RSPH has backed calls made by the Royal College of Physicians (RCP) for a radical upgrade in the way the NHS approaches smoking cessation.

In a new report, Hiding in Plain Sight, the RCP calls out the NHS for a systematic failure to help the one million smokers who are admitted into secondary care every year, proposing instead that delivering stop smoking interventions at the point of contact should become routine practice throughout the NHS.

The encouraging declines in smoking rates seen in the UK in recent years are primarily due to fewer people taking up smoking, rather than more existing smokers quitting.

The report argues that the management of smoking cessation in secondary care settings is ‘woefully lacking’, and that by commissioning for the identification and treatment of tobacco dependency as a core NHS activity, substantial benefits can be achieved both for the public’s long term health and for NHS finances.

The report’s main recommendations include:

  • Stop smoking interventions to be delivered to all smokers on an opt-out basis, at the point of accessing NHS services.
  • Training in smoking cessation interventions to be introduced in all healthcare professional curricula, and as mandatory training for the entire NHS healthcare professional workforce.
  • Legislation requiring NHS facilities to be entirely smoke-free to be introduced throughout the UK. Allowing e-cigarettes on NHS sites can also support smokers and help sustain a smoke-free policy.

The report also breaks down the total financial cost of current smoking to the NHS – a staggering £1 billion annually – and projects that the implementation of smoke-free policies and cessation interventions would yield a cost saving of between £30 million and £60 million in the first year alone.


Shirley Cramer CBE, Chief Executive, RSPH, said: “Tobacco control policies have made great strides in reducing smoking uptake – and this should be applauded, celebrated, and continued – but more needs to be done to help our nation’s existing smokers to quit, and the NHS has a central role to play. Delivering smoking cessation treatment at the point of contact with health services is a highly effective way of doing this, and is a glaring omission from current NHS strategy. Smoking cessation in the NHS makes sense not only as a long term prevention measure, but also as a treatment in and of itself, being a remarkably cost-effective way to treat smoking-related conditions such as lung cancer and cardiovascular diseases.

“Action on this front is all the more urgent given the declining numbers of smokers accessing local Stop Smoking Services in recent years, as a result of central government cuts to local authority public health budgets. However, it is vital that local authorities continue to fund these services, which remain a crucial and cost-effective part of the equation.”