157 Smoking Cessation - Are We Making the Most of the Opportunity to Modify the Long-Term Health of Surgical Inpatients?

Introduction Smoking is the leading preventable cause of death and illness. NICE Guidelines (209) recommend documenting smoking history, providing smoking cessation advice at admission, offering nicotine replacement and behavioural therapy/referral to stop smoking services. A pilot study was undertaken at a district general hospital to establish compliance with the above guidelines. Method Medical and nursing notes were reviewed for patients (N=44) admitted on two surgical wards (Bedford Hospital) on a single date in October 2023 following snapshot audit methodology to establish smoking status documentation. Smokers were identified from the above two wards plus a further 5 wards using a transcript to establish the proportion of smokers who were offered smoking cessation advice, nicotine replacement offer, behavioural therapy, and smoking cessation services referral. Transcript results were cross-checked against case notes. Results 11% (5/44) and 20% (9/44) had smoking status documented in their nursing/medical notes respectively. Seven current smokers were identified of which 57% (4/7) were given smoking cessation advice, 29% (2/7) offered nicotine replacement, 0% (0/7) were offered behavioural therapy and 57% (5/7) were offered referral to stop smoking services. Casenote review established the above were not documented. Conclusions Smoking cessation remains one of our greatest opportunities to modify long term health outcomes, compliance with NICE Guidelines is poor, and actions taken are not well documented. Further work is needed to establish the most effective strategies to improve our care of current smokers and achieve delivery of these key metrics.