by Faye Norman

Poster Download

Background & Problem:

1 in 4 people presenting to hospital smoke and over half a million acute hospital admissions are directly linked to smoking. Despite this, the National Smoking Cessation Audit 2019 and baseline data from our ED showed that many people are not having their smoking habits addressed by healthcare professionals.

For some patients, an admission to ED with an illness can be a sobering experience, thus presenting a good opportunity for beneficial intervention. If discharged, ED clinicians may be the first or only medical professional they see regarding this.

Very Brief Advice (VBA) is an effective way of offering smoking cessation advice and support to patients. It is used by General Practitioners within their time-pressured consultations, presenting a solution for similar constraints in ED.


To improve the number of patients having their smoking habits addressed when presenting to the Emergency Department with smoking related diseases by 50% in 4 months.


  1. Meetings with team members to develop ideas on change concepts.
  2. Departmental and “on-the-spot” teaching sessions.
  3. Personalised emails to different staff group members.
  4. “Message of the Week” and reminder prompts around ED.

Increasing availability of written information for patients.


  • Education measures showed an improvement, but these were difficult to maintain, thought to be due in part to the natural high turn-over of staff in ED.
  • Maintaining availability of written information was difficult despite discussion with senior staff.
  • Increased visibility and reminder prompts throughout ED had a positive effect.

Lessons Learnt:

Ensuring effective and sustainable education measures, especially in areas of high staff turn-over, is difficult and requires consideration at the start of the project.

Next steps:

  1. Discussion with the senior team about strategies to incorporate education into induction sessions for junior doctors.
  2. Involvement of permanent staff within the department.
  3. Continued information sharing with staff on a regular basis.

Quality Improvement Presenter
Faye Norman, Trust Grade Doctor
Quality Improvement Team
Melanie Hamilton, F2 Doctor in tED
Alex Zervudachi, F1 Doctor in ED
Sam Hawkins, F1 Doctor in ED
Phoebe Kapumba, Smoking Cessation Link Nurse in ED
Gold Coach: Helen Mansfield, Emergency Medicine Consultant