Smoke free hospitals: Challenges need to be faced

doi:10.1136/bmj.327.7406.104

BMJ 2003;327:104 (12 July), doi:10.1136/bmj.327.7406.104

Letter

Smoke free hospitals

Challenges need to be faced

The first 150 words of the full text of this article appear below.

EDITOR—McKee et al criticised our decision to provide smoking rooms for patients' use.¹ We have also trained a substantialnumber of clinical staff to offer opportunistic advice aboutsmoking cessation, offering nicotine replacement to all smokerswho are admitted.

Jarvis et al drew attention to the prevalence of "hardcore" smoking in England and its links with age and socioeconomic deprivation.² Most patients in the Royal Victoria Hospitalare elderly, and many come from deprived areas. Even amongpregnant women, who are more motivated to stop smoking, complexinterventions are required.³

Change in smoking behaviour is a process, not an all or nothingevent. High intensity behavioural interventions with followup such as we proposed are effective in promoting smoking cessationin hospital patients. Interventions delivered only during thehospital stay are, however, ineffective.⁴ In all, 70% of ouradmissions are non-elective, with no opportunity for pre-assessmentand intervention. . . . [Full text of this article]

William McKee, chief executive

william.mckee@royalhospitals.n-i.nhs.uk

Michael McBride, medical director, Deirdre O'Brien, director of nursing, Antony Stevens, director of risk and occupational health, Christine Burns, director of facilities

Royal Hospitals, Belfast BT12 6BA

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