tocacco plant Native American Tobaccoo flower, leaves, and buds

tocacco Tobacco is an annual or bi-annual growing 1-3 meters tall with large sticky leaves that contain nicotine. Native to the Americas, tobacco has a long history of use as a shamanic inebriant and stimulant. It is extremely popular and well-known for its addictive potential.

tocacco nicotina Nicotiana tabacum

tocacco Nicotiana rustica leaves. Nicotiana rustica leaves have a nicotine content as high as 9%, whereas Nicotiana tabacum (common tobacco) leaves contain about 1 to 3%

tocacco cigar A cigar is a tightly rolled bundle of dried and fermented tobacco which is ignited so that its smoke may be drawn into the mouth. Cigar tobacco is grown in significant quantities in Brazil, Cameroon, Cuba, Dominican Republic, Honduras, Indonesia, Mexico, Nicaragua, Sumatra, Philippines, and the Eastern United States.

tocacco Tobacco is an agricultural product processed from the fresh leaves of plants in the genus Nicotiana. It can be consumed, used as an organic pesticide, and in the form of nicotine tartrate it is used in some medicines. In consumption it may be in the form of cigarettes smoking, snuffing, chewing, dipping tobacco, or snus.

tocacco Cigarettes are smoking products consumed by people and made out of cut tobacco leaves. Cigars are typically composed completely of whole-leaf tobacco. A cigarette has smaller size, composed of processed leaf, and white paper wrapping. The term cigarette refers to a tobacco cigarette too but it can apply to similar devices containing other herbs, such as cannabis.
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Hardline smoking ban just isn’t fit for purpose

Psychiatric units in England are experiencing considerable difficulties implementing the smoking ban that came into force last July. A report published last month by the Mental Health Foundation (MHF) says 85% of respondents to a survey it conducted said the ban had not been implemented “wholly effectively”. Widespread practical problems reported included a rise in “secret smoking” - with associated safety concerns - and occasions where staff feel obliged to “turn a blind eye”, especially when a patient is very unwell, thus placing them both in a position of breaking the law.

Two years ago, I wrote a piece expressing my concerns about the forthcoming ban. It seemed to me that the issue was a great deal more complex, both practically and morally, than a simple equation of “smoking is bad, therefore we must ban smoking”.

I certainly wasn’t advocating a return to the days when I was first admitted and patients smoked anywhere and everywhere, except for a small no-smoking room, kept locked in an attempt to preserve its unsullied air - which also meant that nobody could go in there. But I felt that the status quo at the time I wrote the piece - with smoking banned everywhere except that same room, now crammed like a rush-hour tube train, with patients lighting one fag off the butt of the last - was far from ideal, but was probably the least bad of the realistic options.

I wasn’t alone in my concerns. A survey conducted in 2006 and published by the King’s Fund health thinktank revealed that fewer than 10% of staff on mental health wards were in favour of a ban. There was considerable anxiety about the pressure it would place on already-stretched staff, the possible impact on patient behaviour, and the right of staff to stop patients - especially involuntary patients - from smoking at all.

Policy-makers responded with a mixture of “guidance” and bullheadedness. “The ‘smoking den’ culture that has afflicted mental health wards for decades is over,” said national director for mental health Louis Appleby, in a letter to this paper more than a year before the ban was even due to be brought in.

Some trusts have introduced the ban effectively, and their experience is informative. One trust quoted in the MHF report had introduced the ban in conjunction with “healthy lifestyle initiatives”. It said that “every ward has stretch and movement to start the day, a gym, and staff trained to diploma level in physical healthcare”.

If stopping smoking is to be seen as a positive choice, rather than the loss of yet another freedom, such initiatives would seem to be crucial, as would a healthy, nutrition-rich diet. I have never been on a ward that offered either.

My local mental health unit, which was purpose-built only a few years ago, does not have a gym at all. Nor, crucially, do wards have direct access to a safe outside space. While smoking is not banned in the grounds, patients not able to go out on their own are dependent on staff to accompany them, putting extra demands on nurses and preventing them using their time in other ways.

Again, this contrasts with the facilities available to “wholly successful” trusts. “The ground floor ward [has] a smoking hut in their specific garden. For the first floor wards, they have access to a specific garden area with a smoking hut and a balcony which can be used.”

If every ward could be provided with such facilities, most people would embrace the ban as a huge step forward. But that is not the reality most staff and patients face. As in so many other areas of government policy, the law-makers appear to be curiously detached from the situation on the ground. And, as so often, it is frontline staff who are obliged to stretch themselves across the gap.

The fact is that psychiatric wards contain people who are ill - some too ill to leave the ward and certainly too ill to appreciate the benefits of not smoking. In the interests of common humanity, staff are turning a blind eye and breaking the law. They shouldn’t have to.
© Copyright: Guardian

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1 comment to Hardline smoking ban just isn’t fit for purpose

  • brittney

    Teen smokers can have many problems I am a teen too and I plan on not having 1 cigarette so be like me plan your future

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