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Dr Phil Button - the "lost" interview

Dr Phil Button is an NHS anaesthetist. (No, that's not him above.) He's a smoker and has his own blog, Pro-Choice Smoking Doctor. A colleague, Marion Finlay, interviewed him in 2006 but the article was never published. I can't remember why.

Yesterday, having typed the name "Ken Denson" (another pro-choice smoking doctor) into my computer (see earlier post), up popped the "lost" interview. I thought you might like to read it. Note: I have checked and Phil is happy for it to be published. Better late than never!


“I think if you go to your doctor for advice, you should be given advice. Not be told what to do. People are bombarded with health advice from the media. If you haven’t heard the publicity that says smoking is bad for you, then you must have been living on another planet.”

That’s a view most sentient people would agree with. What’s unusual is - it comes from a doctor.

The doctor is Phil Button, a 47-year-old anaesthesiologist at a NHS Trust hospital in North Hampshire and a former GP. He’s decided to come out of the smoking closet – despite the inevitable attacks on his professional reputation – because he says we are not being given accurate information about smoking in general and ETS (environmental tobacco smoke or “passive smoking”) in particular. “It’s very politically incorrect to be a smoker and very politically incorrect to talk about it,” he says.

He’s also angry about the increasing “demonisation” of smokers. “Smoking, once labelled as something that is bad for you, has now been transformed by the anti-smoking lobby into being more than just bad for you, but into a bad thing – that smokers are in some way lesser people. They have been demonised, and are considered either weak or somehow substandard.”

Dr Button is also unusual in that he started smoking at the age of 40. “I think I’d always been a ‘closet smoker’ or ‘tempted smoker’, wondering what it would be like. Once I tried it I thought ‘I like this’ and decided to carry on.”

But isn't he concerned about his health? “It’s quite a complex question to answer,” he says. “I’ve always been a great believer in the quality of life rather than the extension of life. Ultimately, I have no control over what is going to happen to me and I don’t regard me smoking as being the one single overriding factor that’s going to cause my demise. There are so many other factors involved.”

He says he smokes – about 30 a day - because he enjoys it. “I like the flavour, smell and I enjoy the contemplative moments. When I’m smoking I’m usually thinking about something else. It helps me to concentrate. Certainly that applies to when I’m driving. If I find myself nodding off, if I have a fag I concentrate again. I just enjoy doing it. I don’t believe I’m doing anyone any harm.”


Dr Button argues that the dangers of second-hand smoke have been wildly exaggerated and that “I can see only one reason we should be talking about smoking being a problem and that is the smell. Some people - and I include smokers in this group - don’t like the smell of smoke in the atmosphere or on their clothes. Ventilation would clearly go a long way to solving this problem.

“As far as I’m concerned, there is no other issue with regards to smoking in public. To push through heavy-handed legislation, and implement anti-smoking policies on hospitals on the basis of smell, is petty and undemocratic.”

Having read studies about the effects of ETS he says: “If you examine the statistical analysis and look at the methods they all - without exception - do not prove a link between ETS and harm to non-smokers.” More controversially he says, “I also believe that the effects of smoking on the smoker as been exponentially exaggerated over the years.”

Then why do doctors say second-hand smoke is so dangerous? “Doctors believe that smoking is bad for you. They believe it with fervour. And that no one should smoke – except them occasionally – and it’s perfectly reasonable to not do anything about an ETS scare as they don’t want to be seen to condone smoking.

“My experience of my medical education is very much about brainwashing. You really are taught every day that smoking is bad for you, further reinforced by anecdotal information in the media,” he says.

How many doctors smoke at your hospital? “I don’t have an accurate figure as to the percentage of hospital staff that smoke. I would say over 25% of the doctors in my department smoke, which is higher than the average number of smokers in the general population. They are the ones I know that come down into the smoking room and smoke openly.

“In the NHS the job, at whatever level you do it – nurse, health care worker, doctor – is very stressful because you are dealing with people’s lives. And some members of the health service take a break to have a cigarette to calm their nerves, keep themselves together, collect their strength.”


So why is he speaking out? “I’ve been through a medical education so have been indoctrinated in the medical story of smoking as it is believed to be by the medical profession. But increasingly, since about the age of 35, I’ve been more inquisitive and questioning. And I have become convinced that the truth about the harm caused by smoking is not as bad as it’s been made out.”

