A NEW national study shows NHS inpatient tobacco dependency services are increasing supported quit attempts among patients from deprived areas, although successful quits remain lower than in wealthier populations.
Smoking remains a major driver of health inequalities, with people from deprived areas more likely to be admitted to hospital and less likely to achieve long-term cessation. The NHS introduced an opt-out model of inpatient tobacco dependency treatment to address this disparity, offering all admitted smokers support unless they explicitly decline.
Tobacco Dependency Support Reaches Most Deprived Populations
The study, covering 111 acute hospital trusts in England and over 243,000 admissions in 2024, found that patients from the most deprived quintile were more likely to engage with inpatient support. Adjusted analysis revealed 24.8% of patients in the most deprived group made a supported quit attempt, compared with 18.3% in the least deprived quintile. These findings suggest the opt-out service successfully reaches populations at highest risk of smoking-related complications.
Quit Success Still Uneven Across Deprivation Levels
Despite higher engagement, quit success followed a different pattern. Patients from the least deprived quintile were most likely to quit successfully (25.3%), while success in the most deprived quintile lagged at 16.0%. The gradient underscores the complex interplay between socioeconomic factors and sustained cessation, even when treatment access is equitable. Clinicians should be aware that initiation of quit attempts is only the first step; tailored follow-up support may be required to improve outcomes in deprived populations.
Clinical Implications for Acute Care Teams
For hospital-based clinicians, the study highlights the effectiveness of opt-out tobacco dependency interventions in encouraging quit attempts across all social groups. However, the gap in quit success indicates further strategies, such as intensified behavioural support, pharmacotherapy adherence monitoring, or post-discharge follow-up, could help reduce inequalities. By combining universal access with targeted support, acute care teams can enhance the public health impact of inpatient tobacco services.
Reference
Agrawal S et al. Is the provision of a national opt-out tobacco dependence treatment service in acute hospitals in England equitable? A national cohort study. Thorax. 2025; DOI:10.1136/thorax-2025-223890.
