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Tackling tobacco dependence

Why change was needed? 

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

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. Additional high-level information relating to smoking and health inequalities are as follows: 

  • 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.

Tobacco dependence treatment is effective and improves the health and wellbeing of the person smoking and their family, as well as saving them money. Helping people tackle their tobacco dependence is a key component of the NHS Long Term Plan (LTP) and forms the NHS’s contribution to wider government action to deliver the 2030 ambition for a smoke free generation.

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 
  • The model will also be adapted for expectant mothers, and their partners, with a new smoke-free pregnancy pathway including focused sessions and treatments
  • 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 


What we did

A system wide project group was established which incorporated key partners from University Hospitals Coventry and Warwickshire (UHCW), George Eliot Hospital (GEH) and South Warwickshire University Foundation NHS Trust (SWFT) to establish how best to proceed with the mobilisation and implementation for acute inpatients and maternity pathways.

The objective for all Trusts was to deliver a systematic in-house treatment, including behavioural support and Nicotine Replacement Therapy (NRT) during the patient’s admission. Upon discharge from hospital, support was then to be provided via the Local Authority commissioned services, which are as follows:

In June, 135 patients were offered tobacco dependency support, and in July, this increased to 167 patients.