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All inpatients should be encouraged to stop smoking, states NICE


Ill smokers should be given nicotine patches or gum the moment they arrive in hospital in a bid to help them curb the habit, according to the National Institute for Health and Care Excellence.

Hospitals should provide all smokers “immediate access” to smoking cessation products to help them stop or temporarily abstain from smoking, said NICE.

In new draft recommendations, the health guidance body also calls on all hospitals to implement smoke-free policies in their grounds.

In some trusts around the country, patients can be seen smoking outside buildings wearing hospital gowns and slippers. While other hospitals have zero tolerance policies on smoking in their grounds.

In the new guidance, which is now open for consultation, NICE says that such a policy should be implemented across England.

It is also calling on trusts to give all patients information about their smoke-free rules and support to help smokers kick the habit.

Professor Mike Kelly, director of NICE’s Centre for Public Health, said: “The benefits of stopping smoking are well known, and people are already required by law not to smoke inside enclosed or mostly enclosed buildings.

“This draft guidance sets out proposals on supporting people in a hospital environment not to smoke, as well as supporting the smoke-free policies in hospitals.

“Secondary care providers have a responsibility to protect the health of people who use or work in their services.

“The draft recommendations propose that this duty of care should also routinely cover providing advice on how to improve health, including stop smoking interventions.

“Some people do not want to give up smoking completely, so one of the draft recommendations advises they should be helped to abstain from smoking during their stay.

“It adds that they should be given advice on using nicotine replacement therapies (such as patches or gum) to help with any cravings. We want to hear people’s views of these proposals.”

Treating smoking-related illness costs the NHS £2.7bn every year.


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Readers' comments (26)

  • I think patients should be banned from leaving the ward inless accompanied by relatives. All too often patients leave the ward and not always telling the staff. Some then collapse outside which causes more stress and anguish to the nurse in charge as they are responsible for bringing them back to the ward safely which then puts other patients at risk while a nurse goes out to retrieve them.

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  • I work in a North East and until fairly recently we had access to in house smoking cessation services if a patient requested referral for support.
    This has now stopped due to costs of running the service, now we simply have to advise patients to either seek help from GP or call at a local pharmacy for a NHS quit kit.

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  • Makes you wonder. The costs of running a cessation service vs costs of long term complications from smoking. Easy to guess which one is less and better value for money.

    How many patients (some with drips running, some on crutches or wheelchairs) + relatives still smoking just outside hospital entrances, whilst still on hospital grounds? Never ceased to be amazed what some people do for a smoke while very ill + likely contributor to them being admitted. Carbon monoxide binds stronger than oxygen to red blood cells. So patients are more likely to be bit more breathless when coming back to their bed, assuming they make it and others know which ward they've come from.
    Thought it was completely no smoking on site. Due to chimney effect, from height of the buildings, smoke + traffic pollution are drawn into the building from surrounding area to affect those inside (especially those nearer the main entrances + outside windows).

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  • you would need to "encourage" all of the staff to stop first. Practice what you preach! How many at NICE smoke?

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  • In NHS Greater Glasgow & Clyde, they are introducing a much more robust approach. Red grid lines being painted all over the ground around all hospital entrances with STRICTLY NO SMOKING in red. Wardens patrolling in pairs to challenge anyone (staff, patients, visitors, etc) caught smoking in contravention of the policy.

    NRT and smoking cessation support have been freely on offer for years to staff and patients. The health board decided that a zero-tolerance approach must be adopted. I will be interested to see how this is received and if it will be effective.

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  • mags | 6-Apr-2013 11:58 am

    that really seems to be going to extremes and what about civil liberties?

    on the other hand, please could you send them over to Europe? Getting on and off trains you have to choke and peer your way through a thick smoke screen as so many get off the train for a quick smoke. Those on the train often already have an unlit cigarette in their hand at the ready.

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  • zena Jones

    Smoking is an addiction though, isn't it ?

    Trying to get politicians to be less deliberately deceptive in their utterances would be nice, as well - but probably not achievable !

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  • Anonymous | 6-Apr-2013 1:17 pm

    I don't think the wardens are going to be armed. At least, I hope they won't be!

    With regard to civil liberties, it is illegal (Smoking Health and Social Care (Scotland) Act 2005) for anyone to smoke within hospital environs, so smokers are breaking the law.

    This crackdown is in response to a substantial amount of complaints from patients, staff and visitors who are fed up with running the 'smoke' gauntlet on their way into hospital buildings. So there is a lot of support for it.

    The wardens will apparently be approaching smokers to offer advice, support, etc, whilst pointing out the policy. It will hopefully get rid of smoking from hospital grounds once and for all.

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  • mags | 6-Apr-2013 4:50 pm

    from Anonymous | 6-Apr-2013 1:17 pm

    good scheme. hope it is successful.

    like i said if they get dispirited or bored send them off to the European railway stations - apart from the thick smoke screens on the platforms they can get away to the lakes and mountains on their days off for plenty of fresh air and sunshine! pay is probably pretty good too. their only job requirement would be to bring cans of red paint with them and knowledge of a European language might be useful for their survival.

    I see in England smoking is banned in all parts of the railway stations. In Europe unfortunately passive smoking is still endemic everywhere except on public transport and most cafés and sadly very common among doctors and nurses!

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  • Surely anything which helps people to stop, or kick starts an effort to stop has to be worth doing?

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