He says, “I don’t have a real issue about smoking. The wider issue is, why do we only see one side of the story and no one ever speaks out on behalf of the other side?

“There is terrible media bias towards the publication of opinions about ETS which sides with the anti-smokers. And the anti-smoking lobby has become an enormous machine. As a result, I treat all media health information as fundamentally flawed.”

Dr Button says he is more concerned about the ill effects caused by stress and the rising incidences of anxiety and depression-related illnesses. “I believe the pressure people are under to live healthy lives is likely to be adversely affecting their mental lives. For example, putting pressure on people who are depressed to quit smoking will add stress. I suspect stress is a bigger killer than anything else as it clearly has obvious physical affects on your cardiovascular system - you sweat, your pulse goes up.

“I attempt to run my life without stress. I don’t believe I’m addicted to cigarettes. I smoke because I like it. If it’s not convenient to smoke, I’ll be happy where I am. Personally, I don’t feel comfortable smoking in front of no smoking signs, particularly if it says you might be removed from the building. I want to relax with a cigarette.”

What about hospital smoking bans? “I understand that hospital managers don’t want to be seen to condone smoking. But I don’t believe that the actions they are taking will deal with that. All the people I meet in the smoking room are going to go to the perimeter of the hospital twice a day or so. I’m sure it will have no effect on the number of people who smoke.”

Dr Button is extremely angry about the murder of a nurse while she was having a cigarette break outside the hospital grounds. “It is not in anyone’s interests to expose people to this level of harassment whereby they are hounded to unsafe places to smoke a cigarette.”

He also thinks the policy is callous towards patients and visitors: “They are potentially abusing the patients’ relatives because they are the people most affected by a patient’s admission. Often they will have to visit the hospital for long periods of time, and while they’re there they don’t want to leave the relative for any length of time. I think that’s cruel.

“And it’s also cruel to patients. I’ve been to hospitals with smoking bans and you still see patients with their catheters and drips smoking outside the entrance. And I defy anyone to tell them not to.”


Of course Phil Button is not the only doctor to stick his head above the parapet and question some of the claims of the powerful anti-smoking lobby. Dr Ken Denson of the Thame Thrombosis and Haemostasis Research Foundation in Oxford is one of Britain’s top experts on the effects of tobacco. He has published two major review articles, together with many letters in leading medical journals, criticising the evidence about the alleged effects of second-hand smoke.

Dr Denson was quoted in the House of Commons Health Select Committee report 2005-06 Smoking in Public Places as saying: “The scientific evidence for any deleterious effect of ETS is wholly false. The hard evidence for any deleterious effect of second-hand smoke is so tenuous and equivocal, that similar evidence would not be seriously considered, let alone published, in any other field of medicine.”

Dr Mike Fitzgerald, a London GP and author of The Tyranny of Health: Doctors and the Regulation of Lifestyle, has questioned whether smoking is an addiction. He has written in the online magazine Spiked about how the smoker has become a pariah, the failure of coercive anti-smoking policies and how anti-smoking propaganda directed at adolescents has proved counterproductive, and the increasingly childlike character of political discourse about smoking.

Dr Theodore Dalrymple, a columnist in the Spectator and other national media, wrote about the ban on smoking in public places in The Times: “The pettiness of this official persecution of smokers (who are not prevented from paying a lot of tax) can hardly be exaggerated.”

While Dr Button is willing to go on the record to voice his concerns about anti-smoking campaigns, he says he doesn’t “evangelise” at work. “It’s not the right forum and I have work to do.” As for anti-smoking policies at his hospital he says, “increasingly NHS Trusts have indicated that disobeying smoking policy would involve disciplinary procedures. If it came to that, I think I might have to back down because ultimately my job is too important.”

In the meantime he says, “My joy in life is very simple: going into town with my wife and doing a bit of shopping then going to a café and having a cigarette. In future, I won’t even be allowed to do that. And for no good reason.”

Reader Comments (15)

"He also thinks the policy is callous towards patients and visitors: “They are potentially abusing the patients’ relatives because they are the people most affected by a patient’s admission."

