A smokefree Trust for staff

Dorset HealthCare is smokefree…are you on board?

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

This means it is not permitted for anyone to smoke on any of our Trust premises.

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

The move to become smokefree is so far 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.

Despite smoking prevalence being at the lowest level since records began (15.5%), smoking remains the single largest cause of preventable death and illness.

We have a responsibility to ensure we promote good health, prevent illness and recognise the right everyone has to breathe clean air. With a nationwide goal of creating an entirely smokefree NHS estate by 2020, the DoH has ambitions to eventually achieve the first smokefree generation.

Click for the Tobacco Control Plan for England

For us to be successful at a local level, we need you to be aware of and to support our smokefree policy by not smoking on our premises and to make others aware of this expectation.

What does going smokefree mean for staff?

  • You must not smoke on hospital grounds, Trust premises and in vehicles owned by Dorset HealthCare
  • You must not smoke in front of patients, their families or carers, and should not smell of smoke while at work
  • You should not be taking extra breaks to smoke yourself or accompanying patients to do so - anyone caught doing this, as well as other breaches of our smokefree policy, should be treated as any other breach of policy in line with the trust’s Disciplinary and Capability policy (IN-115a)
  • We ask that you support us in our smokefree approach, and ask anyone on Trust premises you see smoking to politely refrain from doing so

If you wish to smoke, you must:

  • Smoke during your allotted unpaid breaks only
  • Leave the Trust site you are at, ensuring you are at least more than 50 metres away from the perimeter
  • Temporarily remove or hide NHS name badges and identification - these must not be visible
  • Respect our neighbours – avoid smoking directly outside nearby houses or congregating in large groups on public footpaths
  • Dispose of your cigarette butts responsibly. Respect the environment and do not litter

E-cigarettes

Did you know:

  • the latest evidence from Public Health England shows vaping (e-cigarettes) is at least 95% safer than smoking tobacco?
  • The risk of cancer has been calculated to be less than 1% of that involved in smoking tobacco
  • E-cigarettes do not deliver carbon monoxide, the toxin in tobacco smoke that leads to heart attacks and strokes
  • E-cigarettes can be used on Trust property (not inside buildings) by both patients and staff

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.

The dangers of smoking

Circulation: When you smoke, the poisons from the tar in your cigarettes enter your blood, making it thicker, increasing the chances of clots, raising your blood pressure and heart rate. They narrow your arteries, reducing the amount of oxygen rich blood circulating to your organs, which can increase your chances of a heart attack or stroke by 50%.

Brain: Smoking increases your chances of developing a brain aneurysm. This is a bulge in a blood vessel caused by a weakness in the blood vessel wall. These can burst resulting in a haemorrhage, causing brain damage or even death.

Heart: Carbon monoxide from smoking and the nicotine inside cigarettes put a strain on your heart by making it work faster, increasing your chances of blood clots. Smoking doubles your chances of having a heart attack.

Lungs: Coughs, colds, wheezing and asthma are just the start if your smoke. Smoking can cause fatal diseases such as pneumonia, emphysema and lung cancer. Around 84% of smoking related deaths are from lung cancer and chronic obstructive pulmonary disease (COPD).

Stomach: Smokers have an increased chance of developing stomach cancer and ulcers. Smoking weakens the muscle that controls the lower end of your gullet. Kidney cancer is also a factor.

Skin: Smoking reduces the amount of oxygen that gets to your skin. Skin ages more quickly and looks grey and dull. The toxins cause cellulite. Smoking prematurely ages your skin by between 10 and 20 years.

Bones: Smoking causes bones to become weak and brittle. Women are more likely than men to suffer from brittle bones, more commonly known as osteoporosis.

Mouth and throat: Smoking causes bad breath and stained teeth, and can also cause gum disease. Your sense of taste deteriorates. More than 93% of cancers in the throat are caused by smoking.

Reproduction and fertility: Smoking in men causes impotence as it damages sperm, reducing sperm counts and causing testicular cancer. Around 120,000 men aged between 20 and 30 in England are impotent due to smoking. For women, smoking reduces fertility and causes cervical cancer. Research shows smokers are over three times more likely than non-smokers to have taken more than one year to conceive.

Dangers of Smoking during pregnancy

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

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

Reporting smoking related incidents

We ask that you do everything in your power to help us promote the benefits of a smokefree Trust and adhere to our policy.

If you see a colleague or patient smoking on Trust grounds, please politely ask them to stop and direct them to an appropriate location offsite. We understand this isn’t always easy, but taking these steps will help us enforce our policy.

If you encounter negative reactions or confrontation, please seek the support of a colleague or your line manager, and report the incident on Ulysses so appropriate action can be taken.

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

Supporting mental health patients to quit – Varenicline (Champix)

Evidence from the largest ever smoking cessation clinical trial shows varenicline (Champix) is the most effective treatment to help smokers who wish to quit and this includes smokers with psychiatric disorders.

The study also found that “Varenicline does not significantly increase risk of neuropsychiatric adverse events in patients with a history of psychiatric disorder”

Please find a link to the study here.

The National Centre for Smoking Cessation and Training reinforces this by stating there are no good grounds for excluding patients with mental health problems from taking Varenicline, and because of its high level of effectiveness it may be their best chance of stopping smoking.Evidence from the largest ever smoking cessation clinical trial shows varenicline (Champix) is the most effective treatment to help smokers who wish to quit and this includes smokers with psychiatric disorders.


What support is available

LiveWell Dorset is a free service available to you, and you can visit their website at www.livewelldorset.co.uk or Freephone 0800 8401628.

You can also visit www.nhs.uk/smokefree

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. Please see the “E-cigarettes” section below for further information.

E-cigarettes

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

https://www.gov.uk/government/publications/e-cigarettes-and-heated-tobacco-products-evidence-review/evidence-review-of-e-cigarettes-and-heated-tobacco-products-2018-executive-summary

The devices and e-liquids should always be obtained through a reputable source to ensure they are as safe as possible and avoid the 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 charger provided, which is used 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. However they should only be outside as they can set off smoke alarms.

If you or your patients feel unable or do not wish to quit smoking, we would very much like to encourage consideration of switching to vaping/e-cigarettes. The NCSCT have produced some very informative videos which you might find helpful - https://www.youtube.com/user/NCSCTfilms.

Our Smokefree Trust