NICE idea - not!
Wednesday, April 25, 2007 
I have been busy this morning doing a number of interviews in response to a proposal by the National Institute for Health and Clinical Excellence (NICE) who say that smokers should be allowed to attend clinics in working hours to help them quit. Full story, including my reaction, HERE and HERE. The only thing I would add to what I have already said is, what about people who are overweight - should they be given time off to attend fitness classes as well?
Simon Clark
I subsequently spent the afternoon in a dimly lit studio at BBC Television Centre conducting back-to-back interviews with 14 local radio stations. When I finished I was led, blinking, into the brightly lit News 24 studio to be interviewed by Huw Edwards. Very few people seem to support NICE's idea but a word of warning. On News 24 a representative of small business repeated, ad nauseum, that these proposals are for guidelines only, not legislation. How naive can you get! Government expects 'guidelines' to be obeyed; if people exercise choice (ie ignore the guidelines) politicians tend to get miffed and, before you know it, what began as 'guidelines' are enforced through legislation. Unless, of course, we can persuade them otherwise.
Reader Comments (20)
I am surprised that NICE can afford the time to comment on the smoking ban issue,I would have thought they had enough on their plate with their main brief which as I understand it is to ensure that cancer patients do not receive the medication they need to treat their illness
Who's side is Simon Clark really on on this issue? Certainly not on the smokers who may need all the help they can get in trying to quit. My father smoked about half a million cigarettes in his life, a good many of them at work. Even when seriously ill with heart disease at the age of 46 there was little or no help for him in his attempts to give up. Given the opportunity, I cannot imagine any of Dad's former colleagues begrudging him the chance to receive some desperately needed help to give up smoking, even if it was in working time. Would Simon Clark? In the event, Dad unwittingly cost his employers far more in terms of sick pay and an early death. Today's proposal by NICE is an excellent one and if it helps to make inroads into the UK's 100,000 premature smoking related deaths each year then who can condemn it? It would make a welcome change if instead of bereaved family and relatives crying at the graveside we could see the tobacco industry crying at the demise of their customer numbers and hence profits. So just to remind us, who's side are you really on Simon Clark?
No question you are right Simon. Just more blx from above. It seems to have brought out the old kernel of "smoking breaks". All the smokers I talk to at work whilst inspecting the hospital boundaries agree that we take our allowed breaks but we have to go outside for them. We don't have a lunch break for example, we divide it into two for fag breaks. There is no question that smokers I know abuse their workmates by taking extra breaks. If we were to examine how much time non-smokers spend playing solitaire and bidding on ebay and chatting on msn and getting up my nose then we'd know who was taking the piss!
Robert: I am on the side of people who chose/choose to smoke. If they choose to quit (good luck to them) they do it in their own time. I accept that some (certainly not all) smokers are addicted to nicotine, but would you be happy if an overweight colleague took time off work to attend Weightwatchers? I don't rule out special dispensation in exceptional cases, but not as a general rule - which is what NICE is proposing.
In response to Robert Evans.I have never met a smoker who wanted to force others to continue smoking,I am delighted to know that there is help for people who want to quit and I would urge people who want to quit to make full use of those services,but I also want the non-smokers to leave me and my ilk in peace to continue with my habit,by all means let us be segregated from the non-smokers,please do let us have premises for smokers and for non-smokers,the only problem is the non-smokers will still want to use the smoking premises because they will want to be with their friends who smoke.So what then?are we to make smokers carry a pass to allow them into smoking areas,or shall we register all non-smokers and forbid them from entering smoking premises,we could have our very own form of apartheid,wouldn't that be fun?
Dear Abbyfield, today's issue is just about whether smokers who are desperate to quit are deserving of help from their employers. Perhaps it all depends on how much companies value their staff. Having seen the diseases that smoking causes including coronary heart disease, stroke,leg amputations, COPD not to mention lung cancer I would give all the help in the world to anyone who was struggling to stop smoking. Do you not feel for the 100,000 smokers who die prematurely each year in this country from completely avoidable smoking induced diseases? Surely, any good employer would be only too happy to lend a helping hand.
Robert, but why stop at smokers, why not the overweight and recovering alcoholics? I can imagine someone claiming a donought emergency and leaving work early because it was someone's birthday and they'd brought cakes in.
What a person does on their own time is none of the company's damn business and for decades the number of people smoking has steadily declined without bringing employers into it.
