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National Survey of Stop Smoking Service Provision in Hospitals in Great Britain: Current Practice, Barriers and Facilitators

Barnaby Proctor, Katie Myers Smith, Hayden McRobbie and Peter Hajek

Aim: The UK National Health Service (NHS) funds the Specialist Stop Smoking Service (SSS) that provides help to smokers across various settings. While community services are extensively monitored, little data exist on hospital services. We set out to review current practice and identify barriers and facilitators associated with implementing smoking cessation services in UK hospitals.

Methods: Hospital service leads were identified from a national online forum and invited, via email, to take part in a survey that assessed service characteristics, referral pathways, interventions used, service throughput and outcome, barriers, facilitators and suggestions for service improvement.

Results: Data from 39 services were included in analyses. There was considerable variation in how services were staffed and run. Services employed on average two full time equivalent staff (FTES) and covered two hospitals. The majority (85%) were funded via local public health budget rather than by the hospitals themselves. Most referrals were received from ward nurses over the telephone and services received on average 9 referrals a week per 1 FTES. The majority provided behavioural support on wards and referred patients to community SSS on discharge. All inpatient services were able to provide nicotine replacement treatment, 57% additionally offered varenicline and 35% bupropion.

Conclusions: Smoking cessation provision in UK hospitals is currently highly variable. Ensuring that smokers are referred to treatment is the main challenge. Guidance is needed to help services optimise referral routes and unify data collection. Research is needed into what service models produce the best outcomes.