Find out the facts behind the biggest avoidable cause of inequalities in health
- A number of diseases are caused by smoking including heart disease, cancers and respiratory diseases
- The burden of disease has financial implications for the NHS and wider society
- Smoking is responsible for over 460,000 hospital admissions in England each year
- It is the biggest avoidable cause of inequalities in health
- Smoking in pregnancy causes up to 5,000 miscarriages and stillbirths each year, and increases the risk of premature birth and low birthweight
- In children, secondhand smoke causes sudden infant death syndrome and middle ear disease, and exacerbates asthma
- One in five of the general population smokes, this figure rises to one in three among people with longstanding mental illness and to 70% of people in psychiatric units
A Cochrane review confirmed the positive impact of implementing stop-smoking services for inpatients. This systematic review found that stop-smoking programmes aimed at inpatients with support for at least one month after discharge are effective, regardless of admitting diagnosis (Rigotti et al, 2008).
Patients who remain smoke free during a stay in hospital will heal more quickly and are less likely to be readmitted. In addition, patients are more receptive to smoking-cessation support while in hospital, and are often more motivated to stop smoking following admission (Department of Health, 2009).
National Institute for Health and Care Excellence guidance on Smoking Cessation: Acute, Maternity and Mental Health Services was published in 2013
- · NHS hospitals should help all patients who smoke to stop before and during a hospital stay as well as ideally remaining smoke free after their hospital treatment
- · Patients who smoke should be identified
- · Offering support to stop smoking should be part of routine practice
- · Clinical staff should feel this is part of their duty of care
- · NHS hospitals should provide everyone with verbal and written information about the hospital’s smoke-free policy before their appointment, procedure or hospital stay. This should include the short and long-term benefits of stopping smoking and details of the support available.
- · NHS hospitals should provide intensive support for people using secondary care services, and discussions about past and current smoking behaviour should be included in a personal stop-smoking plan
- · Patients should have access to licensed nicotine-containing products, such as nicotine replacement therapy patches or gum, or other pharmacotherapies.
Adapted from Gilbert L, McIlvar M (2014) Hospitals’ duty of care in smoking cessation. Nursing Times; 110: 4, 22-24.
Department of Health (2009) Stop Smoking Interventions in Secondary Care. London: DH.
National Institute for Health and Care Excellence (2013) Smoking Cessation: Acute, Maternity and Mental Health Services
Rigotti NA et al (2008) Interventions for smoking cessation in hospitalised patients. Cochrane Database of Systematic Reviews; Issue 2, Art no CD001837. DOI: 10.1002/14651858.CD001837.pub.2