NHS hospitals have been advised to ban smoking on their premises and prohibit staff from facilitating patients who want to smoke, according to new guidance.
All hospitals should have an on-site stop-smoking service and staff should be instructed not to assist patients who want to smoke.
Measures should be implemented to help patients stop smoking while they are being cared for and “preferably help them to stop for good”, the National Institute for Health and Care Excellence (Nice) said.
While individual NHS trusts will have the final say, staff and people using NHS services, including clinics, should be told not to smoke on the hospital grounds, Nice said.
Trusts should ensure “there are no designated smoking areas, no exceptions for particular groups and no staff-supervised or staff-facilitated smoking breaks for people using secondary care services”.
Professor Mike Kelly, director of the Centre for Public Health Excellence at Nice, described the guidance as a “culture shift” as opposed to creating a "penal culture" and said it is needed to end “the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances”.
“It's clearly absurd that the most lethal set of toxins to the human body are being passively encouraged in hospitals”, he said.
“We've known since the 1950s that smoking kills you and 61 years have passed and we're now tackling the problem in hospitals. That's too long.
“Smoking is the most important health problem facing the NHS. It's the leading cause of premature death in England: nearly 80,000 lives are lost each year due to smoking."
Figures released by Nice suggest continuing to smoke throughout pregnancy has contributed to up to 5,000 miscarriages and still-births and increases the risk of a premature labour.
The figures also show patients with mental health issues are more likely to smoke. One in five people in the general population smoke, but this figure rises to one in three among people who have long-term mental health issues. Seventy per cent of patients in psychiatric units smoke.
Professor Sue Bailey, president of the Royal College of Psychiatrists, said: “There is a common but mistaken belief among some mental health professionals that it's all right for patients in their care to smoke.
”This is wrong. Patients with mental health problems are far more likely to smoke than the general population, they suffer disproportionately higher rates of physical illnesses and they die earlier."
Dr Keith McNeil, chief executive of Cambridge University Hospitals NHS Foundation Trust, is backing the initiative and said smoking will not be allowed anywhere on its grounds from the New Year.
He said: "I have spent a large part of my professional life dealing with the terrible effects of smoking: deaths from cancer, emphysema and lung transplantation. As well as this, smoking costs the NHS and society billions of pounds each year.
“As a leading healthcare organisation we should be encouraging a healthy lifestyle, and smoking is not part of that. I know how hard it is to quit and I want to do everything I can do to support staff and patients to give up."
However, smokers lobbying group forest said banning patients from smoking outside was "heartless and inhumane" and argued it would be impossible to enforce without installing CCTV cameras and wardens to monitor the area.
"Many smokers are in hospital for reasons that have nothing to do with smoking. Why should they be told they can't nip outside and have a cigarette in the open air?
"Tobacco is a legal product and a lot of people smoke to relieve stress. A cigarette break at work or while they are in hospital is something they look forward to."
Additional reporting by Press Association