Why are people still smoking outside hospitals?

Go to any hospital and you are likely to witness a challenge that health bosses are struggling to tackle - people smoking in the grounds.

Hospital trusts across the country may have declared themselves smoke-free zones, but the reality is quite the opposite.

Patients, visitors and even staff are often seen lighting up right outside the hospital doors, every hour of every day and no matter the weather.

Most weeks I can be found reporting from hospitals across the south of England, but for the first time I have had the chance to talk to smokers outside University Hospital Southampton.

Jane Gibbs, 72, was accompanying her daughter to an appointment on the day I met her.

While waiting, she had a cigarette outside the main entrance where signs clearly say it is a smoke-free zone.

I asked her why she did not walk off the site and smoke there instead.

She replied: "You've got cars coming down here with their exhaust fumes, so what's the difference between their exhaust fumes and my cigarette?

"When they stop [the cars] then maybe I'll think twice about smoking, but I'm in the fresh air, so it dissipates. I wouldn't smoke indoors - absolutely not.

"As far as I'm concerned, if it's my enjoyment then it's up to me to take responsibility. I would never smoke around children or really sick people. If I'm near people I will say 'do you mind if I have a cigarette?'"

Grant Middleton, who is in his 50s, told me he had been smoking since he was about 10 and had no plans to quit.

I asked him if it bothered him that he was smoking in a smoke-free zone - just metres from the hospitals front door.

"No not at all," he said. "If people came out and said 'we'll not tolerate it', you wouldn't smoke, would you?

"But they do tolerate it so people are going to smoke... if they enforced it I would go elsewhere and smoke."

Inpatient Anthony Nichol was sitting beside the front door smoking when I met him.

He said: "I should take notice of it, because it is unfair to people that don't smoke. I think we are losing a lot of our freedoms. OK, so it might sound silly, but what goes next?"

I told him there was talk of a new law that could make it illegal to smoke on hospital grounds. I wanted to know how he felt about that.

"I'd have to abide by it," he told me, "because you would be fined or thrown off."

Senior figures at the hospital, which became a smoke-free site in April 2024, are not without sympathy.

Paul Grundy, the chief medical officer, said: "It is an addiction - they're here, often at the most stressful time in their lives, so we know this is a big ask.

"It isn't that far to the edge of the hospital site for most people - it's 20m or 30m away, but for some of our patients who are less mobile that is a real challenge so we have got some real problems here to work through.

"But we can do it, we can get there."

The trust has a dedicated smoke-free strategy outlining priority areas for development, and a quarterly tobacco dependency steering group monitors progress, identifies challenges, and drives continued improvement.

A Tobacco and Vapes Bill going through parliament aims to outlaw smoking in a range of places, including outside hospitals.

A public consultation on proposals is open until May and there will be a six-month implementation for any new rules bought in.

You can follow BBC Hampshire & Isle of Wight on Facebook, X (Twitter), or Instagram.