HEDS Report on Smoking and the risks of adult diseases

Laura Webster,  Colin Angus, Alan Brennan, and Duncan Gillespie have written a short report detailing the risks of disease linked to smoking used in The University of Sheffield's health economic modelling of smoking policies and interventions. You can access the report form here 

New Report - Providing Smoking Cessation For Patients in Hospital Will Save Lives and Money

Dr Duncan Gillespie

A major new report has been released by the Royal College of Physicians calls for a radical change in the way the NHS treats smoking, by providing opt-out cessation services as a routine component of all hospital care. Dr Duncan Gillespie from HEDS was the lead on chapter 3 of the report which looked at how much current smoking is likely to cost the NHS in England through hospital admissions.

Dr Gillespie said: "The report is very important because it shows how the NHS might do more to help people stop smoking and we have shown what the potential economic payoffs might be." 

Dr Gillespie collaborated alongside HEDS colleagues Laura Webster, Colin Angus, Dr Rob Pryce and Professor Alan Brennan.

CC BY 2.0 Dustin Gaffke
http://bit.ly/2MZgDcV

Dr Gillespie added: "Our involvement in this report builds on our collaboration with universities around the UK in the UK Centre for Tobacco and Alcohol Studies, where we lead the economic component of the Centre's work in Sheffield."

The report found that by giving smokers the help they need to quit smoking while in hospital it will save lives, improve quality of life as well as increasing life expectancy for all smokers, and help to reduce the current £1 billion per year cost to the NHS of smoking by patients and staff.  

The report ‘Hiding in plain sight: Treating tobacco dependency in the NHS’ from the RCP’s Tobacco Advisory Group says that:

·         Treating tobacco dependency is not just about preventing disease: in many cases it represents effective disease treatment. Clinicians working in all areas of medicine can improve their patients’ lives by helping them to quit.

·         Current models of delivering stop smoking services separately from mainstream NHS services, while successful in the past, may now not be the best approach because the patient has to seek help themselves

·         Most health professionals receive little or no training in treating smokers

·         The NHS does not collect data on smoking treatment delivery, or have a payment tariff for treating tobacco dependency

·         Smoking treatment also tends to be squeezed out, even in the management of diseases caused by smoking, by other, less cost-effective interventions

To address all these issues, the report recommends:

• ·         As smoking cessation treatments save money for the NHS, in the short as well as the long term, they should be prioritised as a core NHS activity
• ·         Smoking cessation should be incorporated as a systematic and opt-out component of all NHS services, and delivered in smoke-free settings
• ·         As systematic identification of smokers and delivering cessation support doubles quit rates, health service commissioners should ensure that smokers are identified and receive cost-effective smoking interventions – failing to do so is as negligent as not treating cancer
• ·         We should allow e-cigarettes to be used on NHS sites to support smokers to remain smoke-free and help to sustain smoke-free policies
• ·         Legislation requiring hospitals to implement completely smoke-free grounds should be introduced, as the current guidance isn’t being implemented
• ·         Training in smoking cessation should be introduced into all undergraduate and postgraduate healthcare professional training curricula and as mandatory training for the entire NHS healthcare professional workforce.

The report was lead by Professor John Britton, chair of the RCP’s Tobacco Advisory Group and Dr Sanjay Agrawal, consultant in respiratory and intensive care medicine, University Hospitals of Leicester NHS Trust and a member of the RCP Tobacco Advisory Group

Professor Britton said: ‘Treating the more than one million smokers who are admitted to hospitals every year represents a unique opportunity for the NHS to improve patients’ lives, while also saving money. For too long the NHS has failed to take responsibility for smoking, while prioritising other, less effective activity. Smoking, the biggest avoidable cause of death and disability in the UK, is hiding in plain sight in our hospitals and other NHS services; the NHS must end the neglect of this huge opportunity to improve our nation’s health.’

SYNTAX PROJECT: Integrated evidence synthesis for joint appraisal of tobacco and alcohol tax interventions for harm reduction in the UK

Professor Alan Brennan and Dr Duncan Gillespie from HEDS are leading a project with other ScHARR colleagues and collaboration with The University of Bath on alcohol and tobacco taxation. Both collaborators are part of the UK Centre for Tobacco and Alcohol Studies @ukctas http://ukctas.net/ The project aims to investigate how tobacco and alcohol taxation can be changed to improve health for all. This is a three year project funded by the NIHR Public Health Research Programme. Researchers will talk with consumers, policymakers and experts and use survey and sales data to look at how tobacco and alcohol tax can work together: to change consumer behaviour and health; to benefit disadvantaged communities; and reduce NHS costs at a time of limited budgets.

Image CC BY 2.0 Andrew Goloda http://bit.ly/2AiyGEv

Background to the project
One in five adults in the UK smokes and one in five adults drinks alcohol in hazardous or harmful ways. These ‘lifestyle factors’ are leading causes of preventable illness and death, including from heart disease and cancers. Over 80,000 people a year die earlier than they should from diseases caused by drinking or smoking. For those who smoke and drink alcohol, the risk of developing these preventable diseases is even greater. This preventable human loss is compounded by an annual cost to the NHS of over £6 billion.
There is evidence that people buy less cigarettes and alcoholic drinks when the price increases. Health advocates are therefore calling for higher taxes and changes to tax structures on alcohol and tobacco products to encourage people to quit smoking and reduce their drinking. However, it is not clear what effect this would have on tax revenues and the wider economy. There is uncertainty about the effects of tax increases on smokers and drinkers who are on a low income or unemployed. Consumers can change their behaviour in response to changes in prices (for example, by switching to cheaper or illegal products).Uncertainty can also arise because tobacco and alcohol companies and retailers can alter prices to ensure some products stay affordable despite tax increases. The planned research will address these areas of complexity.

More information can be found here