The staff smoking review

Background: NHS staff play a key part in smoking cessation advice and treatment. However an estimated 73,000 members of NHS staff currently smoke. This costs the NHS over £206 million a year (£2,800 per staff smoker) due to sickness absence, time spent on smoking breaks and seeking NHS care for smoking-related illness. NICE guidance states that NHS staff should be offered smoking cessation support on site, in work hours and with immediate access to nicotine-replacement therapy (NRT). Study objectives: To establish whether NHS Trusts are offering support for staff to stop smoking, to describe modalities of smoking cessation offered, and estimate what proportion of Trusts are ‘smoke free’. Methods: A short electronic survey, utilising open and closed questions, was sent to occupational health providers across England. Descriptive statistics were used to summarise survey responses. Results: We received data for 89 Trusts in England. Staff smoking prevalence ranged from 5% to 20%. Smoke free policies were in place in 60% of Trusts, 30% of these allowed e-cigarette use on site. Support for staff varied between Trusts. Over half of Trusts provided either vouchers for NRT, on site NRT and/or on site counselling. However, 45% were only able to provide referral to external organisations at best, with 50% of these Trusts expecting staff to complete self-referrals to external organisations to access smoking cessation support. Limitations to provision of support include reduced budgets, decommissioning of local services, and prioritising patient smoking cessation before staff. Conclusions: Smoking cessation services for NHS staff varies greatly across England. This needs to be addressed in a cost-effective and acceptable way, to proactively support NHS staff to stop smoking.