This is the text of my introductory remarks for a session called ‘Hot Off The Press: Outdoor Smoking Bans’ at the Battle of Ideas conference, October 18th 2015. Other panellists were Josie Appleton and Dolan Cummings from civil liberties campaigning group The Manifesto Club, and Simon Clark, Director, smoker’s rights group FOREST. Chair: Rob Lyons, Action on Consumer Choice. My remit was to talk about outdoor bans as they afflict sufferers of mental illness within psychiatric wards where outdoor bans are gaining pace.
I don’t think anyone should be forced to give up smoking against their will. I know we are in the middle of ‘Stoptober’, but come on – giving up when you’re in the middle of a mental breakdown is inhuman. I can’t think of a worse time or place to quit.
That’s the way I see it, but public health quangos instead say it’s a prime time to intervene because they have a powerless captive audience.
They really believe they have a duty to treat one’s smoking as if it was a part of your condition, so are demanding a total outdoor ban.
This goal of health is a joke – since the indoor ban came in, cases of self-harm are up 56%. In America, since outdoor bans came in, violence is up 22% and average duration of detention has increased by nearly 90%. This is interpreted by authorities that we are in a ‘mental health epidemic!’, oblivious to the more likely truth that smoking bans are causing bad behaviour.
Furthermore most patients go back to smoking within 5 days of discharge anyway. Some result.
Public Health England think the high rate of smoking amongst the mentally ill is a ‘health inequality’ that must be tackled. The main problem with this is that the old principle of autonomy never gets a look in.
Because they have overlooked autonomy, smoking bans are cruel at a time when the individual is at their most distressed. Smoking is often their only comfort. Also bans inevitably deter smokers from seeking help if they are developing mental illness because the idea of spending time in a clinic is unbearable.
Back in 2001 when I was Sectioned after trying to contact Star Trek Voyager’s Seven of Nine, not the actress, the actual character, the care was pretty good back then. You could smoke both in a dedicated room and outdoors. Barriers between patients and staff were also broken down thanks to a shared smoke and their getting your tobacco.
Smoking bans destroy that trust – a nurse confiscating your tobacco upon entrance would appear like a prison guard rather than someone on your side.
The next step will be to replace vending machines that currently sell Coca-Cola and chocolate with one’s that sell only carrot juice and Omega 3 supplements – after all, patients also have a tendency to become obese.
If you were a smoker in hospital for a broken leg, a ban wouldn’t stop your healing. But if we understand mental illness as a breakdown in reason and autonomous functioning, then smoking bans do prevent full recovery by cementing the patient’s lack of self-control.
One of the first clinics to ban smoking was Islington. They said “We are filling the void with activities like dance”.
It seems to me they don’t want patients to regain their humanity but sing like children: “If you’re happy and you know it clap your hands”.
Public health types argue patients will be grateful for the smoking ban, coming out as ‘changed beings’. But really this is like Winston Smith in Orwell’s 1984 after having endured Room 101, he declares “I love Big Brother”.
If we add this all up, then metaphorically speaking, think of the treatment endured by Jack Nicholson’s character in One Flew Over The Cuckoo’s Nest. In that film, after massive electricity is applied to his brain, he emerges as a grinning blob who has been lobotomised. We should wonder why today’s public health managers want to replicate that.