Personally, I don't see ANY reason for a smoker to leave work. Are they craving a cig? So what, they're at work and can't smoke anyway - leaving work to go talk with some reject social worker isn't likely to make things any better.
Robert, surely any good employer knows their responsibilities begin and end in the workplace? Advocating the position of employers taking an active interest in employee activities outside of the time they are paid to work (or workplace) is advocacy of passive slavery.
Currently employers set work times, duration and wages. Intervention into the private lifestyles of any employee is leaving the door open to 18th century employee ownership philosophies. Or perhaps you'd like having your time with family and friends managed and moderated by your employer (under private contract to the state)? It's for your own good, you know.
Robert, I am sorry to hear about your father.
But evidence shows that am longest living people are smoker
Does anyone ask how many fatalities are caused by antismoking scaremongering done by antismoker activists?
Does anyone ask how much increase of dementia and other mental illnesses is caused by not smoking?
Does anyone think that antismoker activists really care for other people’s health and wellbeing?
This is unworkable. Doesn't it occur to the people at NICE that smokers in workforces occur at a variable rate. What happens in businesses that have an above average incidence of smokers? Is the employer expected to pay for all of them to go for smoking cessation help? Who is to do the work of those employees when they are not there? What of businesses with a low profit margin – are they to be derided as 'unsound' if they don't have masses of extra capital to plough into extra staff costs (rather like those pubs here in Scotland that can't afford capital improvements for accomodating smokers, even though they functioned adequately for years before the smoking ban took hold).
This seems to be another scheme to make life difficult both for smokers and for those who employ them – with the usual rider that those who don't want to co-operate with the idea of stopping everyone from smoking are irresponsible,
And also (I can't help wondering) do NICE or any of the people who wield power there have any financial links with smoking cessation interests?
Hmmm, an interesting point Belinda. Imagine for a moment that employment law was ammended to grant smokers paid time off to go to smoke cessation sessions - wouldn't that be a GIGANTIC incentive to NOT hire smokers. The EU has already ruled that's it's ok not to consider someone for a job if the candidate is a smoker.
So, not only would the habit be expensive, difficult to enjoy on a night out AND effect your career!!
The media has widely reported the NICE figures about the costly burden of employing smokers. But if you look at the various NICE documents supporting their recommendation http://www.nice.org.uk/phi005, the figures they use are couched in terms like ‘estimated’ and ‘evidence suggests’. If you dig further, you find the billions of pounds quoted are guesstimates, based on shoddy methodology, cooked up to bolster their case.
So I must congratulate ASH and the anti-smoking movement. While the majority of businesses will ignore the NICE recommendations, nonetheless, the thrust of their message has now been accepted into the mainstream media, namely that smokers are unproductive and a tremendous burden on employers. So, along with being ‘unhealthy’, filthy, killers (through ‘passive’ smoking), smokers should not be employed.
And the reason I mention ASH is that, along with being listed as one of the over 100 ‘stakeholders’ contributing to the report, their director provided ‘expert testimony’ and the committee called on their ‘expertise’ for supporting documentation. (As for the other stakeholders, 99% represented either the ‘health’ lobby or anti-smoking groups. Not one stakeholder represented the quarter of the adult population of the UK that smokes. And to answer Belinda, Pharma giant Pfizer was a stakeholder.)
So, what will be the themes of future reports from Government committees made up of ASH and their ilk (and funded by the taxpayer)? Smokers contribute to global warming? Smokers murder baby seals? How far will they go to create intolerance towards smokers so as to increase their pariah status? Any guesses?
The suggestion yesterday by NICE was that it would be beneficial for businesses to allow staff to attend smoking cessation because then fewer employees would need to take smoking breaks or time off sick as their health would have otherwise deteriorated. Even companies with high staff turnovers should benefit as new employees may already have quit the habit thanks to help from previous employers.
The idea that some employers would discriminate against new job applicants because they were smokers and therefore may require time out to attend smoking cessation may prove true. But on the bright side this may provide added incentive for people changing jobs to give up. And once word gets around, school leavers through career advisers may even be discouraged from taking up smoking in the first place.
If NICE has suggested bringing in a 'carrot' to help people give up smoking then prospective employers may now be providing a 'stick'.
