Posted on Jan 24, 2014 by Ruth Loftus
The statistics suggest that every day in the UK about 1000 people go into hospital with health conditions resulting from smoking. The most bizarre thing is that once admitted, many patients promptly go back out of the hospital door in order to smoke. Now, the National Centre for Health and Care Excellence is saying that the spectacle of patients standing in pyjamas outside a hospital – perhaps even with a drip still in place - is simply unacceptable and the crackdown on smoking on health service premises should extend even further.
Patients are to be strongly discouraged from smoking outside premises and it has been suggested that facilities such as smoking shelters – which offer the smoker some protection from the elements - be removed altogether.
Smokers in mental health hospitals are particularly prevalent. The NICHE guidance suggests that psychiatric hospital staff should be strongly discouraged from assisting patients out of bed to enable them to leave their premises to smoke and also that staff themselves should perhaps be subject to a particular discipline if they continue to smoke.
It has also been recommended that patients who are smokers be identified while in hospital and be encouraged to quit – in the hope that quitting might be even more effective at a time when people are already being brought face to face with the consequences of their addiction. In the interim, hospitals and staff could provide patients with nicotine replacements and with other therapies to prevent them from having to manage the additional stress of being in hospital and undergoing other treatment.
Smoking choice organisation, FOREST, however complained that hospital staff shouldn’t be involved in the nagging, cajoling or bullying smokers with the aim of making them quit the habit.They argued that it was both heartless and inhumane to forbid patients from smoking outside hospitals and clinics and argued that it was impossible make the ban work without incurring the cost of things such as CCTV and wardens to monitor the grounds.
The ‘quit smoking’ programme is generally seen as very successful. Reports from observing over a decade of its operation praised it as the ‘jewel in the crown’ of NHS programmes with its record of helping almost 150,000 people give up smoking in that period. At a cost of some £84 million, this stands very well when compared with other medical interventions.
However, there was still room for improvement and had the service performed to its full potential, then around 300,000 people might have rated as long-term quitters (people who have succeeded in giving up smoking for at least one year). It was particularly effective in engaging with people from more disadvantaged groups – where possibly there is a particular concentration of remaining smokers.
The success of the programme was attributed to both the therapies used which included nicotine substitutes and counselling and also the approach of using dedicated staff solely committed to this programme, rather than looking to practice nurses with a range of other responsibilities.
Organisations such as the British Heart Foundation and the British Lung Foundation each paid tribute to the importance of maintaining a real effort to encourage and support people trying to give up smoking.