Smoking Cessation

The elimination of tobacco-related lung disease in the UK population has been a key BTS objective for over 30 years.  We are delighted to see that offering smoking cessation advice and support in hospitals is a clearly defined objective in the NHSE Long Term Plan that was published on 7th January 2019.  We hope that smoking cessation services in the community will also be supported  after sustaining severe reductions in funding in recent years.  

BTS is committed to working in partnership with others to move toward this goal, providing clinical expertise in national discussions, and local expertise to directly assist those who wish to stop smoking. Smoking is the leading cause of health inequalities, and the greatest cause of reduced life expectancy in those with serious mental health problems. Two thirds of smokers want to quit. 

We have had Smoking Cessation Champions for many years.  Now, everyone who works in the NHS should be a Smoking Cessation Champion.  Here are some tools to help.

NEW: BTS Smoking Cessation Quality Improvement Tool, 2018

This aims to help hospitals undertake local quality improvement (QI) projects. The Tool contains background on QI methodology and includes a number of resources for smoking cessation, together with examples of how to tackle three main improvement objectives: referral for stop smoking support; prescription of nicotine replacement therapy and staff training. The Quality Improvement Tool and Appendices are available via the links below. See our QI methodology page for more information on this topic.   

Quality Improvement Tool - Smoking Cessation (British Thoracic Society)

Appendix 1 - Example Patient Record (The Cure Project, Manchester)

Appendix 2 - Electronic Recording Case Study (University Hospitals of Leicester NHS Trust)

Appendix 3 - Example Ask, Advise, Refer Stickers (University Hospitals of Leicester NHS Trust)

Appendix 4 - Example Electronic Referral Record (South London & Maudsley NHS Foundation Trust)

Appendix 5 - Patient Group Directive for NRT (Wendy Preston and George Eliot Hospital NHS Trust)

The above documents are available for use by secondary care teams and may be adapted for local use. Please acknowledge the relevant individuals and organisations as the source of any materials developed from these documents. 

Smoking Cessation Audit

The 2016 BTS national smoking cessation audit collected data on 14,500 inpatients to assess how well smoking status was being recorded and, where patients were current smokers, what support was being offered. The audit used standards derived from the BTS Recommendations for Hospital Smoking Cessation Services and NICE guidance and quality standards. See the National Report for details of the findings and national improvement objectives and this Clinical Medicine article for more information on the audit.

An updated version of the audit is available for local use to help hospitals compare their performance over time, or to assist in data collection for local quality improvement initiatives. We will shortly start work on the next national smoking cessation audit.

Commissioning for Quality and Innovation (CQUIN)

The Commissioning for Quality and Innovation (CQUIN) payment framework is a national initiative where trusts agree a set of local quality improvement goals with their commissioners with financial incentives attached. More information on the CQUIN  scheme and an example CQUIN for recording, advising and referring is available here. Additional information on the 2017/19 CQUIN 'Preventing ill health' which focusses on smoking and alcohol is available here. 

The Case for Change

This 2011 campaign aimed to persuade every hospital in the country to have a Stop Smoking Service to treat sick smokers. Smoking cessation interventions are the single most cost-effective life-saving intervention provided by the NHS, and hospital contact is an ideal time to advise patients and provide support to those who want to quit. Please see the full Case for Change report for further details. 

In 2014 BTS established a network of Stop Smoking Champions to raise the profile of smoking cessation and provide education and support to patients and colleagues. For other ways to get involved see also Individual and Organisational Strategies in Smoking Cessation

Quit Smoking Return on Investment tool 

This tool was developed in collaboration with the NHS Institute for Innovation and Improvement to enable organisations to quantify the potential benefit to setting up a stop smoking service, and to help them to demonstrate the business case to commissioners. 

Return on Investment tool

Return on Investment user guide

Return on Investment demonstration

Educational materials

Slides Sets:

The e-cigarette slides include research and information on the pros and cons on their use - we have tried to maintain a balanced view to the topic, but would welcome any feedback.  

Stopping Smoking - What health professionals should know (slide set)

Stopping Smoking - What health professionals should know (notes)

Electronic Cigarettes (slide set)

These slide sets may be used for educational purposes provided no changes are made to the content and full attribution is given to BTS.

Training videos:

BTS has been involved in the production of two videos to encourage healthcare professionals and patients to take advantage pre-op smoking cessation.   

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