Birmingham outpatient clinics now offer stop smoking support at the point of care
University Hospitals Birmingham has widened access to stop smoking support across its outpatient pathways, bringing behavioral counseling and pharmacologic help directly into routine hospital visits. The service is funded by Birmingham City Council Public Health and is open to Birmingham residents attending UHB outpatient sites, with particular emphasis on respiratory, pre-operative assessment and cancer services. In practical terms, the intervention moves tobacco treatment away from a separate referral pathway and into the same setting where patients are already confronting symptoms, diagnoses, and treatment decisions.
The expansion covers Queen Elizabeth Hospital, Heartlands Hospital, and Good Hope Hospital. Patients can receive support face-to-face or by phone, and the program includes regular follow-up through the quit attempt. Free treatment options include nicotine replacement therapy and vapes, paired with specialist behavioral support. For a population with entrenched nicotine dependence, that combination matters because cravings, withdrawal, and habit loops often derail quit attempts long before motivation disappears.
Why hospital-based cessation support carries extra clinical weight
Smoking remains a major driver of preventable disease, and the hospital setting gives clinicians a rare opening to intervene when the medical consequences are already visible. Outpatient encounters tied to respiratory illness, surgery, or cancer care are especially relevant. In those settings, tobacco exposure can worsen airway inflammation, impair wound healing, reduce physiologic reserve, and complicate treatment response. Patients often recognize the harm in broad terms, but the direct connection between cigarettes and their own care plan can be especially persuasive when it is explained during a specialist appointment.
Councillor Nosheen Khalid described smoking as one of the biggest drivers of ill health and hospital admissions in Birmingham, and that framing aligns with the broader clinical burden seen across chronic disease services. Birmingham’s estimated adult smoking prevalence stands at 10.2%, while local hospital data show thousands of admissions each year linked to smoking-related illness, including COPD, pneumonia, lung cancer and cardiovascular disease. Those are not abstract public health numbers. They translate into exacerbations, delayed recovery, repeated admissions, and avoidable strain on already busy clinics.
Smoking cessation is one of the few interventions that can improve several downstream outcomes at once. It can reduce perioperative complications, improve tolerance of therapy, and lower the risk of ongoing tobacco-related injury after diagnosis. In oncology, abstinence may support treatment response and decrease the likelihood that patients arrive for procedures already physiologically compromised. In respiratory care, stopping smoking can ease bronchial irritation and reduce the cycle of inflammation that drives recurrent symptoms and hospital use.
How the referral model is designed to catch patients earlier
The service accepts referrals from UHB clinical teams, but it also allows self-referral by email. That dual route is important because not every smoker is identified in the same way during an outpatient visit. Some patients respond better when a clinician makes the referral in real time; others act only after receiving a direct invitation to engage. Eligibility is limited to adults aged 18 or older who are registered as UHB patients, live, work, or are registered with a GP within a Birmingham City Council ward, and currently smoke while being willing to attempt quitting.
This kind of embedded model reduces one of the most persistent barriers in tobacco treatment: the gap between advice and action. Many smokers know they should quit, but the logistics of finding a separate service can be enough to delay treatment indefinitely. Bringing support into outpatient clinics changes the default. The quit conversation happens where the medical need is already obvious, and the handoff to treatment can happen before motivation fades.
David Thickett, Professor of Respiratory Medicine and Clinical Lead for Tobacco Addiction Cure Team at University Hospitals Birmingham Foundation NHS Trust, tied the service to a familiar clinical truth: smoking drives cardiovascular and respiratory disease, cancer, and poorer outcomes after both medical and surgical treatment. The biology is straightforward. Tobacco smoke injures the endothelium, promotes inflammation, impairs mucociliary clearance, and increases thrombotic risk. Those effects accumulate over time, but the consequences are often seen first in the clinic, where patients struggle to recover as expected.
Bedside consequences in respiratory, surgical, and cancer pathways
Respiratory services are likely to feel the most immediate benefit because smoking perpetuates the very inflammation and airway damage that these clinics spend so much time treating. For patients with COPD, cessation can reduce ongoing lung injury and may lower the likelihood of future exacerbations. For surgical patients, abstinence before a procedure can help reduce complications tied to poor tissue oxygenation and impaired healing. For oncology patients, a quit attempt may improve the ability to tolerate treatment and recover from therapy-related stress.
The service is also available to NHS staff through the outpatient and staff clinic pathway, which adds another dimension to the program. Clinicians and support staff are not immune to nicotine dependence, and accessible treatment can help remove the stigma and inconvenience that often keep healthcare workers from seeking help. When a hospital normalizes cessation treatment for its own workforce, it sends a signal that tobacco dependence is a treatable clinical condition, not a moral failing.
A final practical detail stands out: patients are not being asked to navigate the system alone. They can receive follow-up, tailored behavioral support, and medication access in a format that fits around outpatient care. That combination is likely to matter most for people with long smoking histories, high stress burdens, and repeated contact with healthcare services, where quitting may feel both necessary and daunting.
The program’s success will depend on uptake, retention, and sustained abstinence across the outpatient population, but the service now exists at the point where hospital medicine, preventive care, and addiction treatment meet.