Recent calls for an expansion of hospital smoking bans to outside areas as well have been reignited by Public Health England.
Coverage of the issue in the national media over the weekend has reawakened the debate, which has its originals in a blog written at the end of last year by a leading public health official.
“The NHS must be front and centre for us to secure a tobacco free generation”
Stories by the BBC and several national newspapers, including the Observer and the Sunday Times, highlighted PHE’s ambitions to make the NHS “truly tobacco free”.
Based on interviews with PHE chief executive Duncan Selbie, they reiterated themes set out by him in an official blog published in December.
In the article, Mr Selbie noted that “smokers huddled outside hospital doors” were a common sight since smoking inside healthcare settings was banned in 2007.
“Continuing to normalise smoking in hospital settings is damaging the health of not just those that our doctors and nurses are trying to help, but of future generations too,” he said.
“Just as schools should be free of unhealthy fast foods, there is no place for smoking in the NHS,” he said. “Banning smoking inside hospitals was an important step, but we must do more.”
Mr Selbie, himself a former trust chief executive, highlighted that he had written to the leaders of every trust in England, calling for their personal commitment to work with PHE towards a “truly tobacco-free NHS”.
“Banning smoking inside hospitals was an important step, but we must do more”
He defined this as no smoking anywhere in NHS buildings or grounds, smoking cessation support offered on site or referrals to local services, and every frontline professional discussing smoking with their patients.
“I believe we can make the NHS a place that provides a supportive tobacco-free environment for patients, staff and visitors,” he added.
Mr Selbie highlighted that action was already underway to support trusts to become truly tobacco-free.
For example, he said PHE had developed a menu of preventative interventions for local sustainability and transformation plans to adopt.
Secondly, from next year, all patients coming in for a hospital stay will be asked if they smoke, and if the answer is yes, referred to advice and support on quitting.
PHE has also commissioned online training on delivering brief advice on smoking from the National Centre for Smoking Cessation and Training, which would be available for all healthcare professionals.
In addition, Mr Selbie recommended that trusts would “want to update” their smoking policies to cover the increasingly popular e-cigarettes and that PHE had published five principles as a guide.
He stated: “Tackling the devastating harm of tobacco is a national priority and the NHS must be front and centre for us to secure a tobacco free generation in England.”
The blog was published to coincide with a major audit, suggesting NHS hospitals were falling short on National Institute for Health and Care Excellence guidance on helping patients who smoked to quit and national policies on enforcing smoke-free premises.
The British Thoracic Society report warned that many hospitals were missing out on a “golden opportunity” to provide what is often the most effective front-line treatment for smoking patients who are sick – support and medication to help them quit tobacco.
The report – titled Smoking cessation: policy and practice in NHS hospitals – reviewed the smoking cessation and smoke-free policies and practices of 146 hospitals, including 14,750 patient records.
Among the main findings of the report were that 72% hospital patients who smoked were not asked if they would like to stop and 27% hospital patients were not even asked if they smoked.
Meanwhile, 50% of frontline healthcare staff in hospitals were not offered training in smoking cessation, according to the society’s research.
The report noted that 25% of hospital patients were recorded as being “current smokers”, which is higher than the 19% rate for the general population.