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Support for clinicians in addressing inpatient tobacco dependency unveiled by BTS

A new framework to help hospital clinicians support patients in addressing tobacco dependency during a hospital stay has been published by the British Thoracic Society (BTS).

It forms part of the new ‘Clinical Statement on the Medical Management of Inpatients with Tobacco Dependency’, which has been developed to provide evidenced-based, practical advice for hospital clinicians to identify, initiate treatment and ensure specialist care for adult inpatients who are tobacco dependent.

The framework itself is formed of six ‘building blocks’ to help hospital clinicians create effective plans to incorporate tobacco dependency treatments as a standard part of high-quality, holistic care. These are:

  • Screening for tobacco dependence
  • Advising on the role of nicotine
  • Initiating combination nicotine replacement therapy as soon as possible
  • Completing a referral to an on-site tobacco dependency advisor
  • Providing accurate and consistent information about vaping
  • Offering and prescribing nicotine analogue medications.

It is hoped that the Clinical Statement and framework will ‘empower all hospital clinicians across the multidisciplinary team to proactively deliver these interventions [which] may in turn greatly impact the future of patient health and behaviour change’, the BTS said.

Professor Jon Bennett, president of the BTS, said: ‘This document provides vital information for all those working in secondary care. We need to build skills and confidence to help our colleagues across the hospital talk to people who smoke and provide up to date, evidence-based information about how their tobacco dependence can be treated.

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‘This shift in conversation is vital in helping to prioritise and raise the profile of treating tobacco dependence. Recording smoking status and then providing effective treatment and management needs to form part of every person’s in-patient stay.’

Professor Sanjay Agrawal, co-chair of the Clinical Statement Guideline Group, added: ‘Addiction to tobacco is a condition that affects around a million people who are admitted to hospital each year. Treating tobacco dependency systematically, rapidly and effectively should be a clinical standard of care in the same way as we look after people who are admitted with pneumonia, heart attacks or strokes.

‘We hope this new clinical statement on the medical management of tobacco dependency will equip clinicians with the knowledge and confidence to break this lethal addiction.’

Earlier this month, the Federation of the Royal Colleges of Physicians in the UK warned of ‘significant and avoidable’ demand on NHS due to socio-economic inequalities, which included the impact of smoking.

In February, the European Respiratory Society updated its position statement on novel nicotine and tobacco products and reinforced its position that all nicotine and tobacco products are highly addictive and harmful, and that quitting smoking entirely is the best option.

And last summer the withdrawal of varenicline led to discussions over whether cytisine – a drug not yet licensed in western Europe – might serve as an alternative pharmacotherapy to help patients to stop smoking.