27th November 2013 – The days when hospital patients could pop outside to smoke are numbered after a health watchdog announced that hospitals and clinics should become completely smoke-free.
New guidance from the National Institute for Health and Care Excellence (NICE) says people using acute, maternity and mental health services in England should also be given intensive help to stop smoking.
Professor John Britton, who chaired the NICE guidance development group, tells BootsWebMD: "Smoking kills more people than any other avoidable cause… and so it makes no sense at all for the NHS to be trying to deal with those problems rather than addressing the cause."
The new guidance makes a series of recommendations, including:
Providing written information about non-smoking policies before an appointment, procedure or hospital stay, including the benefits of stopping smoking and help available, thus encouraging patients stop smoking before they are admitted to hospital
Making smoking cessation medication available to patients as soon as they are admitted
Banning smoking from all NHS hospitals and clinics, as well as their grounds
Removing shelters or other designated outdoor smoking areas, and that staff, contractor or volunteer contracts do not allow smoking during working hours or when in uniform or on hospital business.
Making smoking cessation help 'routine'
"When a smoker is admitted to hospital, he or she can expect to be given the right medication and the right counselling support that has helped so many smokers to quit," says Professor Britton, who is director of the UK Centre for Tobacco and Alcohol Studies, University of Nottingham. "That will all be delivered very quickly after admission to hospital, making that a routine thing – systematic within the NHS – rather than something that's sometimes felt like an optional extra."
The NICE guidance recognises that smoking is responsible for over 460,000 hospital admissions in England each year and is the biggest avoidable cause of inequalities in health.
Also, in children, second-hand smoke causes cot death, middle ear disease and exacerbations of asthma. Smoking is especially common among people with mental health problems: whilst 1 in 5 of the general population smokes, the figure rises to 1 in 3 among people with longstanding mental illness and rockets to 70% of people in psychiatric units.
Professor Mike Kelly, director of the NICE Centre for Public Health, says in a statement: "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 smokefree policies to make NHS secondary care an exemplar for promoting healthy behaviour."
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