NHS hospitals and clinics should become completely smoke-free to create a culture where smoking is no longer considered the norm, says NICE.
Patients who smoke should be offered smoking cessation drugs, nicotine patches, and counselling as soon as they are admitted to an acute, maternity or mental health setting to encourage them to quit.
NHS staff, visitors, and family members should also be encouraged to stop smoking as part of a cultural shift in the way in which the NHS tackles smoking.
Smoking shelters and other designated smoking areas should all be removed from secondary settings as part of the smoke-free plans.
“It is absurd that smoking is still being passively encouraged within hospitals, said Professor Mike Kelly, Director of Public Health at NICE.
“We need to end the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances. This new guidance can help make that contradiction a thing of the past by supporting hospital smoke-free policies to make NHS secondary care an exemplar for promoting healthy behaviour.”
Professor Kelly called for strong leadership among Trusts to tackle a problem that has dogged the NHS for years.
“Smoking has been thought to be a difficult nut to crack and so it is high time for this guidance. It recommends strong leadership and individual trusts have to own this. The professionals have to be willing to take this guidance on.”
Professor John Britton, who led the development of this guidance and is Director of the UK centre for Tobacco and Alcohol Studies at the University of Nottingham, said that stopping smoking needed to become a priority for the NHS.
“If you provide the support that people need, the medications they need, the behavioural support and counselling that they need, immediately and you put them in an environment where they are not seeing the drivers of smoking, like people standing outside the ward doorway or standing in the car park, then they can achieve it. That's what this guidance is all about,” he said.
Smoking is responsible for over 460,000 hospital admissions in England each year, and is the single biggest preventable cause of death - nearly 80,000 lives per year.
Smoking is especially common among people with mental health problems, with 70 per cent of people in psychiatric units estimated to be smokers.
Most of the reduction in life expectancy among people with serious mental illness is attributable to smoking, which also increases the dose requirements of psychotropic drugs by £40 million a year across the UK.
Professor Sue Bailey, President of the Royal College of Psychiatrists, said: “There is a common but mistaken belief among mental health professionals that it's alright for patients in their care to smoke.
“The majority, 90 per cent, of patients with mental health problems who smoke want to stop smoking. It may take them a little longer but they can achieve it”
Mary Yates, Matron at the South London and Maudsley NHS Trust, added: “A lot of nurses are actually facilitating smoking among patients. There are cases where patients have quit smoking and have then taken it up again when they enter our wards.
“The new NICE guidance can help to change the culture whereby smoking is acceptable on NHS grounds and make it easier for hospital staff to set a clear example in helping patients to be successful in their attempt to quit smoking for good.”
Listen to a podcast with Mary Yates, who led on the introduction of a smoking cessation service for patients within her trust.