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BTS Audits the NHS

The British Thoracic Society has audited NHS hospital-based Tobacco Dependency Treatment Services

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The British Thoracic Society has audited NHS hospital-based Tobacco Dependency Treatment Services and discovered that there has been no major improvement since 2019. It concluded that the NHS is still some way off meeting its commitments and is missing opportunities.

In its 2021 national Audit of the Management of Tobacco Dependency in Acute Care Trusts, The British Thoracic Society “looked at how effectively the national standards for the medical management of tobacco dependent smokers that attend hospitals have been implemented across the UK.

The Society looked at provision in 120 hospitals across the UK and analysed over 14,000 patient records. It said that during 2021, “the NHS was still some way off fulfilling its commitment to help all hospitalised patients that smoke to quit by 2023/4.”

Going further, as its results pretty much resembled those from the previous year, the Society added that, “the NHS might have missed opportunities by not reaching smokers with advice and treatment when they were already within the healthcare system.”

The 2021 Audit revealed that recording of smoking status in patients remained below target, with 79% people admitted to hospital had their smoking status recorded compared to 77% in 2019.

Of the people that were identified as smokers:

  • Less than half (45%) were provided very brief advice (VBA) to quit
  • Only 40% were offered a referral to a tobacco dependency service (down from 44% in 2019)
  • Fewer than 1 in 10 (9%) were seen by a tobacco dependency practitioner while in hospital
  • Only 1 in 20 (5%) were provided with the most effective interventions recommended by NICE (4) (nicotine replacement therapy-NRT, varenicline-a medicine that reduces cigarette cravings, and vaping)

They noted that a decline in the number of smokers presenting at hospital was an encouraging improvement in the data – but this fails to recognise the role many suspect nicotine played in preventing worse Covid symptoms – 21% of acute patients smoking in 2021 compared to 24% in 2019.

Dr Matt Evison, British Thoracic Society clinical audit lead, commented: “This BTS audit unfortunately shows that we are still struggling to make meaningful progress in helping patients quit smoking at a national level. However, despite the disappointing figures from last year, I am confident we are approaching a turning point.

“Since we raised concerns about the state of hospital-based smoking cessation services in of our 2019 audit, the NHS has shown a renewed commitment to do better, with dedicated funding for tobacco dependence treatment and the appointment of a National Specialty Advisor for Tobacco Addiction. NICE also published new guidance on treating tobacco dependence, which gives more clarity to clinicians on how to support patients who smoke.

“Most of these initiatives came into being too late for their effect to be seen in our audit, but everything is in place now and we will keep a close eye on the next iteration. While the results are disappointing today, I am looking at this audit as the start, the baseline against which we now need to improve.”


Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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