Debbie has co-developed treatment pathways, staff training, and smokefree policies with mental health Trusts. She leads a programme of research on tobacco dependence treatment in acute and mental health services in Southeast London and collaborates with the NIHR Policy Research Unit in Addictions, on a national evaluation of the new annual £70 million investment in community stop smoking services. Her work focuses on groups often excluded from mainstream tobacco control, with particular interest in vaping’s role in supporting quitting among high-prevalence populations and in assessing its harms compared with smoking. She is a trustee of Action on Smoking and Health.

Abstract

Improving the uptake and outcomes of tobacco dependence treatment in hospitals

Tobacco dependence treatment in hospitals has expanded rapidly under the NHS Long Term Plan, which required all acute, maternity and mental health hospitals to provide services by March 2024 at the latest. Between 2022 and 2025, 600,000 people who smoke were identified on admission to acute hospitals and 20,000 in mental health. Of these, 112,530 acute patients and 1,685 mental health patients were supported by a Tobacco Dependence Advisor, with quit rates of 18% and 42% at four weeks. In early 2025, the government instructed Integrated Care Boards (ICBS) to halve their running cost budgets. The cuts are already leading some ICBs to decommission hospital stop smoking services. The full impact is not yet clear, but there is a real risk to both sustainability and equity, particularly for people with the highest smoking rates. In this presentation, Debbie will draw on a decade of research developing, implementing, and evaluating hospital services to share lessons learned, explore differences in outcomes among people with different health conditions and highlight what it will take to sustain progress. The challenge now is not whether hospital-based tobacco treatment works, but whether the system will allow it to continue.