Around September last year I was contacted by someone on Facebook who highlighted a growing problem of cigarette butt litter on the Ipswich Hospital site and in particular a path/cycle path laying between the hospital grounds and Copleston High School.

I went along to investigate and it was pretty disgusting.

Over the past year I’ve visited again on numerous occasions. I’ve collected well over 40,000 cigarette butts, spoken to smokers around the site, had a couple of meetings with hospital management, shared countless photos and videos on social media and also appeared in local press and on local radio talking about the problem.


I’ve even witnessed members of staff sitting on the ground blocking the path. Yep, you read that right, sitting in the dirt and discarded cigarette butts in their uniforms and then going back into the hospital to work.

Pretty unbelievable! 

Unfortunately, not a lot has changed so it’s time to start pushing harder for change.

That’s why I’ve put together this list of Questions and Observations and Ideas and Suggestions that I will be sending to Nick Hulme, the CEO of East Suffolk and North Essex NHS Foundation Trust and his team. Hopefully I’ll get a constructive reply! I’ll let you know how I get on.

Questions and Observations

  1. What is the ESNEFT Smoke Free Environment policy?
  • Where can I find the document? Version 3 of the document is available on the old Ipswich Hospital website but this document has a review date of 10 October 2016.
  • Section 3.3.2 states ‘Members of staff are not permitted to smoke off-site whilst on duty, for instance, if they are working in the community’. This is consistently happening as staff congregate around the perimeter of the site to smoke.
  • Section 3.4 states ‘Trust employees are responsible for maintaining a professional image of Ipswich Hospital at all times. Therefore, if members of staff are not on duty, and are off-site, they are still responsible for ensuring they are not wearing a Trust uniform, or have visible ID badge, before smoking’. This is also prevalent around the perimeter of the site with staff regularly congregating in uniform to smoke. I have also personally witnessed and photographed staff sitting on ground littered with cigarette butts whilst wearing their uniforms.
  • How have smokers been involved in shaping the smoke free policy?
  • What’s been tried before? What has worked/failed?
  • What is the ESNEFT Vaping policy?


  1. What is the smoking policy/process for staff, inpatients and visitors coming on site?
  • There is no general information about smoking on site on the ESNEFT website – for visitors or patients (or staff).
  • There is no Visitors/Visiting section on the website.
  • Information about smoking policy and advice is not currently included on the ‘inpatients checklist’.
  • ‘Quit Smoking’ does not appear on the full list of services offered by ESNEFT or are there links to any external ‘Quit Smoking’ service providers.


  1. What is the immediate support offered to inpatients with regard to smoking cessation?


  1. What is the process for cleaning up cigarette butts on the hospital site? Around entrances to buildings? Around car parks? Around the perimeter of the site?


  1. No smoking signage is obviously not working across the site. When was the last time signage was reviewed and updated?


6. What is the policy for enforcement of the smoke free policy on site? Anti-littering policy?

Ideas And Suggestions


There are many points above that I cannot answer on your behalf or help with but there are a number of ways in which I could potentially help…


  1. Conduct a survey of smokers visiting the hospital site to find out why they ignore the no smoking policy, what would make them stop smoking on site, what would stop them dropping butts on the ground etc.


  1. Put together a team of volunteers to conduct a survey of the site to


  • Pick up cigarette butts
  • Log grot spots/areas of concentrated cigarette butt littering
  • Count the number of butts collected.
  • Dispose of the collected butts in the most appropriate way.


  1. Form a community group of volunteers that will regularly monitor the level of cigarette butt littering on site and around the perimeter.


  1. Help with the development of new messaging and placing of new signage that clearly states policy and enforcement details.


  1. Work together to help create educational materials and workshops to raise awareness of the issue within the community (for adults and children).


  1. Suggest the placement of Charity Cigarette Butt Bins in strategic locations around the perimeter of the site. Branding and messaging can be tailored to match campaign goals. Charities chosen can be directly linked to the hospital. Rubbish Walks will commit to regularly inspecting and emptying the Charity Cigarette Butt Bins for a minimum of 12 months to monitor effectiveness.