I’m Rebecca and I am a Tobacco Dependence Advisor at South London and Maudsley. I have worked in Public Health for nearly eight years with a background mostly in nutrition and weight management. However, soon after joining the NHS, it wasn’t long before I added smoking cessation work as another valuable string to my bow.
I have been based at the Bethlem Royal Hospital site for nearly three years where I work with inpatients across our specialist PMOA wards. I’m supported by a wider team of colleagues across our acute, forensic and CAMHS services.
Smoking remains the biggest preventable cause of premature death in the UK. It increases the risk of developing a long spectrum of serious physical health conditions including a range of cancers, heart disease and stroke. It exacerbates mental health conditions and adds to financial hardship. On average, the life expectancy of a smoker is ten years less than that of non-smokers.
Unfortunately, rates of smoking amongst mental health patients remains significantly higher than amongst the general population. Our team is stoic in its mission to reduce this inequality, and we have a collective aim of reducing our inpatient smoking rates across South London and Maudsley hospitals to just 15% by 2030. Tobacco is often used as a vehicle for other illicit substances, so this is an added focus across our work also.
As a team, we’re no strangers to resistance; our opening conversations can be challenging with patients feeling defensive, or anxious they’ll be forced into quitting. Our first priority however is to make patients comfortable whilst in our smoke free environment. Most of our smokers quickly understand that our service isn’t punitive and that we’re here to help. Once we have these positive relationships established, our work towards achieving a successful quit journey can properly begin.
Due to the nature of the PMOA wards, my patients are mostly long stay admissions. This allows me to work closely with them to overcome the physical dependency to nicotine (by offering a range of nicotine replacement therapies) and provide ongoing behavioural support.
Most of our smokers recognise that their daily routines are punctuated with cigarettes; it’s important we help to plan alternative activities to smoking and productive ways in which to spend smoke free leave. We’re particularly keen to promote other areas of wellbeing and aid our patients in taking advantage of the Bethlem’s spacious grounds, and to engage with nature. Smokers regularly participate in our smoke free wellbeing walks and make use of our outdoor gym spaces.
Over the last year, we have also begun encouraging our patients to be mindful about their smoking behaviours and the impact on the environment. Cigarette butts are made from plastic fibres and take up to ten years to decompose, yet over 4 trillion cigarette butts continue to be littered annually - this contributes to more global plastic pollution than plastic bottles and straws combined. Some of our smokers reject traditional motivations (such as health and money) to quit but have been receptive to conversations about the impact of cigarette butt littering on wildlife, oceans and green spaces.
Currently, the Smoke Free team will be promoting the annual, nationwide event of “Stoptober” with a series of events, talks and giveaways running across each of South London and Maudsley’s four sites. Stoptober is aimed at encouraging smokers to abstain from cigarettes for 28 days with the aim of stopping smoking permanently – research has shown us that if a smoker can quit for four weeks, they’re more likely to quit for good!
The Smoke Free team are always very happy to extend their support to both patient and staff smokers and would welcome visits to any of our Stoptober events this month.
If you’d like to find support close to home, you can find your nearest smoking cessation service here or for support in the palm of your hand, you can also download the NHS Quit Smoking app on your smartphone.
What are our top three smoke free tips?
Don’t Go it Alone
Did you know that if you have the support of a smoke free advisor, you’re 4x more likely to have a successful quit attempt? Reach out to your local, free NHS service who can help you with both an NRT and behavioural support plan, and be your cheerleader along the way. If there are smokers in your family or social circle, be open about your quit aims and ask them to respect your journey.
One Size Doesn’t Fit All
Everybody’s smoking cessation endeavours will be different. Finding a workable set of distraction techniques to help keep your hands off a cigarette may take some tweaking; it’s normal for quitters to experiment with everything from running to knitting, and cleaning to origami! Your smoke free advisor will help you expand on your own ideas and find what you enjoy best.
Be Kind to Yourself
Even talking about quitting smoking is a really positive first step. We know that moving away from cigarettes is hard and you’re allowed to feel fed up along the way. Keep reminding yourself of your motivations and recognise that you can keep going even if you suffer a momentary blip in your quit plans. Why not try setting aside the money you’d usually spend on cigarettes for one month? Once the month is over, you can use this saved cash for treats you might not have previously been able to afford. Congratulating yourself on your achievements will help you stay on a smoke free path!