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Treating Tobacco Dependency in Coventry and Warwickshire

Smoking remains one of the largest causes of preventable illness and premature death with 80,000 deaths per year from smoking related illness. 13.8% of Coventry and Warwickshire’s population smoke and is associated with 7,188 hospital admissions and 2,954 premature deaths, per annum.

Per year, smoking related spend amounts to £332 million, £32 million of which is accrued in health care and a further £21million for social care. 

Tackling tobacco dependence will have a positive impact on health inequalities, for example, smoking alone accounts for more than half the difference in life expectancy between the richest and poorest in society, alongside the following high-level information:

  • Those working in routine and manual occupations have significantly higher prevalence of smoking than those among managerial and professional occupations.
  • Rates of smoking in pregnancy have a strong social and age gradient with poorer and younger women much more likely to smoke in pregnancy.
  • Ethnic minority groups in general have slightly lower rates of smoking; however, some communities are at higher risk of harm, for example from shisha use.

Impact of smoking on Core20PLUS5 in Coventry and Warwickshire ICB can be found here

A key element of tackling tobacco dependency is that it is everybody’s business, and all health and social care practitioners can trigger quit attempts through a life-saving intervention called Very Brief Advice (VBA). VBA involves asking individuals about their current smoking, advising them on the best methods of stopping smoking available to them and helping them access evidence-based stop smoking support. For free training on VBA, please see the training section. 

The NHS Long Term Plan (LTP) was published in January 2019 and includes priority commitments to support people remaining healthier for longer through the funding of new evidence-based NHS prevention at scale programmes. The focus of the NHS programme is on reducing smoking and for the NHS to treat tobacco dependency by 2023/24.

The LTP outlines clear commitments to tackle avoidable illness in conjunction with easing demand for NHS services in relation to smoking admissions, which are:

  • By 2023/24, all people admitted to hospital who smoke will be offered NHS funded tobacco treatment services. 
  • Second, the model will also be adapted for expectant mothers, and their partners, with a new smoke-free pregnancy pathway including focused sessions and treatments. 
  • Third, a new universal smoking cessation offer will also be available as part of specialist mental health services for long-term users of specialist mental health, and in learning disability services. 

All four Trusts are rolling out and embedding the NHS tobacco dependency programme for the above pathways, including specialist support from dedicated Tobacco Dependency Advisors (TDA). Tobacco dependency teams within Trusts will offer highly effective and evidence-based therapies to patients upon admission, to support those dependent on tobacco to safely manage their nicotine use while in hospital.

Treatments combine nicotine replacement therapy and bespoke behavioural support. Nicotine replacement therapy (NRT) consists of patches, inhalators, tablets, and mouth sprays. Support will continue upon discharge through transfer of care to community stop smoking services or through an enhanced pharmacy offer.

You can find out more about the three service pathways below:

  • Acute
  • Mental Health
  • Maternity

Across Coventry and Warwickshire, support for NHS staff to quit smoking is available via local authority commissioned stop smoking services. For more information, please select either the Coventry or Warwickshire community stop smoking link below. 

Both services provide 12 weeks free stop smoking treatment including bespoke behavioural support and nicotine replacement therapy. 

For pregnant NHS staff, there are dedicated Stop Smoking in Pregnancy services, which offer friendly and confidential support through experienced advisors. For more information, please select either the Coventry or Warwickshire community stop smoking in pregnancy link below:

Coventry and Warwickshire ICB look forward to welcoming a national digital offer which will launch first for NHS staff around April 2024.

A wide range of training is available to understand the harms from tobacco, and how tobacco dependency can be treated. The National Centre for Smoking Cessation and Training offer a wide array of free courses and competency checklists, available to all healthcare professionals, stop smoking practitioners and beyond. Please see the below online briefings and training via the NCSCT on:

  • Smoking cessation: a briefing for midwifery staff
  • Standard Treatment Programme for Pregnant Women: a briefing for midwifery staff
  • Very Brief Advice on smoking for pregnant women online training
  • Secondhand smoke: promoting smokefree homes and cars online training
  • E-cigarettes: a guide for healthcare professionals

It is recommended that all healthcare professionals, or anybody with direct client contact should complete Very Brief Advice training. Very brief advice comprises of three simple steps:

ASK – all patients if they smoke, and document this
ADVISE – the most effective way to quit is with a combination of behavioural support and nicotine replacement therapy/use of a vape
ACT – provide a referral or offer behavioural support and treatment (NRT/vape)

  • Health Education England's e-Learning for Healthcare (e-LfH) has collaborated with PHE, NHS Improvement and the NCSCT to develop some new e-learning resources highlighting the importance of supporting women to have a smokefree pregnancy. The resources focus on the delivery of Very Brief Advice (VBA) and Carbon Monoxide monitoring. There are also a series of new educational materials to support local training on these topics, including two short films.