Anything that positively helps to reduce the prevalance of cigarette smoking in the UK has got to be a good thing. And very few people are making any other constructive suggestions as to how we are going to reduce the annual toll of more than 100,000 premature deaths each and every year in the UK from smoking induced diseases.
Robert, what a horrific authoritarian society you're describing. It's certainly one I would flee from. Bags packed and across the border without a backward glance.
How would you feel if it was applied to something you enjoy? Do you play sport? Go hill walking, whatever. Odds are you do something for your enjoyment that puts you in harms way.
Perhaps you're a touch overweight. How would you feel about employers taking one look at your waist line and knocking you out of the running for a job? Or maybe your present employer demands you reach your target weight or they terminate your contract?
What about if they demand you refrain from consuming more than your state-approved quantity of alcohol?
The point is; this is companies meddling in the private lives of their employees for the sake of their own profit margins, and whilst profits are important I don't think they're important enough to invade employees home lives. It is none of any company's business whether I smoke or not and we don't need any stupid suggestions encouraging them to start frame their contracts to encompass parts of my private life.
Reducing the number of smokers is society DOES NOT justify tossing freedom (from either government or corporate interference) out the window.
Rob,I don't think there's any danger of our country becoming horrific or authoritarian simply because people are encouraged to give up smoking or not to start in the first place.
As for other lifestyle pursuits that you mention, they just don't compare in terms of risk. There is no other activity that I can think of that kills 50% of its followers and that includes binge drinking.We don't have anywhere near 100,000 early deaths each year from liver cirrhosis or other alcohol induced diseases. And if we did,would it not be a reasonable suggestion that every encouragement should be given to help those people who were suffering from alcoholism?
I just can't see the offer of a helping hand to smokers who want to quit being synonymous with throwing freedom out of the window.
Robert, You're not describing "a helping hand", you're describing coercion. Having to choose between unemployment or quitting smoking is by no stretch of the imagination "a helping hand".
On the 100,000 deaths a year, that number has always been scaremongering at its best, it never take account of the age at death (some of these people were over 100 at time of death for example), nor does it pay any attention to the incident rates of the same diseases in non-smokers, but that's not the point - the 50% death rate is also a gross exaggeration, but I'm starting to digress again.
The point is that in a free society it is the government's responsibility to provide us with the best information and let us make up our own minds and NOT coerce us until making the "proper" decision - that's what masters, rather than servants do. Nor is it it's job to give tax payer's money to lobby groups.
This government with it two ideas of tax it or ban it has clearly forgotten its place and with complacency being the norm amongst the populace it's been easy for it to get away with assuming the role of master.
Robert, apart from the points raised by Rob you have to realise that the success rate of many smoking cessation treatments is struggling to reach 10 per cent, and paying employees to attend treatment sessions is not really cost effective. People who give up because they are under pressure to do so will have the least chance of success. The idea that employers should pay will again broaden divisions between the wealthier smokers in society whose employers might think them worth the investment, and the poorer ones in unskilled jobs – may be easier just to give them the boot. Specifically banning employers from providing for smokers is a despicable part of the legislation, will make their lives much more difficult in many cases and will make giving up harder and not easier.
I have to agree with Robert that those wishing to quit should be given plenty of help. Smoker have, afterall, paid enough tax to cover any cessation program. However, there's a big difference between helping people quit and forcing them be it through employment prospects or by witholding medical treatment. The outcome might be the same, but the methods echo of two very different societies.
Like Simon I want a tolerant liberal society and had we stuck to those concepts smoking would STILL have been on the decline. It's been dwindling for the past 40 years and 30 years from now had we done nothing it's probable there'd only be a very small minority left, perhaps as small as 5% of the population.
But trying to make people's lives a bit less pleasant because they smoke (so they'll give up) isn't tolerant or liberal, it's intolerant and authoratative and speaks volumes about how little is understood about the situation.
A smoker will give up only when he or she truly wants to. They can't be persuaded into it, they can't be cajolled into it. They will continue to smoke but feel victimised and marginalised and how does doing this to 25% of the population make us a better society?
Exactly Rob: but there is no reason why this should come out of employers' budgets (and I am not an employer) ... but as you point out the climate for giving up smoking has never been more unfriendly.
As irrational as it sounds the idea of quitting now feels like defeat. Like giving in to the anti's who're trying so hard to make my life less pleasant (for my own good). The LAST thing you should be doing, if your goal is to "help" people quit is to give them a big reason not to.