Health authorities want to end the bizarre spectacle of patients in gowns, some with medical tubes hanging off their bodies, smoking on streets outside "smokefree" public hospitals.
But, not by asking politicians to ban smoking on public streets. Instead, they want all smokers who are admitted to hospital to be offered nicotine replacement therapy for the duration of their stay and afterwards if the patient wants to make an attempt to quit smoking long-term.
This is partly why the Government in May introduced the requirement that 80 per cent of hospitalised smokers be given advice and help to quit.
The date for compliance is July next year. The required percentage will rise to 90 the following year and 95 in 2012. And from next year, district health boards will be held accountable not only for their own hospitals' performance on providing better help for smokers, but also for GP clinics.
Performance in the first league table for July to September was generally dismal, mainly because it is a new target. Of the 21 district health boards, only Wairarapa exceeded 80 per cent.
Waikato came second on 39 per cent. Waitemata, which came 20th, blamed "technical issues around accurately collecting the data".
The Health Ministry's national director of tobacco control, Dr Ashley Bloomfield, said yesterday: "This [target] is one of the ways we are going to address the ongoing issues some hospitals have of patients having to go, often to the front entrance, where they very visibly have a cigarette.
"This is a significant addiction. In the first instance, we try to make sure any smoker in hospital is given nicotine replacement therapy so they don't smoke in hospital. We also want to help them make a quit attempt in hospital."
The target measures how many smokers are given a "brief intervention". This is a one- or two-minute discussion in which a hospital staffer, mainly a nurse:
* Asks if the patient smokes.
* Explains to smokers how harmful it is.
* Offers a referral to a quit-smoking service.
Dr Bloomfield said it had been established that for every 40 smokers approached in this way, one would be found to have remained smoke-free when checked at 12 months.
"If you add nicotine replacement therapy, you double the effectiveness."
He said the benefits of reducing smoking prevalence were immense.
Some 5000 deaths a year are related to smoking. Half of long-term smokers die prematurely, on average losing 15 years of life.
New Zealand
One DHB out of 21 meets 'quit smoking' target
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