RCP calls for radical change in NHS approach to smoking cessation

The Royal College of Physicians (RCP) is proposing that opt-out smoking cessation services should be provided as a routine component of all hospital care.

The RCP states that failure to identify smokers and offer smoking interventions is as negligent as not treating cancer. | iStock.com/Sezeryadigar
The RCP states that failure to identify smokers and offer smoking interventions is as negligent as not treating cancer. | iStock.com/Sezeryadigar

In its report, 'Hiding in plain sight: Treating tobacco dependency in the NHS', the RCP recommends that as smoking cessation treatments save money for the NHS, they should be prioritised as a core NHS activity and smoking cessation incorporated as a systematic and opt-out component of all NHS services as a complement to local authority services.

It adds that current models of delivering smoking cessation services separately from mainstream NHS services, while successful in the past, may now not be the best approach because they rely on patients seeking help themselves. 

The report states that giving smokers the help they need to quit smoking while in hospital will save lives, improve quality of life as well as increasing life expectancy, and help to reduce the current £1 billion per year cost to the NHS of smoking by patients and staff.

Systematic identification of smokers

According to the report, systematic identification of smokers and delivering cessation support doubles quit rates. It recommends that health service commissioners should therefore ensure that smokers are identified and receive cost-effective smoking interventions, adding that failing to do so is as negligent as not treating cancer.

Training needed

The RCP states that clinicians working in all areas of medicine can improve their patients' lives by helping them to stop smoking but that most health professionals receive little or no training in this area. The report recommends that training in smoking cessation should become an integral part of all undergraduate and postgraduate healthcare professional curricula and should be introduced as mandatory training for the entire NHS healthcare professional workforce.

Smoke-free settings

The RCP states that smoking cessation should be delivered in smoke-free settings and that it is unethical to do otherwise. It adds that current guidance regarding smoke-free policies is not being implemented and that legislation requiring hospitals to implement completely smoke-free grounds is needed.

It also proposes that e-cigarettes should be allowed on NHS sites to support smokers in remaining smoke-free and to help sustain smoke-free policies.

Professor John Britton, chair of the RCP's Tobacco Advisory Group and lead editor of the report, said: 'Treating the more than one million smokers who are admitted to hospital every year represents a unique opportunity for the NHS to improve patients' lives, while also saving money.'

'Smoking, the biggest avoidable cause of death and disability in the UK, is hiding in plain sight in our hospitals and other NHS services; the NHS must end the neglect of this huge opportunity to improve our nation's health.'

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