A smokefree Trust for patients/visitors

Despite the number of smokers being at the lowest level since records began, smoking remains the single largest cause of preventable ill health and premature death costing the NHS an estimated £2.5billion each year.

As a health care Trust, we have a responsibility to ensure we promote healthy lifestyles, prevent illness and recognise the right everyone has to breathe clean air.

Dorset HealthCare went completely smokefree in April 2017 in a bid to promote and support good health for you, our service users, your families/carers and our staff.

This means it is not permitted for anyone to smoke anywhere on any of our Trust premises. This follows recommendations from Public Health England and The National Institute for Health and Care Excellence (NICE). The recommendations state that we should make no exceptions or provision for smoking such as smoking shelters or allow staff to escort patients off-site to smoke.

The Department of Health is aiming to make the entire NHS smokefree by 2020.

The move to become smokefree is proving successful, but we realise this is a big a culture change that will take time to implement fully, and we ask for your support in helping us achieve this for everyone’s benefit.

What does going smokefree mean for you?

  • You must not smoke on hospital grounds or any premises owned by Dorset HealthCare
  • If you are admitted as an inpatient to one of our wards, you are asked not to bring any tobacco related products with you.
  • If you do wish to smoke, you must do so at least 50 metres away from the Trust site
  • If you are found smoking on a Trust site, you will be politely asked to put out your cigarette, or move off the premises
  • If you see other service users smoking on one of our Trust sites, please feel free to alert a member of staff who can ask them to stop
  • Use of e-cigarettes / vaping is permitted on Trust sites for both patients and staff, but only outside due to them setting off smoke alarms. This decision was made following evidence from Public Health England that they are at least 95% less harmful than smoking tobacco.

Smoking and Mental Health

Although the number of people smoking in the general population has fallen drastically, this hasn’t happened for people with a serious mental illness where over 40% still smoke. This results in premature death (10-20 year reduced life expectancy), disability and poverty.

The myth that smoking is somehow therapeutic for people with mental illness is a belief that still exists even in some health professionals. Evidence now confirms that as well as the physical health benefits, becoming smokefree also reduces stress, anxiety and depression.

Smokers also require higher doses of medications such as Clozapine so quitting can lead to reduced doses and the unpleasant side-effects that come with them.

Smokefree and our mental health services

Since the Trust went smokefree back in April last year, the greatest impact has been on our inpatient mental health services where a smoking culture was deeply embedded.

We would like to hear your thoughts about us becoming smokefree, whether you are a member of staff or a patient.

Has the policy influenced smoking habits? Which products are working best? And what changes might help to make things better?

The Gather tablets located on inpatient wards now have a staff and a patient survey loaded onto them.

We would like to encourage as many of you as possible to share your thoughts and experiences with us through these surveys over the next few weeks.

As ever, thank you for your continued support.

Smoking and surgery

It is strongly recommended that smokers stop before surgery. This will lead to:

  • Reduced risk of complications
  • Quicker healing
  • Less chance of infection
  • Possible reduction in the length of stay in hospital

Home Visits

To protect our staff from the potential harm caused by second-hand smoke, we ask that you provide a smokefree environment for their visit. As a minimum, please ensure the room is smokefree for an hour prior to the visit and refrain from smoking while they are in attendance.

Enforcing our smokefree policy

We are extremely strict with our policy on smoking. Anyone found to be smoking on our premises, will be politely asked to put out their cigarette, or to move off the premises.

We ask that this action is respected, and that anyone asked to stop smoking refrains from becoming abusive to staff or other patients. Anyone who becomes aggressive will be reported to the police. Please remember, our aim is to improve health and wellbeing, we are happy to provide alternatives and support.

There is no excuse to smoke anywhere on Dorset HealthCare premises.

E-cigarettes

The latest evidence demonstrates that vaping / e-cigarettes are at least 95% less harmful than smoking tobacco.

The devices and e-liquids should always be obtained through a reputable source to ensure they are as safe as possible and avoid use of unnecessary contents like diacetyl which can be harmful. They will also be as safe as charging a mobile phone as long as it is done with the provided charger, charged in line with manufacturers recommendations and not tampered with.

National guidance is telling us that vaping should not be treated in the same way as smoking so these products can be used on trust premises by both patients and staff although this should be outside following incidences of them setting off smoke alarms.

Smoking in Dorset…the figures

  • From 2014-2016, smoking caused over 4,100 deaths. For each of these, approximately 20 people are suffering a smoking related disease such a COPD (lung disease), cancer, heart disease or stroke.
  • In 2016/17, over 13,500 hospital admissions were a result of smoking.
  • At current smoking rates, over 3,500 years of life will be lost to smoking across the county

Why quit smoking?

  • 20 minutes: Your blood pressure and pulse rate return to normal
  • 8 hours: Oxygen levels in your blood return to normal and carbon monoxide levels reduce by half
  • 24 hours: Carbon monoxide is eliminated from your body. Your lungs start to clear out mucus and other smoking debris
  • 48 hours: Your ability to taste and smell improves
  • 72 hours: Breathing becomes easier. Your bronchial tubes begin to relax and your energy levels increase
  • 2-12 weeks: Circulation improves throughout your body, making walking and running much easier
  • 5 years: Your heart attack risks fall to about half that of a smoker
  • 10 years: Your risk of lung cancer falls to about half that of a smoker
  • 15 years: Your risk of heart disease is nearly the same as someone who has never smoked

We are committed to helping you quit smoking

If you are a smoker admitted to any of our inpatient services, you will be offered Nicotine Replacement Therapy within 30 minutes of arrival. It is vital that you use these products correctly and in sufficient amounts for them to be effective. We have staff who are trained to help you with this.

You may just wish to use these products to abstain from smoking for the time you are admitted. Alternatively, we would really like you to take the opportunity to quit for good. Our trained staff will be able to help you create a plan to change your habits and reduce the triggers that lead you to smoke. They will be able to offer you positive support throughout your quit attempt.

Nicotine Replacement Therapy products that we can provide:

  • Patches – provide a level of nicotine throughout the day reducing cravings
  • Lozenges – are a good alternative for people who do not like gum
  • Inhalator – are like a small plastic cigarette that holds disposable nicotine cartridges. It provides some behavioural replacement for the hand to mouth action of smoking
  • Gum – delivers nicotine to the bloodstream and is absorbed by the tissues of the mouth

In addition to these we can also explore the possibility of using Varenicline (Champix), which is proven to be the most effective product in supporting smokers to quit.

Support in the community

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LiveWell Dorset is a free service that offers friendly, supportive guidance and advice.

You can visit their website at www.livewelldorset.co.uk or Freephone 0800 8401628

Switching to e-cigarettes / vaping

If you feel unable or do not wish to quit smoking, we would very much like to encourage you to consider switching to vaping / e-cigarettes. Public Health England state that this option is at least 95% less harmful than smoking tobacco. There are many options and you might not find the first one you try very effective or enjoyable. It is important to try various types and various e-liquid. There are some very informative videos that you might find helpful here - https://www.youtube.com/user/NCSCTfilms

Our Smokefree Trust