Here's something from our National Treasure, Great Ormond Street Children's Hospital, to cheer up children with cancer and their parents:

Sorry to all you decent hard working families with tragically ill children, but I stopped my small donation to CRUK a couple of years ago.

April 9, 2010 at 12:39 | Unregistered Commenterjon

Obviously Great Ormond street are in the habit of spraying copious amounts of Nitrous acid around the wards then.
Would that be the same Nitrous acid that was used in the junk, quack quack, yank pseudo science study that first suggested the creepy third hand smoke lie.
What a bunch of creeps .
These NHS administrators are the lowest parasites on the planet, sack em.

April 9, 2010 at 13:16 | Unregistered CommenterSpecky

I applaud Phil Button's guts in being open about smoking - and I couldn't have imagined making such a statement even a few years ago.

So, who's going to expose the truth about third hand smoke before it passes into popular consciousness as gospel?

April 9, 2010 at 15:59 | Unregistered CommenterJoyce

Good interview. Nice to hear from a sane doctor.
One minor quibble.
I think "Dr Mike Fitzgerald, a London GP and author of The Tyranny of Health: Doctors and the Regulation of Lifestyle" should read:
"Dr Michael Fitzpatrick"

April 9, 2010 at 18:47 | Unregistered CommenterTonyW

It's people like Phil and the late Ken Denson who keep me a hair's breadth from despair in our benighted land.

Bless 'em all !

April 9, 2010 at 22:03 | Unregistered CommenterMartin V

-absolutely impressed.

@specky: "So, who's going to expose the truth about third hand smoke before it passes into popular consciousness as gospel?"

christopher snowdon has

April 9, 2010 at 23:22 | Unregistered Commentersmockr

Excellent interview, and well done PB for being so brave as to put his head above the parapet.

Perhaps Dr Hillary would care to enlighten us concerning how Dr Button could be so misguided? Or perhaps he also is in need of urgent psychiatric care?

April 9, 2010 at 23:24 | Unregistered CommenterRose Whiteley

(Interestingly, the term “fourth-hand smoke”—the theory that you can get cancer from simply watching a movie in which Humphrey Bogart is smoking—is now getting 56,600 Google references.)

I was wondering what the 4th hand smoke bandwagon would be based on.

Makes perfect sense if you swollow the 2nd hand bullshit.

Expect a press announcement from ASH/CRUK etc soon...

April 10, 2010 at 10:43 | Unregistered CommenterJospeh K

Thank you for publishing this Simon, I had wandered what had happened to it!

I must say, I still stand by my words. I was interviewed on the day that Robert Feal-Martinez, Bil Gibson, Lorainne Gostling and myself visited The house of Lords to see Lord Stoddart of Swindon.

Much water has passed under the bridge since then and not all negative. I feel that we have a stronger presence and I believe many more people are familiar with the evidence against passive smoking, the arguments for better ventilation giving choice for business and the economic damage done by bans.

The are several things that exercise my mind now:

1. That scientific integrity has been damaged by the bogus evidence for harm form ETS and this issue has not been resolved.

2. That our understanding of the mechanism of influence of the anti-smoker is still not fully understood.

3. That various antismoking factions and government use manufactured and incomplete economic arguments to further their cause.

4. That NHS money is squandered on social engineering against personal choice.

5. And that alcohol drinkers did not heed our advice that they were next.

Most significantly for me and my wife though, we still have to huddle together in the cold to simply enjoy a chat, a coffee and a fag. So we will never give up the fight and I hope that we are not alone in our determination to defeat the anti-smoker.

April 10, 2010 at 12:33 | Unregistered CommenterPhil Button

I have been commenting in the British Medical Journal and got this superb reply from a Management Consultant.

"I'm sorry to disappoint Dave Atherton, but he clearly doesn't understand the rules of argument when "just causes" such as the campaign against smoking are being debated.

The medical profession knows that smoking is very bad and it is therefore happy to use any means--no matter how illiberal or illogical--to reduce it. Since smoking is bad, passive smoking must also be bad. The scientific quality or credibility of studies about the effects of passive smoking are entirely irrelevant: only the propaganda value counts.

There are no public health brownie points in fighting for truth and high quality science.

