PHE calls on all NHS Trusts to ban smoking on hospital grounds

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  • thousands are admitted to hospital because of smoking-related conditions every day
  • new Public Health England (PHE) survey shows more NHS Trusts are now smokefree than ever before
  • PHE calls for all Trusts to ensure total smoking bans on hospital grounds

Public Health England (PHE) has found that Trusts are making steady progress in becoming smokefree, with smoking now banned completely on the grounds of more than two thirds (69%) of NHS acute Trusts in England. Yet despite this progress, almost a third (31%) have not yet enforced total smoking bans across hospital premises.

The survey was carried out as part of PHE’s Smokefree NHS campaign, which encourages all hospitals to provide smokefree environments as part of supporting smokers to quit and reducing tobacco-related harms. The NHS Five Year Forward View included a commitment for all Trusts to have fully smokefree sites by spring 2020.

Duncan Selbie, Chief Executive, Public Health England said:

One in four hospital beds are occupied by a smoker, and most of them want to quit. Many patients or visitors will be going through difficult times, but smoking remains England’s biggest preventable killer and it is time for the NHS to stop smoking within its hospital grounds, everywhere.

It cannot be right that it is more acceptable in some hospitals to smoke at the front door than it is outside a pub.

As well as encouraging Trusts to prohibit smoking on site, the Smokefree NHS campaign calls for all patients who smoke to be offered evidence-based quitting support. The NHS Long Term Plan, published in January 2019, commits to offering NHS-funded tobacco treatment services to all inpatients who smoke, regardless of why they are in hospital, by 2023 to 2024.

Professor Steve Powis, National Medical Director, said:

Quitting smoking has clear health benefits, which is why the NHS Long Term Plan details a number of practical actions to help people kick the tobacco habit.

Smokefree NHS premises are an important part of this drive, and the successful schemes we are seeing already provide a blueprint for other Trusts to achieve this over the coming year.

The survey highlighted examples of how Trusts are successfully implementing smokefree policies, including:

  • effective leadership to ensure policies implemented quickly
  • establishing smokefree steering or working groups
  • investing in dedicated staff to deliver stop smoking support to inpatients
  • tannoy system reminders about ‘no smoking’ to reduce confrontation
  • promoting healthy environments – for example, fruit and veg stalls at hospital main entrances
  • shelters with plants and trees
  • partnerships with local schools to produce ‘no smoking’ signage

NHS acute Trusts such as mid-Yorkshire, Northumbria and South Tees are among those highlighted as adopting innovative approaches to help ensure smokefree premises.

Some NHS Trusts reported that implementing policies on e-cigarette use and allowing vaping in designated areas had helped them to achieve smokefree status.

Seema Kennedy, Public Health Minister said:

No one should have to walk past a cloud of smoke in order to enter or leave their local hospital – we must lead by example, and I am determined to see a smoke-free NHS by 2020.

Smoking is still one of the biggest causes of death in this country, and through our NHS Long Term Plan, every smoker admitted to hospital will now be offered targeted NHS support to quit. I am encouraged by this new survey, which shows great strides have already been made towards a smokefree NHS – I strongly urge all Trusts to follow suit.


The PHE survey ran from December 2018 to March 2019. Participation in the survey was voluntary, with Trusts participating on condition of anonymity. Out of 145 Trusts contacted by PHE, 134 responses and 11 nil-returns were recorded.

Being a smokefree Trust was defined as providing evidence-based support for smokers to quit and prohibiting smoking anywhere on the premises, in line with NICE Guidance.

Trusts were scored on a seven-point scale according to the smokefree policies they have in place. Trusts with nil-returns were automatically scored zero for all criteria.

Main findings:

  • almost half (46%) of Trusts achieved maximum points, although this does not necessarily mean that all smokers were offered support to quit
  • two thirds (63%) of Trusts were rated ‘green’ as smokefree or substantially smokefree
  • nearly one third (31%) did not have a policy prohibiting all smoking on the premises
  • policy prohibits smoking in the grounds

Good examples of smokefree policies across NHS Trusts

Mid-Yorkshire Hospitals NHS Trust

  • tannoy announcement system plays anti-smoking reminders recorded by children. Any member of staff, patient or visitor can play the announcements by pressing a button located inside the hospital foyer
  • on-site Stop Smoking Service at Pinderfields for staff, patients and visitors, with plans to launch additional services at more sites
  • almost 3000 patient-facing clinicians have completed Very Brief Advice training on Smoking
  • currently recruiting for a Clinical Nurse Specialist in smoking cessation

Further information is available.

Northumbria Healthcare NHS Foundation Trust

  • all smoking shelters replaced with trees and plants
  • award-winning ‘Change is in the Air’ campaign has been adopted by other trusts across the region
  • dedicated training for all staff groups on offering Very Brief Advice for quitting smoking
  • information on smokefree included as part of staff induction and appraisals
  • ‘I want to quit’ button included on staff intranet to help signpost expert advice and support

Further information is available.

South Tees Hospitals NHS Foundation Trust

  • stop smoking support and brief advice training provided to all staff
  • over 80 smokefree champions to advise staff and patients being recruited across all clinical areas
  • Nicotine Replacement Therapy (NRT) routinely offered to inpatients, with NRT available on all wards

Further information is available.

Great Western Hospitals NHS Foundation Trust

  • trolley dashes around all wards and departments with information (for example leaflets, promotional literature) to raise awareness of smokefree site
  • public and staff education evenings held on smoking cessation as well as stop smoking drop-in clinics.
  • due to install announcement service with anti-smoking reminders recorded by children (for example “my grandfather is receiving treatment in this hospital, please do not smoke.”)

Further information is available.

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