Smokefree trust

Nicotine management and stop smoking support. Information for patients, families, carers and supporters.

Why are we smokefree?

As a Trust, we are committed to making sure we provide a safe environment for our patients, their carers, staff and visitors.

We have a duty of care to protect the health of people who use or work in our services and to promote healthy behaviour.

The National Institute for Health and Care Excellence (NICE) 2013 guidance recommends that all NHS sites are smokefree.

There are some worrying statistics:

People with serious mental illness die on average 15 to 25 years earlier than the rest of the population.
Smoking is the largest single cause of early deaths and preventable illnesses in England.
Smoking-related illnesses account for over 80,000 deaths per year.
One in two long-term smokers will die early from smoking-related diseases.

What does smokefree mean?

Smokefree means smoking will not be permitted in any premises or on any grounds owned or leased by the Trust.

What are the health benefits if you give up smoking?

Stopping smoking increases your chances of living a longer life. It can take as little as 20 minutes for your body to start healing once you quit smoking.

The chart below will show you how soon you will see physical/health benefits:

20 minutes: Your blood pressure and pulse go back to normal
8 hours: Nicotine and carbon monoxide levels in your blood reduce by half. Oxygen levels return to normal
24 hours: Your lungs start to clear out mucus and carbon monoxide will be eliminated
48 hours: Your body is free of nicotine and your sense of taste and smell have improved
72 hours: Your breathing is easier and you should have more energy
3 to 9 months: Your lung capacity can improve by up to 10%, leading to improvement with coughing, breathing and wheezing
5 years: Your risk of a stroke falls to about the same as a non-smoker
10 years: Your risk of lung cancer falls to half that of a smoker and risk of heart attack falls to the same as a non-smoker

Separate information related to the use of e-cigarettes

Key facts

Tobacco smoke contains over 4000 chemicals, making smoking damaging to the smoker and others around them.
Replacing smoking with nicotine replacement therapies (NRT) such as patches can ease withdrawal symptoms and increase the overall physical and mental health of the smoker.
Stopping smoking is associated with improved mental health including a reduction in anxiety, depression and stress as well as improved psychological quality of life.
It is estimated that 36% of people with bi-polar disorder and 56% of people with psychosis are smokers compared to 20% of the general UK population.
Health problems associated with smoking are mainly caused by components in tobacco smoke other than nicotine.

Is it a Human Right to be allowed to smoke?

The British High Court (2008) ruled that smoking is not a basic human right. It is reasonable to expect the Trust to take action to preserve the health of patients and staff.

There is currently no documented evidence related to the safe distance that staff would be required to stand away from a patient who is smoking. In order to protect Trust staff from second-hand smoke exposure, the Trust has taken the decision that no staff member will be expected to accompany or support a patient to smoke at any time. All escorted leave plans will be negotiated in advance so that individual patients are clear they will not be permitted to smoke in the company of their staff escort.

What does this mean for patients who are admitted to hospital?

If you are admitted to hospital, you will be introduced to a member of staff who is trained to assess your needs. The staff member will offer:

advice and support on remaining smokefree
support to choose an appropriate nicotine-containing product
nicotine replacement products to be made available within 30 minutes of admission
an individualised care plan to support you whilst you are smokefree
information about the frequency of use of nicotine-containing products in this care plan
behavioural support and advice
increased alternative social activities alongside nicotine-containing products

Staff will be able to provide nicotine replacement therapies (NRT), such as patches, inhalators or lozenges. NRT will help with cravings for a cigarette and wards hold a stock of these for people staying in hospital.

Should you require any additional information, please ask to speak to a trained member of staff on your ward. Please do not be tempted to have a cigarette. Help is available to support you and to make sure you are comfortable during your stay in hospital.

Should you come into hospital with tobacco products, cigarettes, lighters or matches,

staff will safely store these and then return them to you on discharge. Alternatively they can be given to a family member or carer to take home with them.

What does this mean for patients in the community?

