RCP Report about Treating Patients for Tobacco Dependency

The Royal College of Physicians in the UK (RCP), has released a report arguing that the NHS should be treating all hospitalized smokers for their tobacco dependency.

Diane Caruana

June 28, 2018

The report titled Hiding in plain sight: Treating tobacco dependency in the NHS, argues “that responsibility for treating smokers lies with the clinician who sees them, and that our NHS should be delivering default, opt-out, systematic interventions for all smokers at the point of service contact.”

“Smoking cessation is not just about prevention. For many diseases, smoking cessation represents effective treatment.”Royal College of Physicians

Below is the summary of the report:

“The principle of autonomy requires that patients who smoke and who are in contact with health services have their smoking ascertained, and information and treatment offered, to enable autonomous decisions on future smoking.
The principle of justice requires that we offer smokers help to quit smoking; failure to so implies that smokers’ health is less important than that of other patients.
Failing to provide help to quit smoking while delivering other similarly or less cost-effective interventions to smokers represents distributive injustice which both perpetuates and exacerbates health inequalities. > Opt-out models of treatment help to sustain autonomy and justice in treating smoking, and should be the norm.
It is at least as important to address smoking in patients using secondary care as those in primary care.
Treating the physical health of patients is also no less important than treating mental health. Treating smoking improves both.
Since most people would prefer to avoid being ill than to go through illness and treatment, prevention should be given a proper place in the allocation of health service resources.
Proper use of health service resources also requires that more cost-effective treatments are used in preference to less cost-effective treatments.
Smoke-free NHS estates protect the health of patients and staff, signals that smoking is a crucial health issue, and supports smokers who are trying to quit.
Heath service commissioners and practitioners have a responsibility to ensure that cost-effective smoking interventions are provided and properly implemented. Failure to identify and treat smokers is no less negligent than failure to identify and treat patients with cancer. Systems failure is no less negligent in this respect than individual failure.
Smoking cessation should be incorporated, as a priority, as a systematic and opt-out component of all NHS services as a complement to local authority services, and delivered in smoke-free settings. It is unethical to do otherwise.”

Smoking cessation is a disease treatment in itself

The report concludes by pointing out that endorsing this approach would mean that clinicians specialized in all areas of medicine would see their patient’s symptoms improved. “Smoking cessation is not just about prevention. For many diseases, smoking cessation represents effective treatment.”