors aware that they must comply with the law and highlight associated fines.

4.4

NHS Fife will support public health awareness campaigns in relation to smoking and will support and encourage employees and patients who wish to give up by offering stop smoking support and providing information about local stop smoking services. Further information on stop smoking services in NHS Fife are detailed in Stop smoking service | NHS Fife website.

4.5

NHS Fife will ask patients, their carers, or relatives not to smoke when NHS Fife staff visit them at home during the course of their duties and ideally for an hour before the scheduled time of any visit. This will be detailed in appointment letters. Home visits may be at risk if patients or families refuse this request, and this should be reported on Datix. A risk assessment may be required to ensure the employee’s exposure to second hand smoke is reduced by adopting safer systems of working.

4.6

A risk assessment should be undertaken before home/off site visiting in the case of staff who have a pre-existing condition such as asthma, chronic obstructive pulmonary disease (COPD) or cardiovascular disease made worse by exposure to tobacco smoke, or who face additional risks. Additional advice can be sought via a management referral to Occupational Health and Wellbeing.

4.7

Staff should include an assessment of each patient’s smoking status on admission and take account of the possible need to deal with nicotine withdrawal symptoms in developing care plans. NHS Fife will endeavour to offer appropriate advice and support on how to stop smoking to those patients who wish to quit by contacting Fife.smokingcessation@nhs.scot.

Additional advice can be sought via a management referral to Occupational Health and Wellbeing.

4.8

Staff must advise patients to refrain from leaving NHS premises and grounds to smoke. Patients who still decide to leave must be advised by staff that they do this at their own risk, and this should be recorded in patient notes.

Staff are not to escort patients outside NHS Fife buildings and grounds in order for them to smoke.

4.9

This Policy is part of each staff member's employment documentation and prospective staff must be informed of the policy at recruitment stage. The policy will be confirmed to successful candidates along with their contract of employment.

5. RISK MANAGEMENT

5.1

NHS Fife is responsible for:

  • Maintaining a safe and healthy working environment;
  • Protecting the health of patients and staff, and not subjecting them to hazardous environments and materials; and
  • Ensuring that staff understand their responsibilities to take reasonable care of the health and safety of themselves and others.

5.2

NHS Fife has a duty to comply with the Smoking, Health and Social Care (Scotland) Act 2005 which prohibits smoking in enclosed public places and associated legislation. Failure to comply with this legislation could result in individual on the spot fine being issued.

NHS Fife could be exposed to the risk of prosecution should smoking take place in those NHS premises subject to this legislation.

5.3

Failure to implement this policy would place NHS Fife at risk of claims from employees relating to occupationally acquired smoking-related conditions. This would lead to loss of reputation as an exemplar employer and as a health promoting organisation: and possible financial consequences should any action be successful.

6. RELATED DOCUMENTS

7. REFERENCES