If you are receiving treatment at home or in a community setting, you will be asked to provide a smokefree environment when Trust staff visit you.
Staff can signpost you to other services for support to stop smoking should you wish or you can contact your local stop-smoking service directly. The Trust also now has a number of “in-house” smoking cessation clinics available, so please ask a member of staff for further information.
For those smokers who feel unable to stop at the moment, a harm reduction approach may be offered. This will look at reducing harm by limiting the number of cigarettes you smoke and using nicotine replacement to support you in the longer term.

We understand that trying to stop smoking can be difficult, but advice and support is available. Local community stop-smoking services have specially trained advisors who are friendly, approachable and non-judgemental. They can give you advice and medications to support your attempt to quit.

Many pharmacies and GPs are also trained to offer support locally.

Can patients use electronic cigarettes?

The Trust currently supports the use of e-cigarettes by patients within in-patient areas, except within the Secure Services or any areas where there may be identified security risks. (Ward staff will be able to discuss such risks and provide alternative treatments.) For those areas of the Trust where e-cigarettes are not allowed to be used, a comprehensive programme of support for patients will be offered to enable them to remain smokefree.

Public Health England advise that encouraging smokers who cannot or do not want to stop smoking to switch to e-cigarettes could help to reduce smoking-related disease, death and health inequalities. They recognise that e-cigarettes are 95% less harmful than smoking a cigarette and therefore may support compliance with TEWV’s smokefree policy and help smokers to manage their nicotine dependence.

E-cigarettes are currently not recommended for use by pregnant women or young people under the age of 18 and currently we do not promote or advocate their use. However, should a pregnant woman come into hospital already using an e-cigarette, then, following a risk assessment, she may be supported to continue with their use and will be referred to appropriate stop-smoking services on discharge.

E-cigarettes will only be available for use by patients in identified areas (such as in courtyards or single occupancy bedrooms) but not in any communal areas and should be stored safely and securely.
E-cigarette models with the exception of modified devices can be used following an individual risk assessment of a patient’s suitability for the charging of their own e-cigarettes, ensuring the appropriate charger is used.
E-cigarettes must be disposed of appropriately in identified bins.

What happens if I smoke within the grounds?

If you feel tempted to have a cigarette, please ask staff for additional support with nicotine replacement. Any person smoking within Trust grounds will be asked to stop smoking and then offered the opportunity to be involved in a discussion with ward staff, which would be recorded within their notes as all interventions are. This discussion will include:

the risks of smoking whilst using NRT e.g. Patches
the potential effects on some medications of smoking or cessation

Smoking can affect the way some psychiatric drugs are metabolised so those who smoke may require more medication than non-smokers. Not smoking will usually mean lower doses of some medication will be necessary and therefore fewer side effects. (Further information is available from a member of ward staff)

Please do not be offended if you are approached by a member of staff. They are looking to protect your health and that of other patients, carers, staff and visitors to the Trust by keeping the premises smokefree.

Help us to help you…

The Trust now has a team of Tobacco Dependency Advisors who are based across multiple hospital sites including Durham, Darlington, Teesside, York and Scarborough and are available for advice and support to help you remain smoke free whilst an inpatient.

These trained specialists can also help to support you upon discharge if you would like further assistance to reduce or stop smoking. Team members regularly visit inpatient wards at West Park Hospital, Lanchester Road Hospital, Auckland Park Hospital, Roseberry Park Hospital, Foss Park Hospital and Cross Lane Hospital.

You may see them on your ward chatting with patients and staff, delivering awareness sessions about the dangers of smoking, or presenting a display in a hospital reception area about harm reduction. You can ask any staff member to contact them if you would like to discuss your options and they will be happy to visit you and offer whatever help they can

It is important that people do not smoke in secret either inside or outside Trust property. We are here to support you and the best way we can do this is by being open and honest with one another.

Call the Smokefree National Helpline number:

Tel: 0300 123 1044

Discover more on the NHS Smokefree site.