{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T02:01:35Z","timestamp":1768528895135,"version":"3.49.0"},"reference-count":14,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2023,9,8]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>Smoking remains the single largest cause of preventable death, disability and health inequality. Smoking tobacco directly contributes to over 500 000 hospital admissions each year, making hospitals an important location to optimise treatment for tobacco dependency. The third British Thoracic Society Tobacco Dependency Audit was undertaken to determine how effectively national standards for treating tobacco-dependent smokers have been implemented and assess if any progress has been made from previous audits. Data on 14579 patients from 119 hospitals revealed 21% of patients were current smokers, 45% were offered very brief advice and 5% prescribed combination nicotine replacement therapy or varenicline. Only 9% completed a consultation with a specialist tobacco dependency practitioner during their inpatient stay and fewer than 1% of smokers were abstinent at 4 weeks following discharge. Clinical leadership of tobacco dependency services was deficient, and staff were ill equipped in supporting current smokers in their efforts to quit with only 50% of trusts offering regular smoking cessation training. There has been little meaningful improvement from previous audits and there remains woefully inadequate provision of tobacco dependency treatment for patients who smoke. The National Health Service (NHS) Long Term Plan has committed substantial, new funding to the NHS to ensure every patient that smokes admitted to hospital will be offered evidence-based support and treatment for tobacco dependency. The findings of this audit highlight the urgency with which this programme must be implemented to tackle the greatest cause of premature death in the UK and to achieve the wider well-recognised benefits for the healthcare system.<\/jats:p>","DOI":"10.1136\/bmjresp-2022-001532","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T12:55:16Z","timestamp":1701262516000},"page":"e001532","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["\u2018The dark before the dawn\u2019: the 2021 British Thoracic Society Audit of the treatment of tobacco dependency in acute trusts"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5012-4165","authenticated-orcid":false,"given":"Nikesh","family":"Devani","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaheer","family":"Mangera","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, North Middlesex University Hospital NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Smith","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7777-0201","authenticated-orcid":false,"given":"Jessica","family":"Gates","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Kingston Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arran","family":"Woodhouse","sequence":"additional","affiliation":[{"name":"Tobacco Dependence Team, King's College Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duncan","family":"Fullerton","sequence":"additional","affiliation":[{"name":"Respiratory Department, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aravind","family":"Ponnuswamy","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Countess of Chester Hospital NHS FT, Chester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4066-5253","authenticated-orcid":false,"given":"Matthew","family":"Evison","sequence":"additional","affiliation":[{"name":"Lung Cancer and Thoracic Surgery Directorate, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"2025083110433518000_10.1.e001532.1","unstructured":"Action on Smoking and Health (ASH) . 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Available: https:\/\/www.gov.uk\/government\/publications\/tobacco-control-plan-delivery-plan-2017-to-2022 [Accessed 10 Jan 2022]."},{"key":"2025083110433518000_10.1.e001532.5","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2015-052728"},{"key":"2025083110433518000_10.1.e001532.6","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f4004","article-title":"Systematic identification and treatment of Smokers by hospital based cessation practitioners in a secondary care setting: cluster randomised controlled trial","volume":"347","author":"Murray","year":"2013","journal-title":"BMJ"},{"key":"2025083110433518000_10.1.e001532.7","unstructured":"Royal College of Physicians (RCP) . Hiding in Plain Sight: Treating Tobacco Dependency in the NHS. London: Royal College of Physicians, 2018. 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Available: https:\/\/ash.org.uk\/wp-content\/uploads\/2021\/03\/SocialCare.pdf [accessed 10 May 2022]."},{"key":"2025083110433518000_10.1.e001532.12","doi-asserted-by":"crossref","first-page":"196","DOI":"10.7861\/clinmed.2019-0336","article-title":"Feasibility, uptake and impact of a hospital-wide tobacco addiction treatment pathway: results from the cure project pilot","volume":"20","author":"Evison","year":"2020","journal-title":"Clin Med (Lond)"},{"key":"2025083110433518000_10.1.e001532.13","unstructured":"Respiratory Futures, British Thoracic Society . Tobacco dependency roadmap. 2021. 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