NHS hospitals should ban smoking on their premises and staff should be told not to help patients who want to smoke, according to new guidance.
Measures are needed to help patients stop smoking while they receive care and “preferably help them to stop for good”, the National Institute for Health and Care Excellence (NICE) said.
While individual NHS trusts will have the final say, staff and people using NHS services, including clinics, should be told not to smoke on the hospital grounds, Nice said.
All hospitals should have an on-site stop-smoking service and staff will be told not to help or “facilitate” patients who want to smoke.
Trusts should ensure “there are no designated smoking areas, no exceptions for particular groups and no staff-supervised or staff-facilitated smoking breaks for people using secondary care services”.
Patients should be encouraged to stop smoking before planned admissions to hospital, while stop-smoking drugs should be on hand immediately to help people stop.
Relatives, carers, friends and other visitors will also be given information on smoking and told not to smoke near patients.
Professor Mike Kelly, director of the Centre for Public Health Excellence at NICE, said: “The idea behind this is not to create a penal culture but it is about a culture shift. It’s clearly absurd that the most lethal set of toxins to the human body are being passively encouraged in hospitals.
“We’ve known since the 1950s that smoking kills you and 61 years have passed and we’re now tackling the problem in hospitals. That’s too long.
“Smoking is the most important health problem facing the NHS. It’s the leading cause of premature death in England: nearly 80,000 lives are lost each year due to smoking.
“Treating smoking-related illnesses costs the NHS around £2.7bn each year, and costs society an estimated £13.7bn a year. So it’s a no-brainer, we must deal with the problems caused by smoking.”
Prof Kelly said support should be given to all patients and staff who smoke, as part of providing advice on how to improve health.
“We need to end the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances. This guidance can help make that contradiction a thing of the past by supporting hospital smoke-free policies to make NHS secondary care an exemplar for promoting healthy behaviour.”
Failure to quit in pregnancy causes up to 5,000 miscarriages and stillbirths each year, and increases the risk of premature birth and low birth-weight babies.
In children, second-hand smoke is linked to cot death and middle ear disease, and makes asthma worse.
Smoking is especially common among people with poor mental health. While one in five of the general population smoke, the figure rises to one in three among people with long-standing mental illness.
Some 70% of people in psychiatric units also smoke.
Professor Sue Bailey, president of the Royal College of Psychiatrists, said: “There is a common but mistaken belief among some mental health professionals that it’s all right for patients in their care to smoke.
“This is wrong. Patients with mental health problems are far more likely to smoke than the general population, they suffer disproportionately higher rates of physical illnesses and they die earlier.”
Peter Carter, chief executive of the Royal College of Nursing, said: “The RCN supports efforts to reduce smoking, which must include support services and guidance for both patients and staff to help them to stop smoking.
“Although nursing staff should not be expected to enforce non-smoking policies, they continue to play a vital role in reducing smoking by offering advice and support to patients.”
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