Support for patients to stop smoking is set to be rolled out into clinical practice at North East Ambulance Service following a successful trial.
Between August 2023 and October 2024, NEAS paramedics proactively asked patients who smoke if they wanted to enter a trial to receive support to quit as part of the service’s efforts to improve health and reduce health inequalities across the region.
Following the trial, the service is now looking to introduce patient referrals to all local authority commissioned Stop Smoking Services across the region.
Smoking is the number one preventable cause of death, disability and ill health in the UK. It causes around 74,000 deaths in England every year, causes 1-in-4 of all cancer deaths and kills up to two-thirds of its long-term users. Smoking also drives huge pressures on emergency hospital admissions through diseases such as COPD, heart disease and stroke.
The North East has seen the largest fall in smoking in the country through efforts by local authorities and the NHS, from 29% of people in 2005 to 10.2% in 2024.
However, the region still highest hospital admission rate for conditions directly related to smoking and the lowest life expectancy of all English regions.
More than 125,000 people have died in the North East from smoking-related diseases since 2000.
Smoking also costs the North East around £1.99billion a year in healthcare, social care and lost earnings.
The NEAS trial sought to understand whether additional support from ambulance clinicians could improve take-up rates of smoking cessation services.
Between August 2023 and October 2024, patients who received a face-to-face ambulance contact in North or South Tees were asked about smoking and given a short explanation about the early benefits of quitting. Where a patient then asked for further support, the clinician made a referral to their local stop smoking service, where they were provided with nicotine replacement therapy or stop smoking medication.
Regardless of whether the patient was admitted to hospital or treated at home, they then received follow up support, either by their in-hospital tobacco dependency treatment team or local authority community stop smoking team.
Of the 140 patients who agreed to be part of the trial, 31 (22%) had quit when they were followed up 28-days later.
Of the remaining patients who had not yet quit when followed up, six were still being supported to stop, and 27 had no or intermittent access to telephone or internet connectivity so were unable to be contacted by the stop smoking teams.
Of the remaining 76 who had dropped out of the programme, there were a mixture of reasons – some changed their minds about quitting, some were too unwell with other illnesses to take up the offer, and some worried quitting would make them unwell.
Research paramedic Karl Charlton, who led on the study, said: “We know the people in our region – especially those living in areas of deprivation – are more likely to smoke, which obviously then impacts on their health. Smoking harms almost every part of the body, and can cause serious illnesses like lung cancer, heart disease, and breathing problems.
“As ambulance clinicians, we carry a position of trust, and so it’s important to us that we do all we can to improve the health of the population we serve. Ultimately, by helping them to stay well, we hope we can prevent them from needing to use our services.
“Our trial has shown that our patients are generally willing to be approached about making a quit attempt and are open to receiving help to do so when we talk to them about it. We’ve also shown that, by offering that extra help, we can support a significant proportion of patients to quit or at least try to quit.
“The trial also provided some additional information about the challenges people faced when attempting to quit, which we hope will be useful for improving smoking cessation offers going forward.”
Andrew Hodge, director of paramedicine, said: “Our ambulance crews are uniquely placed to reach patients who may not otherwise access health services. Whether they are taken to hospital or treated in their own home by our clinicians, just a simple conversation can make all the difference, and this trial is a great example of our role in a simple public health intervention.
“It’s exciting to see how this research can now be translated into clinical practice going forward and how we can play our part to help the people we serve to lead healthier lives.”
Ailsa Rutter OBE, Director of Fresh and Balance, said: “The region has made great strides in reducing smoking through the combined efforts of local authorities and our NHS in encouraging and supporting smokers to stop.
“However, tobacco is still our single biggest killer, driving disease and both acute and long stay hospital admissions. Many people who smoke would like to be able to quit – so providing options to quit at a time when a patient may be reflecting on health could be life changing.”
If you would like support to quit, visit https://