Almost every minute of every day, someone is admitted to hospital because of smoking. Smoking puts significant pressure on the NHS and tobacco will kill 2 in 3 lifelong smokers early.

NICE guidance on smoking in secondary care settings has concluded that a smoke-free NHS estate – including comprehensive smoke-free policies and accessible tobacco dependence treatment for all smokers – is essential.

This is vital for many reasons:

• Smoke-free policies communicate an unambiguous message about the risks of smoking a cause of serious ill health in an NHS setting.
• There is no risk-free level of exposure to tobacco smoke, especially when this drifts into nearby buildings – so smoke-free policies are necessary to protect people from breathing in secondhand smoke.
• Smoking is a fire risk wherever it is allowed.
• Stopping smoking is a key part of aiding recovery for patients and reducing the risks of them needing to be re-admitted to hospital. One in four patients in a hospital bed is a smoker, making secondary care use a valuable opportunity to promote cessation to improve heath outcomes.
• A smoke-free environment supports smokers who are trying to quit and removes triggers that cause relapse to smoking, potentially undermining in-house support to quit through the work of Tobacco Dependency Treatment Services.

The Smokefree NHS programme in the North East and North Cumbria provides ongoing support to all 10 Trusts, through regular meetings. Through this network, we have collaboratively developed an implementation toolkit to support Trusts take a strategic approach to supporting tobacco-dependent patients.  

Through this same project, a Smokefree Champions toolkit has been developed to support our TDTS teams reach the wider NHS workforce. Adopting a hub and spoke framework, the toolkit aims to  

• To establish a network of clinical and non-clinical Smokefree Champions to promote and embed smokefree policies across NENC NHS Foundation Trust.  

• To develop a cohort of trained healthcare professionals who consistently advocate for:  

• • Routine screening for tobacco dependency  

• • Initiation of Nicotine Replacement Therapy (NRT) and/or vapes, where appropriate  

• • Referral to Tobacco Dependency Treatment Services (TDTS) for ongoing support 

Further information around treating tobacco dependency in the NHS and the importance of smokefree NHS estates is available in the Royal College of Physicians report Hiding in Plain Sight: Treating Tobacco Dependency in the NHS.