Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England
There is a significant body of evidence that delivering tobacco dependency treatment within acute care hospitals can deliver high rates of tobacco abstinence and substantial benefits for both patients and the healthcare system. This evidence has driven a renewed investment in the UK healthcare servi...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/29/5/299 |
| _version_ | 1797500536443895808 |
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| author | Sanjay Agrawal Zaheer Mangera Rachael L. Murray Freya Howle Matthew Evison |
| author_facet | Sanjay Agrawal Zaheer Mangera Rachael L. Murray Freya Howle Matthew Evison |
| author_sort | Sanjay Agrawal |
| collection | DOAJ |
| description | There is a significant body of evidence that delivering tobacco dependency treatment within acute care hospitals can deliver high rates of tobacco abstinence and substantial benefits for both patients and the healthcare system. This evidence has driven a renewed investment in the UK healthcare service to ensure all patients admitted to hospital are provided with evidence-based interventions during admission and after discharge. An early-implementer of this new wave of hospital-based tobacco dependency treatment services is “the CURE project” in Greater Manchester, a region in the North West of England. The CURE project strives to change the culture of a hospital system, to medicalise tobacco dependency and empower front-line hospital staff to deliver an admission bundle of care, including identification of patients that smoke, provision of very brief advice (VBA), protocolised prescription of pharmacotherapy, and opt-out referral to the specialist CURE practitioners. This specialist team provides expert treatment and behaviour change support during the hospital admission and can agree a support package after discharge, with either hospital-led or community-led follow-up. The programme has shown exceptional clinical effectiveness, with 22% of all smokers admitted to hospital abstinent from tobacco at 12 weeks, and exceptional cost-effectiveness with a public value return on investment ratio of GBP 30.49 per GBP 1 invested and a cost per QALY of GBP 487. There have been many challenges in implementing this service, underpinned by the system-wide culture change and ensuring the good communication and engagement of all stakeholders across the complex networks of the tobacco control and healthcare system. The delivery of hospital-based tobacco dependency services across all NHS acute care hospitals represents a substantial step forward in the fight against the tobacco epidemic. |
| first_indexed | 2024-03-10T03:04:17Z |
| format | Article |
| id | doaj.art-d6f61c81713a49ff8188da342921a32d |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T03:04:17Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-d6f61c81713a49ff8188da342921a32d2023-11-23T10:37:31ZengMDPI AGCurrent Oncology1198-00521718-77292022-05-012953738374710.3390/curroncol29050299Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in EnglandSanjay Agrawal0Zaheer Mangera1Rachael L. Murray2Freya Howle3Matthew Evison4Institute for Lung Health, Department of Respiratory Medicine, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UKDepartment of Respiratory Medicine, North Middlesex University Hospital, Sterling Way, London N18 1QX, UKAcademic Unit of Lifespan and Population Health, School of Medicine, Nottingham University, Nottingham NG7 2RD, UKGreater Manchester CURE Programme Team, Greater Manchester Cancer Alliance, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UKLung Cancer & Thoracic Surgery Directorate, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, Southmoor Road, Manchester M23 9LT, UKThere is a significant body of evidence that delivering tobacco dependency treatment within acute care hospitals can deliver high rates of tobacco abstinence and substantial benefits for both patients and the healthcare system. This evidence has driven a renewed investment in the UK healthcare service to ensure all patients admitted to hospital are provided with evidence-based interventions during admission and after discharge. An early-implementer of this new wave of hospital-based tobacco dependency treatment services is “the CURE project” in Greater Manchester, a region in the North West of England. The CURE project strives to change the culture of a hospital system, to medicalise tobacco dependency and empower front-line hospital staff to deliver an admission bundle of care, including identification of patients that smoke, provision of very brief advice (VBA), protocolised prescription of pharmacotherapy, and opt-out referral to the specialist CURE practitioners. This specialist team provides expert treatment and behaviour change support during the hospital admission and can agree a support package after discharge, with either hospital-led or community-led follow-up. The programme has shown exceptional clinical effectiveness, with 22% of all smokers admitted to hospital abstinent from tobacco at 12 weeks, and exceptional cost-effectiveness with a public value return on investment ratio of GBP 30.49 per GBP 1 invested and a cost per QALY of GBP 487. There have been many challenges in implementing this service, underpinned by the system-wide culture change and ensuring the good communication and engagement of all stakeholders across the complex networks of the tobacco control and healthcare system. The delivery of hospital-based tobacco dependency services across all NHS acute care hospitals represents a substantial step forward in the fight against the tobacco epidemic.https://www.mdpi.com/1718-7729/29/5/299NHS long term plantobacco dependency treatment |
| spellingShingle | Sanjay Agrawal Zaheer Mangera Rachael L. Murray Freya Howle Matthew Evison Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England Current Oncology NHS long term plan tobacco dependency treatment |
| title | Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England |
| title_full | Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England |
| title_fullStr | Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England |
| title_full_unstemmed | Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England |
| title_short | Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England |
| title_sort | successes and challenges of implementing tobacco dependency treatment in health care institutions in england |
| topic | NHS long term plan tobacco dependency treatment |
| url | https://www.mdpi.com/1718-7729/29/5/299 |
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