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Smoking and the NHS

I was asked yesterday to comment on a report, embargoed until midnight last night:

According to the press release:

A major new report released today [Tuesday June 26] by the Royal College of Physicians calls for a radical change in the way the NHS treats smoking, by providing opt-out cessation services as a routine component of all hospital care.

Giving smokers the help they need to quit smoking while in hospital will save lives, improve quality of life as well as increasing life expectancy for all smokers, and help to reduce the current £1 billion per year cost to the NHS of smoking by patients and staff.

The report ‘Hiding in plain sight: Treating tobacco dependency in the NHS’ from the RCP’s Tobacco Advisory Group says that:

– Treating tobacco dependency is not just about preventing disease: in many cases it represents effective disease treatment. Clinicians working in all areas of medicine can improve their patients’ lives by helping them to quit.

– Current models of delivering stop smoking services separately from mainstream NHS services, while successful in the past, may now not be the best approach because the patient has to seek help themselves.

– Most health professionals receive little or no training in treating smokers

– The NHS does not collect data on smoking treatment delivery, or have a payment tariff for treating tobacco dependency

– Smoking treatment also tends to be squeezed out, even in the management of diseases caused by smoking, by other, less cost-effective interventions

To address all these issues, the report recommends:

– As smoking cessation treatments save money for the NHS, in the short as well as the long term, they should be prioritised as a core NHS activity

– Smoking cessation should be incorporated as a systematic and opt-out component of all NHS services, and delivered in smoke-free settings

– As systematic identification of smokers and delivering cessation support doubles quit rates, health service commissioners should ensure that smokers are identified and receive cost-effective smoking interventions – failing to do so is as negligent as not treating cancer

– We should allow e-cigarettes to be used on NHS sites to support smokers to remain smoke-free and help to sustain smoke-free policies

– Legislation requiring hospitals to implement completely smoke-free grounds should be introduced, as the current guidance isn’t being implemented

– Training in smoking cessation should be introduced into all undergraduate and postgraduate healthcare professional training curricula and as mandatory training for the entire NHS healthcare professional workforce.

In response Forest issued this statement:

"Providing smoking cessation services to patients in hospital is at best a questionable use of public money.

"Smokers contribute £12 billion a year in tobacco-related taxes. That far exceeds the estimated cost to the NHS of smoking by patients and staff.

"According to polls, the general public would like to see taxpayers' money spent on providing more doctors and nurses and reducing A&E waiting times. Tacking smoking is not a top priority for most people.

"Smoking is a choice and if adults choose to smoke they shouldn't be pestered to quit while in hospital."

Most media reports today led with the recommendation that the use of e-cigarettes be allowed on hospital grounds, which we hadn't commented on.

Nevertheless we were quoted by the Daily Mail, Mail Online, ITV News the Daily Star and, thanks to the Press Association, hundreds of local titles (online).

Curiously, a journalist from The Times rang Forest for a quote but the subs cut it. (Help smokers quit, doctors tell hospitals.

Update: I shall be discussing this on BBC Radio 5 Live between 1.00 and 1.30pm.

Professor John Britton, chair of the RCP’s Tobacco Advisory Group and lead editor of the report, will also be on but he doesn't want to be on at the same time as me!

Update: On the insistence (apparently) of Prof Britton we were kept apart so we couldn't have a direct 'debate'.

Instead Britton was interviewed by presenter Nihau Arthanayake who then interviewed me.

Lo and behold, Britton was then given a second bite of the cherry and used it to attack Forest and our tobacco funding!

Needless to say I wasn't given a chance to respond.

Thanks, Five Live!

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Reader Comments (9)


I am assuming that you were once again too polite with these interviewers and were a gentleman in your replies to their questions. Ideally it would probably make more of an impact if you produced or informed them of the reports and surveys etc that rebut the lies and untruths that are being peddled by the likes of ash and the health zealots and then maybe a big maybe I will admit they may start to reason that there is another sample of truth out there

Tuesday, June 26, 2018 at 15:49 | Unregistered CommenterDavid Kerr

With the honourable exception of a very few professionals - Nicky Campbell, Tony Livesey and Stephen Nolan, for example, Five Live programme presenters are pretty poor. The one you encountered should be on a beach with the Radio 1 Road Show.

