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Nicotine Tob Res. 2019 Oct 5. pii: ntz192. doi: 10.1093/ntr/ntz192. [Epub ahead of print]

Policies for tobacco and e-cigarette use: a survey of all higher education institutions and NHS Trusts in England.

Author information

School of Psychological Science, University of Bristol, Bristol.
Behaviour and Health Research Unit, University of Cambridge, Institute of Public Health, Cambridge.
School of Psychological Science, Bristol.
the MRC Integrative Epidemiology Unit, and the National Institute for Health Research Bristol Biomedical Research Centre (NIHR Bristol BRC), University of Bristol, UK.



There is an absence of evidence regarding the impact of treating tobacco smoking and vaping equivalently in workplace policies. We aimed to describe and compare smoking and vaping policies in acute non-specialist NHS Trusts (n=131) and Higher Education Institutions (HEIs) (n=131) in England.


We conducted a census of smoking and vaping policies through organisational websites searches and direct requests for information. We recorded whether and where smoking and vaping were permitted.


Smoking was prohibited indoors in all organisations. No NHS Trust permitted smoking freely outdoors, in contrast with 60% of HEIs. In 27% of NHS Trusts and 33% of HEIs smoking was permitted in designated areas, while in 73% of NHS Trusts and 8% of HEIs smoking was prohibited anywhere on site. Vaping was prohibited indoors in all NHS Trusts and all but one HEI, but permitted freely outdoors in 18% of NHS Trusts and 75% of HEIs. Vaping was permitted in designated outdoor spaces in 23% of NHS Trusts: 21% had areas shared with smokers; 2% had separate vaping areas. Vaping was permitted in designated outdoor areas in 18% of HEIs, all of which were shared with smokers. Vaping was prohibited anywhere on site in 54% of NHS Trusts and 6% of HEIs.


Policies vary considerably in whether vaping and smoking are treated equivalently. Smoking policies in most HEIs should be reviewed to include more effective tobacco control approaches. Evidence is needed on the impact of imposing shared or separate spaces on vapers and smokers.


This report provides a comprehensive review of smoking and vaping policies in two types of organisation across England. It highlights key discrepancies between current public health recommendations for vaping and existing workplace policies, which often lead to smokers and vapers sharing spaces. The report identifies the need for evidence on the impact of imposing shared spaces on smokers and vapers to inform workplace policies that maximise public health benefit.


NHS England; e-cigarette; higher education; policy; public health; tobacco control


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