Background
Stop-smoking services in hospitals
A 2018 report by the Royal College of Physicians, Hiding in plain sight: Treating tobacco dependence in the NHS advocated for the introduction of stop smoking services within NHS settings to complement community-based services.
" Hiding in plain sight: Treating tobacco dependency in the NHS demonstrates that clinicians working in almost all areas of medicine will see their patients' problems improved by quitting smoking, and that systematic intervention is a cost-effective means of both improving health and reducing demand on NHS services. Smoking cessation is not just about prevention. For many diseases, smoking cessation represents effective treatment. "
- Royal College of Physicians, 2018
The NHS Long Term Plan, published in 2019, states that by 2023/4 anyone admitted to hospital for an overnight stay will be offered NHS-funded tobacco treatment services.
As South Yorkshire and Bassetlaw has higher than the national average rates of smoking, Yorkshire Cancer Research worked with local NHS Trusts to fund and rapidly implement the QUIT Programme in local hospitals with the aim of reducing the rates of smoking-related cancers in the region.
Talking about quitting smoking while in hospital
A crucial part of the QUIT hospital-based service is asking all patients if they smoke and providing assistance accordingly. This proactive approach enables conversations about smoking cessation with people who may not have been motivated to quit on their own.
Although patients in critical conditions may not be ready for such discussions, their longer hospital stays provide an opportunity to offer nicotine replacement therapy and initiate quit attempts.
Smoke-free hospitals
Creating smoke-free hospital grounds helps protect patients from the harms of second-hand smoke and fosters a supportive environment for smoking cessation. However, this requires also providing hospital staff support to quit or avoid smoking on hospital grounds.
Referral to community services
Efforts by hospitals have resulted in increased referrals to community stop smoking services for patients leaving the hospital. The success of these referrals depends on the motivation of the patients to follow through with attending sessions.
A proper handover between the hospital and community services is crucial to ensure motivated individuals continue their quit attempts, and to avoid wasting resources on those who are less motivated.
Services in mental health hospitals
These hospital-based stop-smoking services are also being implemented in mental health hospitals, where smoking rates are higher, and patients require additional support due to the physical and mental health impacts of smoking.
However, addressing smoking in mental health hospitals can be challenging, as smoking has been historically used as a therapeutic tool or reward. Changing this culture is essential to help patients overcome their addiction.
Yorkshire Cancer Research funding
Yorkshire Cancer Research has funded Tobacco Treatment Advisors as part of hospital-based stop-smoking services in the QUIT programme and at Leeds Teaching Hospitals NHS Trust. This includes three mental health hospitals and Sheffield Children's Hospital, where children and also the parents and carers of the children are asked if they smoke and if they do are given brief advice and information to support them to stop smoking.
The charity is funding SCHARR to evaluate the impact of these services which will help existing services make improvements to become more effective and support the roll out of similar services in other hospitals around the country.
