Quality statement 7: Healthcare settings: nicotine-containing products and stop smoking pharmacotherapies

Quality statement

Secondary healthcare settings ensure that a range of licensed nicotine‑containing products and stop smoking pharmacotherapies is available on site for patients, visitors and employees.

Rationale

Secondary healthcare services have a duty of care to protect the health of people who use or work in their services and promote healthy behaviour among these groups. Most secondary and tertiary healthcare settings already have a smokefree policy in place, which includes smokefree grounds. Facilitating abstinence (long‑term or temporary) among patients, visitors and employees (including contractors and volunteers) will help ensure compliance with smokefree policies.

Quality measures

Structure

a) Evidence of local arrangements to ensure that 'stop smoking' pharmacotherapies and licensed nicotine‑containing products are stocked by pharmacies within secondary healthcare services.

Data source: Local data collection.

b) Evidence of local arrangements to ensure that a range of licensed nicotine‑containing products is available for sale within secondary healthcare services for visitors and employees.

Data source: Local data collection

Process

a) Proportion of secondary healthcare settings that stock pharmacotherapies and licensed nicotine‑containing products.

Numerator – The number in the denominator that stock pharmacotherapies and licensed nicotine‑containing products.

Denominator – The number of secondary healthcare settings in the specified geographic area.

Data source: Local data collection.

b) Proportion of secondary healthcare settings that sell nicotine‑containing products to visitors and employees.

Numerator – The number in the denominator that sell nicotine‑containing products to visitors and employees.

Denominator – The number of secondary healthcare settings in the specified geographic area.

Data source: Local data collection.

What the quality statement means for directors and senior managers of secondary care services or their representatives, commissioners and people who work in secondary healthcare services

Directors and senior managers of secondary care services or their representatives ensure that compliance with a smokefree policy is facilitated by a range of licensed nicotine‑containing products and 'stop smoking' pharmacotherapies being available on site for patients, visitors and employees.

Commissioners ensure that their contracts with secondary healthcare settings facilitate compliance with a smokefree policy by including on‑site provision of licensed nicotine‑containing products and 'stop smoking' pharmacotherapies for patients, visitors and employees.

People who work in secondary healthcare services (including contractors and volunteers) are helped to stick to the smokefree policy by being able to obtain a range of licensed nicotine‑containing products and 'stop smoking' therapies on site.

What the quality statement means for patients and visitors

Patients in secondary healthcare services can obtain a range of licensed nicotine‑containing products and 'stop smoking' pharmacotherapies onsite at all times. This helps them follow the smokefree policy within the healthcare grounds.

Visitors can obtain a range of licensed nicotine‑containing products onsite at all times. This helps them follow the smokefree policy within the healthcare grounds.

Source guidance

Smoking: acute, maternity and mental health services (2013) NICE guideline PH48, recommendations 8 and 11

Definitions of terms used in this quality statement

Secondary healthcare settings

All publicly funded secondary health and tertiary care facilities, including buildings, grounds and vehicles. This includes drug and alcohol services in secondary care, emergency care, inpatient, residential and long‑term hospital care for severe mental illness, psychiatric and specialist units and secure hospitals, and planned specialist medical care or surgery. It also includes maternity care provided in hospitals, maternity units, outpatient clinics and in the community. Care can be planned or emergency care. Planned secondary care generally follows a referral from a primary care provider, such as a GP.

[NICE guideline PH48]

Licensed nicotine-containing products

Licensed nicotine‑containing products are a safe and effective way of reducing the amount people smoke. They can be used as a complete or partial substitute for tobacco, either in the short or long term.

Some nicotine‑containing products are not regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and, therefore, their effectiveness, safety and quality cannot be assured. These products are likely to be less harmful than cigarettes. For further details, see the MHRA website.

Different forms of nicotine‑containing products include:

  • patches

  • gum

  • inhalator

  • lozenges

  • nasal spray.

[Adapted from NICE guideline PH48 and NICE guideline PH45]

If alternative nicotine‑containing products (such as e‑cigarettes) gain licensing authorisation in the future, this quality statement will be reviewed.

'Stop smoking' pharmacotherapies

Pharmacotherapy is the treatment of addiction through the administration of drugs. 'Stop smoking' advisers and healthcare professionals may recommend and prescribe licensed nicotine‑containing products, varenicline or bupropion, as an aid to help people to stop smoking. Licensed nicotine‑containing products may also be offered to support temporary abstinence from smoking in the secondary healthcare setting.

[NICE guideline PH48]

Equality and diversity considerations

People whose drug treatment is affected by smoking may need to have the dosage of their drugs adjusted. This is particularly important for people with mental health problems taking antipsychotic medication.