Quality statement 2: Referral to smoking cessation services

Quality statement

People who smoke are offered a referral to an evidence‑based smoking cessation service.

Rationale

Smoking cessation services provide the most effective route to stopping smoking, but many people who smoke do not use these services when they try to stop. It is therefore important that practitioners are aware of and make use of the opportunities to refer people who smoke to an evidence‑based smoking cessation service.

Statement 5 in the NICE quality standard on antenatal care sets out the high‑quality requirements for ensuring that pregnant women who smoke are referred to an evidence‑based smoking cessation service.

Quality measures

Structure

Evidence of local arrangements to ensure that people who smoke are offered a referral to an evidence‑based smoking cessation service.

Data source: Local data collection.

Process

Proportion of people who smoke who are referred to an evidence‑based smoking cessation service.

Numerator – the number of people in the denominator who are referred to an evidence‑based smoking cessation service.

Denominator – the number of people identified as smokers in any healthcare setting.

Data source: Local data collection and the quality and outcomes framework (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 who smoke to be offered a referral to an evidence‑based smoking cessation service.

Healthcare practitioners offer people who smoke a referral to an evidence‑based smoking cessation service.

Commissioners ensure that they commission services that offer people who smoke a referral to an evidence‑based smoking cessation service.

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

People who smoke are offered a referral to an evidence‑based smoking cessation service to help them stop smoking.

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.

Evidence‑based smoking cessation services

These are local services providing accessible, evidence‑based and cost‑effective support to people who want to stop smoking.

The National Centre for Smoking Cessation and Training offers training modules for people delivering smoking cessation interventions.

This statement is linked to statement 1, because advice on how to stop may include a referral to an evidence‑based smoking cessation service.

Statement 5 in the NICE quality standard on antenatal care states that 'Pregnant women who smoke are referred to an evidence‑based stop smoking service at the booking appointment' and the appropriate referral criteria are defined. The supporting information also states that the midwife may provide the pregnant woman with information (in a variety of formats, for example, a leaflet) about the risks to the unborn child of smoking when pregnant and the hazards of exposure to secondhand smoke for both mother and baby.

Equality and diversity considerations

Evidence‑based smoking cessation 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 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.