More healthcare professionals should be trained to give smoking cessation advice to capitalise on “the power of the clinician’s voice”.

Less than half of all smokers admitted to hospital are offered advice to quit, according to preliminary results of the British Thoracic Society’s audit of the state of tobacco dependency treatment services in UK hospitals released to mark No Smoking Day 2022.

According to the audit, which looked at over 14,000 patient records from 120 UK hospitals in 2021, only 45% of smokers in hospitals received Very Brief Advice (VBA), a short conversation in which healthcare practitioners ask if a patient smokes, advise on how they could stop and offer help to do so.

VBA is the simplest and most cost-effective intervention which has proven to encourage quit attempts among patients who smoke, and such a low percentage of it being offered means that the NHS might be missing a golden opportunity to help smokers beat their tobacco addiction.

Clinicians at all levels should be able to provide VBA at any point throughout a patient’s hospital journey to capitalise on the effectiveness of this intervention. However, the audit showed that only 50% of trusts were offering frontline healthcare staff regular smoking cessation training.

The audit also found that pharmacotherapy (nicotine replacement therapy and addiction-breaking drugs) was offered to patients that smoked only in about a third of cases (33%).

Not all preliminary findings were disappointing, as the number of smokers among adult inpatients appears to have reduced from 24% in 2019 to 21% in 2021.

Professor Sanjay Agrawal, National Specialty Adviser for tobacco addiction, said:

“The BTS audit findings demonstrate the considerable opportunity to screen and treat tobacco dependency across the NHS.

 “The NHS Long Term Plan is committing significant resource to put in place tobacco dependency treatment services across hospitals, maternity and community mental health services by 2023-24, that will lead to the systematic identification and treatment of tobacco dependency. We look forward to working with BTS and other partners on this programme of work to improve lung health and reduce health inequalities.”

 “To help fulfil the ambition of the Long Term Plan of providing every smoker in hospital help with quitting, the British Thoracic Society has launched a programme to support healthcare professionals to set up and run a successful tobacco dependence treatment service in their hospitals.”

Through the Respiratory Futures website, BTS is encouraging collaboration, and sharing practical step by step guides, good practice examples and educational material to help clinicians to plan and deliver a comprehensive tobacco dependence service.

BTS published the Tobacco Dependency Roadmap, a seven-steps guide to set up a tobacco dependence treatment service which is accompanied by a series of free webinars. Sessions on this programme of work on the treatment of tobacco addiction will take place in both the BTS Summer and Winter Meetings this year, sharing progress so far.

More work in this area is underway, with a new Clinical Statement on the medical management of tobacco addiction, which will provide guidance to healthcare professionals on how to approach and deliver tobacco dependence treatment to people who smoke.

A smokefree society is a central priority for the Society, and as well as working to support clinicians in their work to help those with a tobacco addiction, we are supporting the No Smoking Day campaign to encourage people to quit smoking.

The campaign launched today and will continue with a month of action, with the theme: “Don’t give up on giving up. Every time you try to stop smoking, you’re a step closer to success.”. The campaign also highlights that the voice of health care professionals is crucial in communicating this message.

A toolkit to with a series of suggestions on how to support the campaign is available on the No Smoking Day website.

Dr Paul Walker, BTS Chair, commented:

"Tackling tobacco dependence is fundamental to respiratory medicine and all respiratory professionals need to make every contact count, using that opportunity to offer advice and help to aid smokers to quit.

 “As we begin to recover services post-COVID we need to ensure that all hospitalised smokers are offered advice and pharmacotherapy, rather than the minority who currently receive this. This requires a focus from frontline healthcare organisations on smoking cessation training which is essential to deliver this intervention."

The full audit report, available later in the spring, will include more data on availability and prescription rates of pharmacotherapy and other NICE-recommended interventions to quit smoking, the availability of tobacco dependency treatment services, the percentage of smoke free hospitals and more.