Abstract
Background: Smoking is a major cause of preventable deaths. Plymouth has an adult smoking prevalence of 22%, costing the NHS in Plymouth £15.6 million (€17.9 million).
Plymouth Hospitals NHS Trust (PHNT) is among the city's larger employers. Smokers gathered outside hospital entrances, in smoking shelters and bus stops. A smokefree policy was made in 2004 but not enforced and later abandoned.
Method: PHNT received funding from Smokefree South West in August 2011 to introduce better tobacco control by No Smoking Day, 15th March 2012. Before this date, we surveyed patients, visitors & staff: 66% felt the site should be smokefree. There were 140 smoking incidents (average) around hospital entrances per 8 hour period.
Following Board approval, we arranged: internal & external communication; new signage; NRT on all wards; a smoking cessation e-learning package. The tobacco control policy was updated to allow staff free NRT and time to attend smoking cessation sessions. We trained nurses in key areas (Emergency Department and medical wards) to prescribe & dispense first dose NRT patch to smoking patients. On 15th March 2012, we removed all smoking shelters.
Results: The number of smoking-related incidents fell sharply (<10) after smokefree status was introduced but has risen slowly since June 2012. Repeating our survey of patients, visitors and staff in Summer 2012, 86% felt the grounds of the hospital should be smokefree. We received positive feedback from patients and staff about the site's status. Ward nurses have been encouraged by being allowed to prescribe NRT per protocol.
Lessons: Nurses giving first dose NRT works well. Maintaining smokefree status in practice requires both clear leadership to maintain focus and enforcement.
- © 2013 ERS
