Lives to be saved with hospital support for smokers to quit
LIVES will be saved and thousands of hospital admissions prevented in the North East and North Cumbria with the launch of a new regional service to help smokers in hospital.
Most smokers start as children, but the new Tobacco Dependency Treatment Service rolled out in the region will aim to help in-patients and maternity patients beat tobacco addiction at a time when they are in contact with doctors, nurses and other NHS ward staff.
Latest figures  show that there are over 33,300 hospital admissions and 224,000 outpatient visits related to smoking in the North East and North Cumbria every year as part of a wider cost of around £124m to the region’s NHS from treating smoking related illness.
In the North East and North Cumbria area, in-house Tobacco Dependency Treatment Services have been rolled out during 2022 in hospital trusts to ensure all in-patient smokers are offered support to manage tobacco dependency while in hospital or if they are pregnant to support a smokefree pregnancy.
The work is part of the NHS Long Term Plan to reduce the harms caused by smoking, to help people stay healthy and manage demand on NHS services.
Smoking during pregnancy also presents significant financial costs and it was estimated in 2015/16 the cost of smoking during pregnancy was over £20 million through 10,032 episodes of admitted patient care. 
Colleagues from the NHS and Local Authority are coming together this week on 14th December for an event to discuss the progress that has been made on a Smokefree NHS in the North East and North Cumbria, and to hear from national and regional speakers.
Dr Ruth Sharrock, Consultant Respiratory Physician and Clinical Lead for Treating Tobacco Dependency on behalf of North East and North Cumbria NHS said: “Smoking is still the single biggest cause of preventable ill health and people who smoke make up a significant number of those admitted to hospital.
“The fact is that smoking not only causes cancer, heart disease, stroke, COPD and dementia but during the winter when demand is at its peak makes illnesses, viruses and infections such as flu and Covid much worse.
“Often I see patients who want to quit but don’t have the confidence or the support in place to quit successfully. We are seeing countless examples when people gratefully take up the offer of support and weeks later their health has been transformed.
“If we can encourage more patients to be tobacco free, even if just for the duration of their treatment, we can improve recovery from illness and make it less likely to have to visit hospital again, and that will ease pressures on our NHS.”
Smoking is still the biggest cause of preventable illness with latest figures showing up to two out of every three lifelong smokers dying from tobacco, losing around 10 years of life on average .
The Royal College Physicians published its seminal report “Hiding in Plain Sight” in 2018 calling on clinicians to ensure all patients are offered support to quit smoking.
The report’s co-editor Prof Sanjay Agrawal, Chair of the RCP Tobacco Special Advisory Group, said: “Over six million people in England still smoke and nearly half a million people in England are still admitted to hospital each year from tobacco-related illnesses. A hospital admission is likely to give anyone who smokes a new reason to quit.
“Within the NHS we need to address smoking as a chronic relapsing long term condition which we need to treat. That in turn helps patients but is also a really cost-effective way of reducing demand on NHS services in the future.
“NHS Trusts across the North East and North Cumbria deserve credit for the commitment for delivering the opt-out support for pregnant smokers and those smokers admitted to hospital and this will make a positive impact on the region’s health. The commitment made some
years ago to set up a regional Taskforce to take forward this focus is a national example of excellence.”
Ailsa Rutter OBE, Director of Fresh and Balance and a former nurse who worked with heart attack patients, added: “We know most smokers start as children and end up regretting it. Most try to quit but it can take a number of tries before succeeding or not managing to quit at all. My dad Stewart was one of them and he died aged just 61 from COPD, a preventable disease.
“It is vital that smokers get encouraged to stop as much as possible and supported to do so – but nowhere is more important than at a time when they are in hospital, when the message is clear it is a vital step for their health.”
Dr Robin Hudson, Medical Director for North East & North Cumbria Integrated Care Board (Central) said: “The NHS Long Term Plan set out actions to make prevention a priority and to reduce the ill-health burden, which is especially important for a region like ours where our communities face high levels of disadvantage and higher rates of disease linked to smoking.
“Our NHS and staff already treat illness but are also in a unique position to prevent it. Smoking rates have always been higher in this region and although we have made massive strides, there is more that could be done.
“We welcome this opportunity to become one of the first Integrated Care Systems for all trusts to deliver this level of support.”
Amanda Healy, Durham County Council Director of Public Health and chair of the Association of Directors of Public Health North East network added: “The North East has historically seen the highest rates of smoking in the country but in recent years we have experienced the biggest regional drop in smoking through working across local authorities and our NHS and with the regional tobacco control programme Fresh in place.”
Anthony Norton was recently admitted to hospital following a fall that left him unable to mobilise independently, meaning that he couldn’t leave his hospital bed. Working with the onsite tobacco advisor, he developed a plan of support for his time in hospital and remained smoke-free for the duration of his four-week stay. Since leaving hospital three weeks ago, Anthony has continued to stay quit. He said: “If I hadn’t had the support and products, I
definitely would have struggled more with the stress and pain without a cigarette. It’s the best thing I’ve ever done. I feel different and I couldn’t have done it without the help and support of the team.”
NHS Tobacco Dependency Treatment Services are a national requirement as part of the NHS Long Term Plan.
By 2023/24 all inpatients in hospitals, or who are engaged with maternity services, will be asked about smoking and offered treatment to stop as part of their routine care.
In the North East and North Cumbria, the Integrated Care System Population Health and Prevention Board committed to going faster to deliver an NHS Tobacco Dependency Treatment Service (TDTS) across the North East and North Cumbria and rolling this out at scale across all NHS Trusts in 2022/23. There are different pathways for hospital acute trusts, mental health and maternity.
All patients being admitted will now be asked if they smoke and offered free Nicotine Replacement Products (NRT) on arrival to manage their cravings whilst in hospital. This helps patients to improve recovery, reducing their chances of re-admission.
-  ASH Ready Reckoner https://ash.org.uk/resources/view/ash-ready-reckoner
-  Hiding in plain sight: Treating tobacco dependency in the NHS. A report by the Tobacco Advisory Group of the Royal College of Physicians
-  Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence
- Emily Banks, Grace Joshy, Marianne F Weber, Bette Liu, Robert Grenfell, Sam Egger, Ellie Paige, Alan D Lopez, Freddy Sitas & Valerie Beral https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0281-z