Introduction and Objectives In 2009/10 there were 1.5 million hospital admissions in adults aged >35yrs with a smoking related illness. Smoking cessation is a cost effective clinical intervention, producing better health outcomes for patients and saving NHS resources. In 2010/11 total expenditure on ‘NHS Stop Smoking Services’ in England excluding prescriptions was £84.3million. NICE guidelines recommend that every smoker should be offered smoking cessation advice and prescription of nicotine replacement therapy (NRT).
The purpose of this study was to identify smoking prevalence in a general medical inpatient population at the time of admission and evaluating the hospital’s provision of smoking cessation advice and NRT prescription.
Methods Using a cross-sectional study design, contemporaneous data was collected from the Acute Medical Unit (AMU) on 6 separate days. All admitted patients were eligible and interviewed using a standardised questionnaire. Three interviewers agreed a standard approach to questioning. Contemporaneous hospital notes and drug charts were reviewed. Exclusions to the study included cognitive impairment, language, not being present on the ward, being significantly clinically unwell and patient refusal.
Results Figure 1. 185 patients were reviewed and 23 excluded. 85% of patients had their smoking status clearly documented. Only 30% of smokers were provided with cessation advice and 7% were referred to Quitters. 69.5% of smokers did not have NRT prescribed but only 19.5% not wish to receive NRT.
Conclusions The medical impatient population has a higher prevalence of smokers (28%) when compared to the national average of 21%. Our results for smoking cessation service provision compare poorly with NICE guidelines which target 100% of smokers receiving smoking cessation guidance.
Awareness needs to be raised amongst the medical staff in order to optimise the provision of advice, referral to quitters and NRT prescription rate in order to achieve the targets set by NICE and the DOH. We are currently embarking upon a series of educational sessions and a ward round ‘checklist’ is under development which will include a prompt for smoking cessation.
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