LONDON — Two hospitals in northern England have allowed an e-cigarette company to open vape shops on their premises as part of a move by the hospitals to ban smoking in and around their buildings.
The ban was introduced last week at two of the largest health institutions in the Birmingham area as “a public health necessity,” according to the BBC, because “smoking kills.”
“Given that simple truth, we can no longer support smoking on our sites, even in shelters or cars,” said Dr. David Carruthers, the medical director of Sandwell and West Birmingham Hospitals N.H.S. Trust, which oversees the hospitals.
Ashtrays have been removed from the hospitals’ outdoor smoking areas, and anyone caught smoking on the premises faces a fine of 50 pounds, or $62. The use of e-cigarettes is allowed on the hospitals’ grounds, aside from near doorways, and former smoking shelters have been turned into vaping areas.
The two vape shops are operated by the e-cigarette company Ecigwizard.
The National Health Service in England attributed more than 480,000 hospital admissions to smoking in a one-year period from 2017 to 2018. And figures published this month by the N.H.S. showed that 77,800 people in England had died from smoking-related illness during that period.
Just over 14 percent of adults in England are smokers, according to the N.H.S., and more than 6 percent of adults use e-cigarettes, double the share in 2014. Half of e-cigarette users in the N.H.S. study said they had switched to vaping to quit smoking.
Smoking was first banned inside British hospitals in 2007, and health officials have urged N.H.S. hospitals to make their premises entirely smoke-free since 2013. Most British hospitals have since banned smoking on their grounds, and the image of patients wheeling their IV drips to outdoor smoking areas has largely disappeared.
Despite the growing prevalence and popularity of vaping around the world, the practice has met with criticism. Saying that e-cigarettes were creating a nicotine epidemic among teenagers, San Francisco last month banned their sale entirely. Critics of the products in the United States say they are becoming the tobacco industry’s new way to hook teenagers.
But in Britain, public health officials have embraced the use of e-cigarettes as effective for people who want to quit smoking. An independent report on e-cigarettes published last year by England’s public health agency concluded that vaping posed “only a small fraction of the risks of smoking” and that switching completely to vaping brought “substantial health benefits.”
The agency, Public Health England, subsequently recommended that e-cigarettes be available for sale in hospital shops to help create a smoke-free environment and to encourage patients and employees to quit smoking.
“It’s not as radical as it might first appear,” Dr. Debbie Robson, a researcher in tobacco addiction at King’s College London, said of the Birmingham hospitals’ new policy. She said e-cigarettes were allowed in most mental health hospitals in Britain, including indoors.
Dr. Robson said Britain’s public health authorities agreed that switching completely to e-cigarettes was far safer than smoking regular cigarettes, an argument that the independent report also addresses.
Although nicotine fuels addiction to cigarettes, the drug itself is not what causes the gravest health dangers, said Ann McNeill, the public health report’s lead author and a professor of tobacco addiction at King’s College London. “The toxic smoke is the culprit and is the overwhelming cause of all the tobacco-related disease and death,” she said in the report.
The report said that regular use of e-cigarettes in the country was almost entirely confined to those who have smoked previously. And the N.H.S. report found a significant drop in smoking rates among young people — down to 6 percent in 2016, compared with close to 20 percent in 2001.
Dr. Robson said that being admitted to a hospital could be a powerful trigger to reflect on smoking. And the hospitals that are most effective in reducing smoking are those that “have a tobacco dependence treatment pathway embedded in the hospital services,” she said, rather than simply banning smoking.