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NHS needs to do more to tackle smoking

Smoking cessation services must be preserved, writes Amanda Sandford

Stopping smoking remains a popular and important New Year’s resolution. However, all too often, it is one that smokers fail to keep, particularly if attempted ‘cold turkey’. This may be due to a loss of motivation, not having a clear plan or not enough support – all of which can be addressed if the smoker seeks professional help.

Nurses have an important role to play in ensuring that patients who smoke are given ‘very brief advice’ to quit and that they are referred to specialist support services. Research shows that behavioural support combined with pharmacotherapy can increase a person’s chances of successfully stopping smoking up to four-fold.

We can be justly proud of the specialist stop smoking services which were set up in England in 2000. At their peak in 2010/11, almost 800,000 ‘quit dates’ were set by users, resulting in an estimated 20,000 people achieving long-term abstinence. Although the number of people attending the services has fallen in recent years, the successful four-week quit rate has remained fairly consistent at 51%.

Despite the proven success of the services, there is growing concern that cuts to local tobacco control and smoking cessation budgets will have a negative impact on both further reductions in smoking prevalence and on the sustainability of the NHS.
Action on Smoking and Health (ASH) research has revealed that since 2015, cuts have been made in smoking cessation budgets in 59% of local authorities and to tobacco control budgets in 45% of local authorities. Meanwhile an audit of smokefree practices in UK hospitals by the British Thoracic Society found that the majority of hospitals were failing to meet national guidelines to help patients stop smoking.

Given the scale of harm caused by smoking these findings indicate a worrying lack of engagement with policies and practices that should be taking place across the NHS. Yet reducing smoking will be essential if the NHS is to meet the challenges of the future. Delivering the NHS Five Year Forward View will require a ‘radical upgrade’ of prevention and public health. While smoking continues to be the leading cause of preventable ill-health, costing the NHS some £2 billion a year, it is clear where the priority should lie in reducing healthcare costs.

The huge financial burden caused by smoking provides a strong case for continued investment in smoking cessation and other tobacco control measures. Every year smoking in England results in over 37,000 deaths from cancer, 23,000 deaths from respiratory disease and 16,000 deaths from cardiovascular diseases.

Hopefully the government will take note of its chief medical officer who put it so succinctly in her most recent annual report: ‘There is an unquestionable need for adequate support for smokers trying to quit and continued provision of stop smoking services is vital.’

Amanda Sandford, information manager, ASH