Competing interests: suffering from an overdose of sarcasm and irony

stephen black,
management consultant
london sw1w 9sr ... 680#234241

April 10, 2010 at 13:17 | Unregistered CommenterDave Atherton

"The medical profession knows that smoking is very bad and it is therefore happy to use any means--no matter how illiberal or illogical--to reduce it."

Quite !

And that is EXACTLY why it is wrong of our politicians to allow said profession so much power.

High time its wings were clipped, and the claptrap of its lobbyists and camp-followers exposed to intelligent scrutiny.

To reduce matters to their most simple, ALL politicians should be asked - in this context - which they would rather live in, if faced with the starkest of choices:

A Healthy Society, or

A Free Society.

No prevarication, no 'buts' allowed, Mr Politician.

Tell me which of the two YOU would choose.

You have five seconds - and the chamber IS loaded.................

April 10, 2010 at 23:07 | Unregistered CommenterMartin V

I remember in 1977, when my daughter had just been born. This is also when I remember hearing about this new scare, passive smoking. One of my wifes work colleagues came to see the baby, and she was smoking, (so was I), and I was a little worried.

Funnily enough, my mother had been worried about my dad working behind a bar, because of the smoke, (he was a smoker), even before the scaremongering began.

Now for the truth. When my mother was diagnosed with lung cancer (she was a never smoker) in January 2004, she knew that it was an inevitable risk from her having had a mastectomy in 1998 - ie breast cancer eventually spreading elsewhere. She died in September. Never once did she mention the fact that her dad smoked. never once did she mention that her husband smoked. Never once did she mention having been a pub landlady in a smokey atmosphere.

Epidemiology. Research into an epidemic. In the case of passive smoking, there was no epidemic, so epidemiology became research to create an epidemic. They didn't do very well. Unfortunately, the general public, including decision makers (MPs) don't know that.

April 11, 2010 at 1:13 | Unregistered Commentertimbone

In many ways the worst thing to happen to the anti-smoking lobby was the smoking ban because: (1) far more people than intended have been negatively affected by it, and not just smokers, (2) now that ASH etc have served their usefulness in fronting the ban, funding is highly likely to be severely restricted after the election, (3) in desperation at this prospect, anti-smoking claims are becoming increasingly outlandish and hard to believe, even by non-smokers, (4) increasing numbers of journalists and writers are, now that the ban is in, being permitted to write articles which challenge the anti-smoker party line, (5) the antis’ clear intention to extend the ban further than just the “enclosed public places” they claimed was all they wanted is worrying many more people than just smokers – the question “who’s next” is now asked much more frequently, and (6) being an anti-smoker has now become a pretty “uncool” thing to be. How many articles these days start with the words “I’m not an anti-smoker, but …….” before launching into an extremely anti-smoker-style diatribe about smelly clothes and sore throats? It’s still OK not to like smoking, but to “be an anti” is something that, these days, even antis will try not to admit to.

Pretty much all of this has sprung up since the ban. How ironic, then, that the survival and continued power of ASH and their cohorts might lie in lobbying MP’s to have their beloved ban overturned or substantially amended, so that they can start the debate all over again ………

April 11, 2010 at 1:14 | Unregistered CommenterMisty

Joyce, third hand smoke is already debunked. I spoke to the researcher the day his report was published last year and wrote a debunk the next day. Chris Snowdon and Michael McFadden have also debunked it.

it isn't finding truth that is the trouble; it's getting people to listen to it

April 11, 2010 at 21:33 | Unregistered CommenterRich White

"it isn't finding truth that is the trouble; it's getting people to listen to it....."

AND getting them to get off their fat, lazy arses and LOOK for it (which, come to think of it, they CAN do whilst still sitting).

Before, that is, our semi-fascist Government (re-sprayed in colours that are more 'now') brings in the Internet Censorship Bill 2011:

"The so-called 'freedom' of the Internet brings with it the obligation of RESPONSIBLE use, and we in government see it as our duty to ensure that only Responsible Citizens......etc etc etc."

Still, at least nobody's blamed Osama Bin Laden for cot deaths.

One absurdity less for us to expose to our listening friends, I suppose................

April 11, 2010 at 23:09 | Unregistered CommenterMartin V

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