Quality statement 2: Stopping smoking

Quality statement

Adults with suspected or confirmed lung cancer who smoke receive evidence-based stop smoking support. [new 2019]

Rationale

People with suspected or confirmed lung cancer who smoke should be encouraged to stop smoking to reduce the risk of treatment-related complications and other smoking-related conditions and increase their life expectancy. They should be provided with evidence-based support to help them to stop smoking.

Quality measures

Structure

a) Evidence of local arrangements to ensure that adults with suspected or confirmed lung cancer who smoke are given advice about why it is important to stop smoking.

Data source: Local data collection, for example, service protocols.

b) Evidence of local arrangements to provide evidence-based support for adults with suspected or confirmed lung cancer to help them to stop smoking.

Data source: Local data collection, for example, service specification and protocols.

Process

Proportion of adults with suspected or confirmed lung cancer who smoke who receive evidence-based support to stop smoking.

Numerator – the number in the denominator who receive evidence-based support to stop smoking.

Denominator – the number of adults with suspected or confirmed lung cancer who smoke.

Data source: Royal College of Physicians National Lung Cancer Audit (measure in development). Data on smoking status and whether treatment for tobacco addiction was given from National Cancer Registration and Analysis Service Cancer Outcomes and Services Dataset.

Outcome

a) Smoking rates in adults with lung cancer having treatment with curative intent.

Data source: Local data collection, for example, audit of patient records.

b) 1-year survival rate for adults with lung cancer treated with curative intent.

Data source: National Cancer Registration and Analysis Service Cancer Outcomes and Services Dataset.

What the quality statement means for different audiences

Service providers (such as primary care, community services, secondary and tertiary care) ensure that processes are in place to provide advice to adults with suspected or confirmed lung cancer who smoke about why it is important to stop smoking. Providers ensure that they can provide evidence-based support to help people with suspected or confirmed lung cancer to stop smoking. This may also include referral pathways to evidence-based stop smoking support.

Healthcare professionals (such as GPs, pharmacists, clinical nurse specialists, consultants and radiographers) provide advice to adults with suspected or confirmed lung cancer who smoke about why it is important to stop smoking. They arrange for them to access evidence-based stop smoking support if they want to stop.

Commissioners (such as clinical commissioning groups, NHS England and local authorities) ensure that they commission services which provide evidence-based stop smoking support to adults with suspected or confirmed lung cancer who smoke.

Adults with suspected or confirmed lung cancer who smoke are told that it is important to stop smoking to avoid complications during treatment and prevent other smoking-related illnesses. They are told that stopping smoking may improve how long they live, and they are given help if they want to give up.

Source guidance

Definitions of terms used in this quality statement

Suspected lung cancer

Adults with symptoms and signs of lung cancer who are referred for investigation.

[Expert opinion]

Evidence-based stop smoking support

The following interventions should be available:

  • behavioural support (individual and group)

  • bupropion[1]

  • nicotine replacement therapy – short and long acting

  • varenicline[2]

  • very brief advice.

[NICE's guideline on stop smoking interventions and services, recommendation 1.3.1 and terms used in this guideline and NICE's guideline on lung cancer, recommendation 1.4.3]

Equality and diversity considerations

Information about stopping smoking should be in a format that suits the person's needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate. People should have access to an interpreter or advocate if needed. For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard.



[1] See information on bupropion hydrochloride in the British national formulary.

[2] See information on varenicline in the British national formulary.