Quality statement 1: Identifying people who smoke

Quality statement

People are asked if they smoke by their healthcare practitioner, and those who smoke are offered advice on how to stop.

Rationale

There is evidence that people who smoke are receptive to smoking cessation advice in all healthcare settings. It is therefore important that healthcare practitioners proactively ask people if they smoke, and offer advice on how to stop.

Quality measures

Structure

Evidence of local arrangements to ensure that people are asked if they smoke by their healthcare practitioner, and those who smoke are offered advice on how to stop.

Data source: Local data collection.

Process

a) Proportion of people who are asked if they smoke by their healthcare practitioner.

Numerator – the number of people in the denominator who are asked if they smoke by their healthcare practitioner.

Denominator – the number of people who have face‑to‑face contact with a healthcare practitioner.

Data source: a) Local data collection and the quality and outcomes framework (QOF) indicator SMOK001.

b) Proportion of people who smoke who receive advice on how to stop.

Numerator – the number of people in the denominator who receive advice on how to stop.

Denominator – the number of people who report that they smoke during face‑to‑face contact with a healthcare practitioner.

Data source: b) Local data collection and the QOF indicator SMOK004.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers ensure that systems are in place for people to be asked if they smoke by their healthcare practitioner, and for those who smoke to be offered advice on how to stop.

Healthcare practitioners ask their patients if they smoke, and offer those who smoke advice on how to stop.

Commissioners ensure that they commission services where healthcare practitioners ask their patients if they smoke, and that they offer those who smoke advice on how to stop.

What the quality statement means for patients, service users and carers

People are asked if they smoke by their healthcare practitioners, and those who smoke are offered advice on how to stop.

Source guidance

Definitions of terms used in this quality statement

Healthcare practitioners

These include, but are not limited to, doctors, nurses, midwives, pharmacists, dentists, opticians and allied health professionals.

Advice

This can vary by healthcare setting. In the context of primary care settings, this would involve evidence‑based, opportunistic advice offered to people who smoke about the options and support available to help them stop smoking. In the context of secondary care settings, advice may involve the practitioner providing people who smoke with information and referring them to an evidence‑based smoking cessation service.

The National Centre for Smoking Cessation and Training offers a training module on the delivery of evidence‑based smoking cessation interventions, to ensure that this is done in a sensitive way within the brief time available with the patient.

This statement is linked to statement 2, because advice on how to stop may include a referral to an evidence‑based smoking cessation service.

Equality and diversity considerations

Advice should be culturally appropriate and accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English.

Advice may include referral to an evidence‑based smoking cessation service. Such services should target minority ethnic and socioeconomically disadvantaged communities in the local population; it is important to ensure that services are easily accessible by people from these groups and that they are encouraged to use them.

Lesbian, gay, bisexual and transgender (LGBT) groups have higher smoking prevalence rates than the general population, and as such, services should be accessible and commissioned to address this need.

Healthcare practitioners should be sensitive to the issue of smoking in young people. NICE guidance recommends that young people aged 12–17 who smoke should be offered information, advice and support on how to stop smoking and be encouraged to use local evidence‑based smoking cessation services.

Practitioners should be aware that some pregnant women find it difficult to say that they smoke because the pressure not to smoke during pregnancy is so intense.