1. Our Smokefree Trust: 4 April 2016 Chris Packham, Associate Medical Director Heather Thomson, Project Lead Mandy Whalley, Senior Project Manager

2. 2  Smoking is the largest single cause of patients with severe mental illness living 15-18 years shorter lives  50% all Mental Health Trusts now implementing PH48.  We are NOT telling people they must stop smoking, just that they cannot smoke whilst on our premises  2 things which makes it so hard for smokers to stop: ○Nicotine addiction (nicotine is the least harmful of the 4,000 chemicals in tobacco smoke) “People smoke for the nicotine but die from the smoke” ○Habit OUR culture of smoke breaks worsens this  Nicotine addiction creates a cycle of stress, it does not relieve stress

3. 3 Planning  We are listening very carefully  We are learning from other places

4. 4 We will have...  Inpatients: ○Access to sufficient NRT to ensure comfort ○we need leadership support to ensure enough inpatient staff are able, trained and confident (at least 50% before April) ○Brief Intervention training for ALL staff ○Increased ward and site based meaningful activity  Outpatients and staff ○Access to smoking cessation services, including on- site, and support in the community

5. 5 Remember lessons from before  It’s not the first time we have gone ‘smoke-free’ and we have learned lessons ○Consistency ○Communication +++  No exemptions ○ any uncertainty makes it confusing and dangerous for patients and staff who are managing this change  Approach for staff will be consistent

6. 6 E-cigarettes  Difficult position  Consistent approach from Forensic: all three Trusts with High, Medium and Low Secure Hospital estate: No e-cigarette use on safety grounds  Non-Forensic services may allow e-cigarette use by inpatients ○Leicester ○Maudsley  E-cigarette use NOT in public areas  All community patients who smoke encouraged to use them

7. 7 This isn’t just about smoking  Recovery focus  Meaningful activity  Genuine parity of esteem  No justification for our historical approach  But this is a journey and we must be sensitive and patient

8. 8 Next….  Regular updates  Ongoing programme of consultation  Policies updated  Phone and email enquiries for questions Heather.Thomson@nottshc.nhs.uk Mandy.Whalley@nottshc.nhs.uk Chris.packham@nottshc.nhs.uk smokefree@nottshc.nhs.uk