NHS staff smokers cost health service £200m a year with cigarette breaks and sick days, report finds

Lost productivity from smoking breaks alone cost £99m with total per smoker approaching £3,000 a year

Alex Matthews-King
Health Correspondent
Tuesday 26 June 2018 00:44 BST
Smoking breaks are discouraged in the NHS, but estimates suggest smokers have an additional 10 minutes of breaks a day
Smoking breaks are discouraged in the NHS, but estimates suggest smokers have an additional 10 minutes of breaks a day

NHS staff smoking habits cost the health service more than £200m a year in cigarette breaks, sick days and treatment, a report on the £1bn a year avoidable cost of tobacco dependency has found.

There are more than 73,000 smokers among the 1.2 million NHS employees in England and the lost working hours from their combined smoking breaks add up to £99m a year, the Royal College of Physicians’ tobacco advisory group has said.

Though smoking breaks are discouraged in the NHS, the report estimates smokers have an additional 10 minutes of breaks per day.

Smokers also had 56 per cent more sick days, amounting to £101m in NHS costs, and cost £6m in treating staff with preventable diseases caused by tobacco. In total, the RCP panel said, this amounts to £2,800 per staff smoker.

“The NHS has more incentive to do that than any other employer on the planet, and certainly in the UK, it doesn’t just lose the productivity it pays for the illness its employees develop,” Professor John Britton the chair of the RCP tobacco advisory group told The Independent.

These costs are “hiding in plain sight” and are in addition to the nearly £620m a year spent by NHS hospitals treating heart disease, lung cancer and other respiratory conditions caused by smoking, the report added.

”Smoking, the biggest avoidable cause of death and disability in the UK, is hiding in plain sight in our hospitals and other NHS services,” Professor Britton added.

“The NHS must end the neglect of this huge opportunity to improve our nation’s health.”

The report recommends that everyone be asked about their smoking status when coming into hospital as part of routine NHS care, and then be offered smoking cessation services unless they explicitly opt out. Trials of this opt-out model in hospitals in Canada were able to double quit rates.

This could be particularly important in mental health services where smoking costs the NHS £204m a year. People in long-term NHS care are much more likely to smoke and typically have worse physical health too, and about £28m is spent on additional drug costs for their treatment.

To achieve all this, the authors are calling for the NHS to take on responsibility for smoking cessation services and restore ring-fenced budgets for these schemes. These have been heavily cut in many areas after becoming the responsibility of cash-strapped councils in the last health service reforms.

Smoking cessation, which includes motivational counselling and support as well as pharmacological aids such as nicotine patches, is among the most cost-effective way of helping people quit.

The RCP also wants all NHS clinical staff to be trained in skills to help smokers quit and for hospitals to keep expanding smoke-free zones on NHS property, though it says ecigarettes, which can help smokers quit, should be allowed.

“This is an open goal for the NHS,” added Dr Sanjay Agrawal, a consultant in respiratory and intensive care medicine in Leicester and a member of the report group.

Duncan Selbie, chief executive of Public Health England, welcomed the “timely” report, adding: “One in four hospital patients are smokers, costing hospitals £1bn a year.

“We fully support the Royal College in saying by far the majority of the NHS could be doing more to help smokers to quit.”

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