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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 25-January-2013, Vol 126 No 1368

Smokers are patients too and deserve more respect: a response to the 'smoking around hospitals' letter by Crane and colleagues
I was encouraged to read the letter from Crane et al1 pointing out the “peculiar perversity” of the Smokefree Environments Act which has moved patients with a smoking addiction from within to the public spaces around our hospitals. Their major concern is with patient safety.
I am astounded at the lack of dignity we give such patients. Our profession has abjectly ignored our obligation to treat such patients with respect. In Auckland Hospital we have a continuous band of smokers in wheelchairs on the main thoroughfare (Park Road). They sit in their hospital gowns, often with bandaged stumps or clinging onto drips or pumps displayed for the derision of the passing motorist or bus passenger. This is akin to the old village stocks where miscreants were placed for the amusement of others. Those unfortunates who are unable to make it to the open road are condemned to experience every nicotinic cell in their body crying out for its fix. The only comfort being transdermal nicotine, which is nothing like the real thing. We enforce such withdrawal on those who only have a few days or even hours left to live.
Smoking is legal. The Government receives significant revenue from the habit. We deny our smoking patients the respect that is due to them. This is in contrast to the opiate addict. Their habit is illegal, there is no cost recovery and yet we, rightly, treat them with compassion, dignity and privacy.
It is time for the Medical Profession to redress this balance and advocate for our patients while maintaining our support of policies to reduce the prevalence of smoking within our communities.
David Spriggs
General Physician
Dept of General Medicine
Auckland District Health Board
Auckland, New Zealand
  1. Crane J, Vega S, Caldwell B, et al. Smoking around Hospitals. N Z Med J. 2012;125(1361):107–108.
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