All health and social care services (and frontline staff in other public services) can play a key role in identifying smokers, delivering very brief advice (VBA) and referring people to local SSS. 67  This in line with the Making Every Contact Count (MECC) agenda and with NICE guidance on identifying and supporting people most at risk of dying early from cardiovascular disease (CVD). 89 In particular, owing to the links between CVD, social deprivation and smoking, targeting adults who are disadvantaged and at high risk of premature death from CVD is recommended.

Given the significant harms from smoking in pregnancy, NICE recommends that all pregnant women should be given a CO test by midwives at their booking appointment.  All women who smoke, have stopped smoking within the last two weeks or who have a CO reading of 7ppm or above B, should be referred (via an opt out system) to the local SSS. 10

 

Notes

  1. It is unclear as to what constitutes the best cut-off point for determining smoking status. Some suggest a CO level as low as 3 ppm, others use a cut-off point of 6–10 ppm. NICE guidance suggests 7 ppm.
  2. It is unclear as to what constitutes the best cut-off point for determining smoking status. Some suggest a CO level as low as 3 ppm, others use a cut-off point of 6–10 ppm. NICE guidance suggests 7 ppm.

References

  1. NCSCT, Public Health England, “Local Stop Smoking Services: Service and delivery guidance 2014,” 2014. [Online]. Available: http://www.ncsct.co.uk/usr/pub/LSSS_service_delivery_guidance.pdf. [Accessed 31 October 2016].
  2. NICE, “Smoking: acute, maternity and mental health services (PH48),” November 2013. [Online]. Available: https://www.nice.org.uk/guidance/ph48. [Accessed 31 October 2016].
  3. “Making every contact count: practical resources,” Public Health England, 2016. [Online]. Available: https://www.gov.uk/government/publications/making-every-contact-count-mecc-practical-resources. [Accessed 28 September 2016].
  4. NICE, “Cardiovascular disease: identifying and supporting people most at risk of dying early,” September 2008. [Online]. Available: https://www.nice.org.uk/guidance/ph15. [Accessed 2 November 2016].
  5. NICE, “Smoking: stopping in pregnancy and after childbirth (PH26),” June 2010. [Online]. Available: https://www.nice.org.uk/guidance/ph26. [Accessed 2 November 2016].
  6. NCSCT, Public Health England, “Local Stop Smoking Services: Service and delivery guidance 2014,” 2014. [Online]. Available: http://www.ncsct.co.uk/usr/pub/LSSS_service_delivery_guidance.pdf. [Accessed 31 October 2016].
  7. NICE, “Smoking: acute, maternity and mental health services (PH48),” November 2013. [Online]. Available: https://www.nice.org.uk/guidance/ph48. [Accessed 31 October 2016].
  8. “Making every contact count: practical resources,” Public Health England, 2016. [Online]. Available: https://www.gov.uk/government/publications/making-every-contact-count-mecc-practical-resources. [Accessed 28 September 2016].
  9. NICE, “Cardiovascular disease: identifying and supporting people most at risk of dying early,” September 2008. [Online]. Available: https://www.nice.org.uk/guidance/ph15. [Accessed 2 November 2016].
  10. NICE, “Smoking: stopping in pregnancy and after childbirth (PH26),” June 2010. [Online]. Available: https://www.nice.org.uk/guidance/ph26. [Accessed 2 November 2016].