New Zealand leads the way in helping patients stop smoking

New Zealand leads the way in helping patients stop smoking

The New Zealand policy of mandatory collection of the smoking status of every health service patient, as well as support to stop smoking, has been trialled in a pilot project in Australia.

Based on the New Zealand model, where it is compulsory to ask, record and report on the smoking status of every patient admitted to hospital, seven sites across Victoria introduced the Supporting Patients to be Smokefree Project which collected data from December 2013 to June 2014.

ANZCA Fellow anaesthetist Dr David Bramley led the pilot at Western Health in Victoria, where he is deputy director of the department of anaesthesia and pain medicine.

He believes all Australian states should look to the New Zealand model and ask all patients about smoking status and to offer advice and support to stop smoking as early as first presentation.

“New Zealand has led the way with the Ministry of Health’s Guidelines for Helping People to Stop Smoking, which set a goal of reducing smoking and tobacco availability to minimal levels, with the aim of essentially making New Zealand smoke free by 2025,” Dr Bramley said.

In 2013, 15 per cent of New Zealanders smoked tobacco every day and the rate was higher among Māori (33 percent) and Pacific peoples (23 percent). Every year 500 people die in New Zealand from smoking-related diseases.

The New Zealand Guidelines provide health care workers with advice they can use when dealing with people who smoke.

“This is something health care workers in Australia are keen to do as well, but it isn’t possible unless we ask the direct question of whether a patient is a smoker or not.”

New Zealand’s policy is in keeping with ANZCA’s finalised guidelines on smoking which state “ANZCA ... recognises that the perioperative period represents a ‘teachable moment’ when many smokers quit or attempt to quit smoking, sometimes permanently”.

The guidelines have been released to coincide with National Anaesthesia Day today (October 16) with the theme “Stop smoking before your anaesthetic”.

It is aimed at spreading the simple message that it is never too late to stop smoking before your operation to reduce your risk of surgical complications.

“Anaesthetists care for patients before, during and after surgery. Helping them stop smoking is one of the many things we can do to improve both surgical and general health outcomes,” Dr Bramley said.

An individual’s surgical journey often involved multiple visits to hospital, which gives us a perfect opportunity to educate patients and support them to stop smoking.

“Asking patients at pre-admission, arming them with facts and linking them to appropriate supports can help cut smoking rates.

“People are very vulnerable at the time of surgery and are more likely to make decisions that will help their recovery.”

Smokers run an increased risk of cardiac and respiratory complications during their operations and are more likely to suffer poor healing and wound infections, Dr Bramley said.

“There are lots of opportunities to intervene – there are 300,000 elective surgeries every year in Australia and New Zealand.

“Anaesthetists have a powerful role to play in reducing smoking rates and improving the health of the population,” he said.

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