Smoking cessation on discharge summaries

To the Editor: With the increasing interoperability of electronic medical records across health services, smoking and e‐cigarette use need to be systematically collected on hospital admission, and advice to quit smoking should be automatically included on hospital discharge summaries. Including information on smoking status in the discharge summary, and ultimately on My Health Record, presents an opportunity to address the use of tobacco and e‐cigarette products — the first being Australia's leading cause of preventable death and disease and the second an emerging exposure of increasing concern.1

Evidence from the United States Surgeon General reports that smoking cessation after cancer diagnosis lowers the risk of dying by 30–40%.2 For some patients with cancer, cessation benefits are equal to or exceed the value of state‐of‐the‐art cancer therapies. In addition, the Surgeon General report shows most patients admitted to hospital wish to quit smoking,2 and there are proven, workable but underused interventions to cease smoking.

Peak medical bodies such as the Australian National Health and Medical Research Council and the Australian Commission on Safety and Quality in Health Care3 advise that adherence to post‐hospital referral practice guidelines leads to better outcomes, fewer readmissions, and improved patient survival. Australia's National Preventive Health Strategy has a goal of reducing the adult smoking prevalence from 14% to 5% over the next 8 years.4 The newly released draft National Tobacco Strategy includes key policy actions to increase the use of cessation services and to support people who use tobacco and e‐cigarettes to quit.5

Around 1.2 million Australian adults are admitted to hospital at least once each year, and it is estimated that about one in five of them would benefit from smoking cessation services.6 Given most hospitalised patients want to quit smoking, providing this recommendation in a discharge summary for appropriate referral to a Quitline (www.quit.org.au) or a general practitioner is a practical solution to provide best practice care to patients, reduce the risk of readmission to hospital, and increase their survival.