From Department of Health
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Today, the Minister for Health, Stephen Donnelly TD, and the Minister for Public Health, Well Being and National Drugs Strategy, Frank Feighan TD, welcome the publication of a new National Clinical Effectiveness Guideline to help healthcare professionals assist adults to Stop Smoking.
This new guideline was developed by a multidisciplinary Guideline Development Group led by the HSE Tobacco Free Ireland Programme. The guideline development group was chaired by Dr Paul Kavanagh.
Tobacco use is the leading cause of preventable death, disease, and disability worldwide, with the World Health Organisation (WHO) describing it as one of the biggest public health threats the world has ever faced. More than 8 million people worldwide die each year as a direct result of tobacco use or from exposure to second-hand smoke.
Tobacco Free Ireland is current government policy, and the second such policy dedicated to tobacco control. While Ireland is recognised internationally as having in place strong tobacco control measures across a wide range of areas, to this point there has been no national clinical stop smoking clinical guidelines. Tobacco Free Ireland makes the specific recommendation that comprehensive national smoking cessation guidelines should be developed. The development of these guidelines has been a priority action in the HSE TFIP Programme Plan 2018-2021.
Smoking causes death and disability on a large scale and it is well documented that cigarette smoking has been causally linked to diseases of nearly every organ of the body, to diminished health status and to foetal harm.
The Healthy Ireland Survey 2021 reported that 18% of Irish adults (aged 15+ years) currently smoke; 16% smoke daily and 2% smoke occasionally. Within the under-25 age group, men are significantly more likely to smoke than women (19% and 11%, respectively). In previous surveys smoking rates were highest among those aged 25-34, for the first time in this survey those aged 45-54 smoked the most.
The development of this Guideline on Stop Smoking is a major step forward. It will strengthen the identification and treatment of tobacco addiction by health professionals across service settings. It will define best practice for care of people who smoke in the general adult population, as well as providing a special focus on helping women who are pregnant and users of secondary mental health services.
NCEC National Clinical Guideline No. 28 was quality assured by the department’s National Clinical Effectiveness Committee (NCEC). This guideline has received Ministerial endorsement to be implemented across the health service.
Welcoming the publication today, Minister Donnelly said:
“I am pleased to endorse this National Clinical Guideline in relation to Stop Smoking to help support safe, high-quality care for adults in contact with health services who are current smokers. Ireland is recognised worldwide as a leader and innovator in tobacco control. Our national tobacco control policy, Tobacco Free Ireland, contains over 60 recommendations to bring us closer to our goal of becoming a tobacco free society.
“This National Clinical Guideline is not only an important resource for our health professionals to assist those who wish to quit smoking but it is also a recognition of the significant public health harms caused by tobacco use and a signal of our continued commitment to reduce and ultimately eliminate those harms. The development of this National Clinical Guideline on Stop Smoking is a major step forward in that it will strengthen the identification and treatment of tobacco addiction by health professionals across both primary and secondary care settings.”
Minister Feighan said:
“With the Tobacco Free Ireland policy as our guide, we are using evidence-based approaches to remove the visibility of tobacco products from everyday life and to protect our children from the effects of smoking. We must use all of the interventions at our disposal – legislative, policy, cessation aids and taxation measures – to support people to quit smoking and prevent smoking initiation.”
Dr Tony Holohan, Chief Medical Officer said:
“I greatly welcome this latest National Clinical Guideline, which was developed by a multi-disciplinary Guideline Development Group, led by Dr Paul Kavanagh and supported by the HSE Tobacco Free Ireland Programme. Making the evidence available in an accessible way to healthcare professionals is critical in enabling evidence-based practice and safe, high quality patient care.
“The guideline has been quality assured by the National Clinical Effectiveness Committee in line with international best practice and has undergone public consultation and international expert review. Ireland now has comprehensive, high-quality evidence based clinical guidelines to support healthcare professionals and citizens as we move towards our Tobacco Free Ireland target.”
Ms Rachel Kenna, Chief Nursing Officer acknowledged:
“The impact of tobacco use as a leading cause of preventable death, disease and disability worldwide; and the 2021 Healthy Ireland survey still reported significant rates of smoking in adults. The development of this national clinical guideline is welcomed to further support best practice care for people who wish to stop smoking. I would like to acknowledge the work of all involved to make these guidelines available for people in Ireland who wish to stop smoking."
Dr Paul Kavanagh, Chair of the Guideline Development Group and Public Health Medicine Specialist, HSE said:
“Smoking is the leading preventable cause of disease, disability and premature death in Ireland. People who smoke are worried about the impact it has on their lives and their loved ones. Most want to stop smoking but too many try to stop without support. Yet there are three simple but powerful steps which every healthcare professional can take to maximise the chance that someone who smokes can successfully stop - asking about smoking, offering advice to stop, and providing practical support through arranging referral to a stop smoking advisor and stop smoking medicines.”
