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Smoke Free at the RD&E - The Policy

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  1. Background
  2. Rationale
  3. Scope
  4. Aims
  5. Responsibilities
  6. Smoking cessation support for patients
  7. Smoking cessation support for staff
  8. Non complaince
  9. Contractors
  10. Signage

1.         Background

This policy underpins the trust’s intention to have a smoke-free environment, for the benefit of all patients, staff and visitors.   It re-enforces the Royal Devon & Exeter NHS Foundation Trust’s (RD&E) health promotion role as a health care organisation.  The policy recognises that second hand smoke adversely affects the health of all employees. It is not concerned with whether anyone smokes, but with where they smoke and the effect this has on patients, visitors and other members of the wider health community. 

The key objectives of the policy are:

2.         Rationale

Smoking is the leading most preventable cause of death and disease in the UK.  There is much evidence to support a move to a smoke-free environment.  Some key facts include:

Smoking has an extremely wide health impact and is cited in the following NHS documents:

Smoking cessation is about disease prevention and health organisations have a duty of care to staff and patients for both physical and mental health. Completely smoke-free hospitals and grounds create a smoke-free environment for people trying to stop smoking and removes triggers that cause many to smoke or relapse to smoking. The availability of a national network of specialist NHS Stop Smoking Services means that support is easily accessible for patients and staff. If smoking is allowed at entrances and outside buildings, the smoke will drift in through doors and windows thereby continuing to be a health hazard. In addition people dislike the smell of cigarette smoke on others. If employee smoking is allowed on site, this can weaken patient’s and staff’s attempts to stop.


3.         Scope

The Trust acknowledges that breathing other people’s smoke is both a public health hazard and a welfare issue. The policy concerns smoking on all RD&E sites and buildings which include:

Having smoke-free grounds as well as buildings sends a strong message from the organisation about the established dangers of smoking and second hand smoke.  People smoking at the entrance to NHS buildings give a very poor impression of the health organisation and this also means that those entering and leaving the buildings have to pass through tobacco smoke. People in the buildings who work or are treated near to open windows are also exposed to other people’s smoke.


4.         Aims

The aim of this Policy is to:

5.         Responsibilities

This policy will apply to all staff, patients, visitors, contractors and other persons who enter the RD&E for any purpose whatsoever.  Responsibility for implementing this policy rests with the Chief Executive. Day to day responsibility for implementation rests with Directors and Managers.


6.         Smoking Cessation support for Patients

Patients will be advised of the new policy on admission via communication methods such as the website and patient information leaflets. Coming into hospital presents many patients with an ideal opportunity to stop smoking. The RD&E will provide practical help, support and advice to patients who wish to take advantage of this opportunity.  On admission the smoking status of all patients will be recorded and the patient will be asked if they wish to be referred to a smoking cessation advisor.


Patients who are admitted electively will be encouraged to seek the advice of their GP if they feel they will need Nicotine replacement therapy (NRT) for the duration of their hospital stay.  Patients admitted as an emergency, and who smoke, will be offered NRT support in accordance with the Joint Formulary which can be accessed through ComEx.


Breaches of the smoking policy by patients will be reported to the manager, (or their representative), of the relevant clinical/non clinical area. If applicable, the clinical area may be asked to provide an escort to return the patient to their own ward or department. The Clinical Manager and the Patient Care Team should be informed of the event and decide upon appropriate action.  Patients should be informed that staff will not support them in smoking.


7.         Smoking Cessation support for Staff

The role of the Occupational Health Service (OHS) is to support staff and to assist the Trust in its legal duty to protect the Health, Safety and Welfare of all its employees.  The OHS will assist with the delivery of information about the smoke-free policy and advice on resources available to assist with quitting smoking.  This will be achieved by:

In addition all occupational nursing and medical staff will undertake an opportunistic enquiry about smoking habits when appropriate and provide information and advice about smoking cessation opportunities with onward referral to the smoking cessation group leader as requested.


Smoking cessation groups will be available for staff who are motivated to quit smoking via the occupational health service (OHS).  The groups will run for a period of six weeks and participants will be able to benefit from peer support.  An assessment for appropriate NRT will be undertaken for those who request it.  NRT is available on prescription via the individual’s GP. 


The OHS will be in a position to support managers in their efforts to ensure that all staff adhere to the policy.  Managers may refer members of their staff who are having difficulty in complying with the policy.

Individual members of staff may self-refer to the OHS for an appointment with an Occupational Health Advisor who has undergone training in brief and intermediate interventions for information, advice and support in relation to smoking cessation issues.


8.         Non compliance

Staff who do not comply with the policy will be interviewed by their line manager and referred to Occupational Health for support and advice as appropriate. Should an individual or group of individuals continue to infringe this policy the manager may invoke disciplinary procedures as a means of encouraging adherence to the Policy. Patients and Visitors who refuse to comply with this policy may be removed from the site.


9.         Contractors

Tenders and contracts with the RD&E will stipulate adherence to this policy as a contractual condition. Existing contacts will be modified as soon as possible.


10.       Signage

To ensure that everyone entering the RD&E understands that smoking is not allowed in the buildings or the grounds, clear signs will be on display.