This project was funded by the NIHR ARC National Priority Consortium for Prevention, including Behavioural Risk Factors, and led by NIHR Applied Research Collaboration North East and North Cumbria.

 

What were we doing?

The 2019 NHS Long Term Plan – a government policy – aimed to tackle smoking through delivering a new service to support smokers to quit, in three settings: acute hospital, mental health inpatients and maternity services. The government wanted to provide smokers who are admitted to any of these settings in England access to a new ‘stop smoking service’ that includes both behavioural support and medication to help them to quit.

 

This research project aimed to investigate how this new service was delivered, and if it was effective.

 

 

Why was it important?

In 2019, 14.1% of adults in the UK smoked, and over 500,000 hospital admissions were due to smoking in 2020. 

 

By evaluating the rollout of the new NHS-funded tobacco dependence service it allowed us to understand how it was being delivered, how effective it was in aiding smokers to successfully quit, and how cost-effective the new service was for the NHS.

 

Having an in-depth understanding of these key areas allows future decision-making to be based on evidence of what worked well, what could be improved and any other factors that were influential in the successful rollout of the new NHS-funded tobacco dependence service.

 

 

How did we do it?

We did four studies across five regions (involving 24 NHS Trusts) in England:

 

1. Interviewed those who designed, funded, and provided the service
2. Surveyed and interviewed NHS staff about their experiences of providing this service. We also interviewed service users who had been offered the new service to understand their opinions and experiences of it.
3. Used hospital records to find out the number of smokers who had been offered and used the service, and how effective the new service was based on the number of people quitting smoking.
4. Used hospital records and other data to calculate the costs of providing the service and find out whether it provided value in helping people who smoke.

 

The findings from this study will support NHS Trusts by giving them information on how to improve the stop smoking service for the future from the perspectives of service users, healthcare professionals, and others.

 

 

 

Early findings (from the first phase of the research study): 

 

Professionals:

• Professionals of varying roles and expertise, including staff with lived experience – reported strong knowledge of the planned service and requirements.
• Professionals identified concerns about the adequacy of resources available to provide a high-quality service.
• Professionals demonstrated strong commitment to delivering the service despite challenges faced.

 

Smokers:

• Smokers found smoking cessation services provided in NHS settings acceptable.
• Smokers found that access to Nicotine Replacement Therapies, including vapes, supported them in smoking abstinence.

 

Preliminary costings show that the cost of delivery per patient ranges from £103 to £1,621, excluding set up costs.

 

The research team also found that:

 

• Interprofessional and intersectoral collaboration is a necessary condition for successful service delivery.
• Supporting a cultural shift to create an environment that reduces or removes the stigma associated with tobacco smoking can enhance service engagement.
• Investment in data collection, monitoring & sharing infrastructure will support sustainable service provision and improvement.
• Support for smokers beyond NHS settings is essential to enable long-term cessation and to tackle health inequalities, particularly providing the tools to quit (NRT, behavioural support), is needed to overcome financial barriers to smoking cessation.

 

Further findings will be available in due course.

 

You can keep up to date with the latest findings from the NIHR ARC North East North Cumbria research project page here.

 

 

Downloadable resources

• Reports
  • Briefing note - commissioners
  • Briefing note - members of the public
  • Briefing note - healthcare professionals
  • Briefing note - findings & recommendations
• Publications
  • Brennan-Tovey K, Aquino MR, Flanagan S, Kaner E, Wearn A, Bigirumurame T, et al., (2022) Implementation of the NHS-funded tobacco dependence services in England: a qualitative study to understand the contexts of implementation. The Lancet

 

 

 

Who did we work with?

• NIHR ARC North East and North Cumbria
• NIHR ARC Yorkshire and Humber
• NIHR ARC Greater Manchester
• NIHR ARC West Midlands
• NIHR ARC West

 

 

More information

 

 

 

Senior Programme Lead

 

Mike Spence

michael.spence@manchester.ac.uk