Dr Kavanagh continued:
“These new National Clinical Guidelines describe the evidence-based best practice for healthcare professionals providing people help to stop smoking. For people who smoke, the guidelines give certainty on the safe, good quality care they can expect. Because of the robust and comprehensive guideline development process overseen by the National Clinical Effectiveness Committee, both healthcare professionals and people who smoke can have confidence that the recommendations are safe, clinically sound and most of all work. We look forward to working with healthcare professionals and the public to implement these guidelines in day-to-day practice across the health services and working with them towards a Tobacco Free Ireland.”
The Minister for Health, Stephen Donnelly congratulated the Guideline Chair, the Guideline Development Group and all who worked to bring this guideline to final publication today so that the guideline is available for healthcare professionals to use in patient care.
The National Clinical Effectiveness Committee (NCEC) provides leadership for clinical effectiveness through prioritisation and quality assurance of National Clinical Guidelines and National Clinical Audit. Twenty-seven NCEC National Clinical Guidelines on a range of conditions and healthcare processes have already been published. Extending, updating, and implementing the suite of NCEC guidelines remains a priority of national health policy.
The guidelines will be available at the following link after 3pm Wednesday: https://www.gov.ie/en/collection/c9fa9a-national-clinical-guidelines/
Clinical effectiveness is a key component of patient safety. The integration of best evidence in service provision, through clinical effectiveness processes, promotes healthcare that is up to date, effective and consistent. Clinical effectiveness processes include guidelines, audit and practice guidance.
1. Provide strategic leadership for the national clinical effectiveness agenda.
2. Contribute to national patient safety and quality improvement agendas.
3. Publish standards for clinical practice guidance.
4. Publish guidance for National Clinical Guidelines and National Clinical Audit.
5. Prioritise and quality assure National Clinical Guidelines and National Clinical Audit.
6. Commission National Clinical Guidelines and National Clinical Audit.
7. Align National Clinical Guidelines and National Clinical Audit with implementation levers.
8. Report periodically on the implementation and impact of National Clinical Guidelines and the performance of National Clinical Audit.
9. Establish sub-committees for NCEC work-streams.
10. Publish an Annual Report.
Further information about the NCEC and National Clinical Guidelines is available at: https://www.gov.ie/en/publication/90221b-clinical-effectiveness/
Internationally the WHO reports that more than 8 million people die each year as a result of tobacco use; more than 7 million of these deaths are as a direct result of smoking, with approximately 1.2 million deaths among non-smokers as a result of exposure to second-hand smoke (SHS).
Smoking causes death and disability on a large scale and it is well documented that cigarette smoking has been causally linked to diseases of nearly every organ of the body, to diminished health status and to foetal harm.
It is estimated that 6,000 deaths per year in Ireland were attributed to smoking (1-in-5 of all deaths) in recent years. In 2016, there were an estimated 55,000 hospital episodes (day case & inpatient) in publicly-funded hospitals attributable to smoking and exposure to SHS.
The Healthy Ireland Survey 2021 reported that 18% of Irish adults (aged 15+ years) currently smoke; 16% smoke daily and 2% smoke occasionally. Within the under-25 age group, men are significantly more likely to smoke than women (19% and 11%, respectively). In previous surveys smoking rates were highest among those aged 25-34, for the first time in this survey those aged 45-54 smoked the most.
In 2005, Ireland ratified the WHO Framework Convention on Tobacco control (WHO FCTC). Article 14 addresses demand reduction measures concerning tobacco dependence and cessation and it requires that “each party shall develop and disseminate appropriate, comprehensive and integrated guidelines based on scientific evidence and best practices, taking into account national circumstances and priorities, and shall take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence.”
Tobacco Free Ireland is current government policy, and the second dedicated to tobacco control.
Stop smoking services are key to a comprehensive approach to tobacco control and Ireland’s goal of becoming tobacco free by 2025 is critically dependent on accelerating progress with smoking cessation.
The development of this Guideline on Stop Smoking is a major step forward. It will strengthen the identification and treatment of tobacco addiction by health professionals across service settings. It will define best practice for care of people who smoke in the general adult population, as well as providing a special focus on helping women who are pregnant and users of secondary mental health services and ensure that people who smoke across the country receive consistent and standardised care, based on the best available evidence.
The 2022 QUIT campaign commenced in January 2022. The HSE Quit service provides practical personalised support to help people stop smoking for 28 days and beyond.
There are many different ways to get help to quit from the Quit Service:
Further information about the HSE Tobacco Free Ireland programme is available at: https://www.hse.ie/eng/about/who/tobaccocontrol/national-clinical-guidelines/