1. 1 Why go Smokefree?

2. 2 Rationale for going Smokefree in secondary care Smoking has a negative effect upon operative outcome People who smoke in the weeks before anaesthesia and surgery are more likely to; Have lung, heart and infection related complications Experience reduced bone fusion after a fracture Experience excess infections including resistant pathogens such as MRSA Show impaired wound healing Be admitted to an intensive care unit Have an increased risk of dying in hospital Remain in hospital longer

3. 3 Cost of staff smoking (name) employ (no of staff) staff (from website) 20% prevalence of smokers = (number) smokers Smokers take on average 4 x 15 mins breaks/day (Ash audit 2010) (name) lose (? ) hours/day Assuming 5 day week/40 weeks/year. Av.salary £22,300 (2004 NHS staff earnings survey) Equates to (?) people being employed to smoke full time The cost = £………… Note: See ‘Cost Calculator’ on resource disc

4. 4 Sickness for staff who smoke Smokers are estimated to have 33 hours extra sick leave than non smokers (NICE) (?) smokers = (?) people working full time to be sick/year = £……….. Total £…………(breaks plus sickness) Note: See ‘Cost Calculator’ on resource disc

5. 5 Branding & Process

6. 6 Example Smokefree Signage

7. 7 Process Checklist Board level champion and policy development Very Brief Advice Training:15 minutes for all patient facing staff Modify all admissions and discharge paperwork – add 2 lines Temporary abstinence protocol to enable NRT for those who choose not to quit Choice of pharmacotherapy available Local NHS Stop Smoking Service to have database for the site/patients to enable follow up Special and separate support available for staff who wish to stop smoking Passionate action team determined to deliver Commitment to evaluation and plan for each site Internal and external promotional materials in place

8. 8 Next steps Who do we need to see? What permissions do we need? Read the ‘Making your hospital Smokefree’ guide What do YOU think we need to do next? Who do we need to engage on our action team?