When did the Trust go Smokefree?
The Trust became a Smokefree organisation on 1 April 2018.
What does going Smokefree mean?
Smokefree means that service users, carers, staff and other visitors to our premises will not be allowed to smoke on any of our sites, including all wards, buildings, grounds and vehicles. There will no longer be designated areas where smoking is allowed.
If you smoke, we will support you to make an attempt to quit, or to temporarily abstain whilst in hospital.
Why did the Trust go Smokefree?
The Trust wants to reduce harm to patients, staff and others who visit our sites. We want to create an environment that promotes wellness.
As an NHS organisation, we have a duty to protect and care for both the mental and physical health of our patients. This includes supporting smokers to stop smoking.
Our decision is also supported by recommendations from the National Institute for Health and Care Excellence (NICE), who raise the need for all NHS premises to become completely Smokefree
Do you stop people smoking whilst they are receiving care in hospital?
We do not prevent service users from using other sources of nicotine but we do prohibit smoking on our premises. We do ask that service users make every effort to abstain whilst in hospital.
Prior to being admitted to hospital patients are advised that smoking is not permitted in the hospital or grounds and they are offered support to temporarily abstain or quit.
Any tobacco products brought to the hospital on admission will be locked away safely until patients are discharged or go on an extended period of home leave.
How do you support patients who are unable to smoke?
All ward staff are trained to offer basic brief advice and support to help you abstain from smoking. A number of staff on each ward can also offer the full range of stop smoking interventions.
All service users will be asked about their smoking when they are admitted to hospital. Whilst some service users may want to make a quit attempt, there will be others who do not but who are required to temporarily abstain from smoking. This might be for a number of reasons such as being legally detained in hospital.
We recognise that stopping smoking can be very difficult and want to do all we can to manage withdrawal effects. All service users who are making quit attempts, or who are unable to go and smoke, will be offered nicotine replacement and/or other support to help them to manage this. We know that with stop smoking support and nicotine replacement therapy people are 4 times more likely to quit successfully, or manage to abstain whilst in hospital.
How will you ensure that service users do not smoke on Trust sites?
Service users will be told that smoking is not permitted on our premises and they will be offered support to temporarily abstain or quit. This includes nicotine replacement therapy and intensive behavioural support.
If a service user attempts to smoke on our premises they will be reminded of our policy and asked to refrain. We appreciate that some might find it difficult to stay smoke free. In such circumstances the clinical team will review their care plan and consider how best to support the individual not to smoke on the premises.
How have you informed people that the Trust has gone Smokefree?
We have let people know about the Trust going Smokefree in several ways. These include:
- explaining what Smokefree means and what support is available in our publications, website, intranet and on banners
- producing leaflets with specific information for staff, patients and carers
- contacting stakeholders such as partner organisations and commissioners to brief them on the change and answer any questions
- visiting wards to brief staff and patients and identify any potential issues and answer questions
- installing new signage, which will highlight that smoking is not allowed anywhere on Trust premises
- including information about Smokefree to the staff induction so that new staff are fully advised of the policy
- including information about Smokefree and the support available in outpatient letters so that patients know of the policy in advance of attending appointments
Is not allowing someone to smoke on-site an infringement of their human rights?
It is not an infringement of a service user's human rights for the Trust to be Smokefree. This argument has been legally tested and was upheld by the Court of Appeal in 2008 after Rampton Hospital in Nottinghamshire went Smokefree. It ruled that a hospital is not the same as a home environment and is instead a place that should support the promotion of health and wellbeing. Therefore patients can be prevented from smoking for health and security reasons.
Has the Trust got a legal right to be completely Smokefree?
Yes, it is legal for the Trust to go completely Smokefree. Banning smoking in workplaces and enclosed public spaces is covered by legislation, introduced in England in July 2007. Banning smoking in our grounds is a recommendation of NICE.
Could not allowing a patient to smoke be detrimental to their mental health?
Some clinicians and patients believe that smoking helps with stress, anxiety, low mood and symptoms of psychosis but there is not any clear or consistent evidence to support this.
However, there is emerging evidence that when patients with psychosis, depression and anxiety are supported to stop smoking, with psychological support and either NRT or other medication, on average their mental health symptoms actually improve.
Tobacco smoke also reduces the effectiveness of some medicines, which means a smoker needs a higher dose of medication compared to a non-smoker. When someone completely stops smoking their medication can be reviewed and the dosage lowered in some instances.