Tuesday, June 26, 2018 at 16:01 | Unregistered CommenterJonathan Bagley

Once again a media outlet displays outright antismoker bias. They present tobacco control propaganda as if it is an ultimate truth. The reality is somewhat different. Te data used to justify the persecution of smokers is exaggerated, manipulated, fraught with bias and confounding variables, and at times outright lies.

The body of data disputing these corrupt manipulations has been suppressed. The result is an increase in likely deaths due to ignoring all other possible causes of some diseases. Hence, lung cancer is up in non-smokers. The likely cause — diesel fumes was known at the start of the attack on smoking but dismissed because of potential negative impact on the economy. The Whitehall Studies demonstrated that smokers and nonsmokers faced the same risk for many diseases but that finding was glossed over. The second hand smoke and 'heart attack miracle' ruses have been demonstrated as false many times over.

No wonder the antismokers avoid direct debate. They know their data is dodgy!

Tuesday, June 26, 2018 at 19:07 | Unregistered CommenterVinny Gracchus

This is getting terrifying. What happens if you are "offered help" to quit and you refuse? With all this dehumanising talk of "tobacco dependency" one wonders how long before a patient's refusal to accept "help" leads to incarceration within some form of health institution to ensure "help" to quit is accepted.

I honestly believe there is nothing they consider to be too tyrannical or authoritarian in their methods to cleanse smokers from society and ensure they get their future puritan world without individuality, dissent, free thought or smokers.

Wednesday, June 27, 2018 at 0:35 | Unregistered CommenterPat Nurse


Don’t worry too much, if the authorities commence with this attitude, then they will be in breach of the law. For example, just last November I was in a hospital in Delft in Holland for my yearly physical, with the heart specialist. I was asked if I had any problems ie shortness of breath etc, I replied “no”, The specialist insisted on an angiogram, I asked him if I would be allowed to go for a smoke as the hospitals here also do not allow smoking inside. He replied yes I would be allowed to go for a cigarette. However he neglected to mention it would be six hours or more before I would be allowed to go for a smoke due to the procedure and the rest time required after. I informed him that there would be no angiogram carried out on me, when he enquired why. I told him it was because of the draconian attitude to smokers by the hospital. He gave me the answer, well it is your choice. I replied no it is your employers choice in that they are denying my wish to go for a smoke when I wish to go for a smoke. He made no other comment but to remind me that I would see him next year. This may seem silly to some folk, but I will not be bullied into something that I do not agree with.

Wednesday, June 27, 2018 at 11:03 | Unregistered CommenterDavid Kerr

Smokers have no protection from anything in law. We have been deliberately excluded from laws that protect every other minority including the right to work, the right to housing and the right to healthcare.

Wednesday, June 27, 2018 at 15:13 | Unregistered CommenterPat Nurse

Well done, David Kerr. It takes courage to defy medics. I know because my wife suffers from multiple sclerosis. She was prescribed laxatives at a rate of 2 or 3 packets in water per day. After a while, it became obvious that the dosage was far too high. After some experimentation, it turned out that half a packet per day was quite sufficient.
It is very hard NOT TO accept the word of doctors as gospel.

Wednesday, June 27, 2018 at 16:08 | Unregistered CommenterJunican

I thought that pretty much all quit services were offered by the NHS already (wasn’t that the reason for cutting the funding to groups like Smoke Free South West or whatever it was called?) I can see that they want to, effectively, make it compulsory for smoking patients to attend these sessions once they've got them in their clutches, but surely they are shooting themselves in the foot a bit if they are advocating allowing e-cigarette use in hospitals at the same time? Surely all that will happen is that smokers will use the e-cigarettes whilst they are in hospital to get them by (vile though they are, they are at least useful as a stopgap), say “thanks very much, I’m a vaper now, so no more need to go to your daft quit sessions” and then simply return to smoking the moment they are discharged – and, if they’ve got any sense, they’ll refuse continuing sessions after discharge because they’re now - ahem - “vapers” instead (yeah, right). I know that’s exactly what I would do!

Thursday, June 28, 2018 at 1:55 | Unregistered CommenterMisty

I will never be forced to vape just because I am forced not to smoke. Whether I vape or quit it will be my choice and not because some bully has forced me to either.

I have a tobacco burner, an Epipe that heats real tobacco. If vapers are allowed to vape while smokers are banned, I will smoke tobacco in an Epipe and hide behind the vapers. The device looks the same and the thugs in the healthist industry don't know the difference.

Thursday, June 28, 2018 at 13:13 | Unregistered CommenterPat Nurse

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