Have you got a right please?

The emphasis on the proposed health bill is to protect workers and the general public from second-hand smoke. Passive smoking causes about 12 000 deaths per year (Royal College of Physicians, 2005); 500 of these are due to exposure at work.

As my workplace extends to patients' homes, should I not expect the same protection as I would in an NHS building and therefore demand that a patient ceases to smoke in their own home? Community doctors and nurses, who spend vast amounts of time in patients' homes would argue that the amount of second-hand smoke inhaled per day is sometimes very high. Many of us have been in the situation where we battle through a smog of smoke just to find the patient. The next hour is painful, every breath a chore, until we hear a polyphonic wheeze deep inside our own struggling lungs. We leave and take our first heavenly gasp of fresh air, but every breath for the remainder of the day is tainted by the smell of ashtray clinging to our clothes.

Pregnant workers will understandably go to great lengths to avoid cigarette smoke and subsequent harm to their baby. Is it not their right, and some might say the right of the unborn child, to refuse to enter the house of a patient who smokes?

Of course, it is unrealistic to expect patients to stop smoking in their own homes. We could, however, follow our friends in the health visitor sector who have been requesting for over a year that patients do not smoke for an hour prior to their visit. If this practice is recognised as a condition of the visit, by previous written request, it gives health workers the right to refuse to enter the home if this is not adhered to.

Some would say that asking patients not to smoke in their own homes goes too far, adding to the ‘Big Brother’ milieu in which we find ourselves. Others would say that the culprits' human rights appear to be more valuable than those of the innocents, and that these rights sometimes outweigh reason. Our needs are important and we should enforce a one-hour smoking ban.