Background The NHS Long Term Plan (LTP) aims to offer a package of behavioural support and Nicotine Replacement Therapy (NRT) to support smoking cessation for everyone identified as a smoker on admission to hospital. This includes mental health inpatients, acute inpatients, pregnant women, and their partners. This study aimed to describe services available in NHS settings prior to the LTP.

Methods We conducted a document analysis using the Template for Intervention Description and Replication (TIDieR) framework. The framework comprises twelve items that cover the rationale and procedures for intervention delivery, implementation settings. Documents included NHS trust smoking policies, delivery models and guidance for prescribing NRT. Documents were anonymised prior to analysis. After coding to the framework, data were summarised narratively. This was led by the first author and validated by the wider team.

Results We collected 31 documents from mental health, acute and maternity settings across the North East and North Cumbria, West Yorkshire, West Midlands and South West. Six of these were excluded due to not including enough information for the TIDieR framework, leaving 25 documents for analysis. Findings showed that pre-existing services within acute and mental health inpatient settings asked patients about their smoking status and provided Very Brief Advice (VBA). In some settings, patients were offered Nicotine Replacement Therapy (NRT) to aid in managing their nicotine withdrawals. In maternity settings, policies outlined a structured care/treatment pathway, where pregnant women would be offered access to a Smoke Free App and a referral to a stop smoking service. They would also be referred into a high-risk smoking scan clinic pathway where they would receive additional scans and 10 contacts. Patient facing staff within maternity services are required to undertake 2-day specialist training (including VBA, using Carbon Monoxide (CO) monitors and behavioural support).

Conclusion Current findings provide an insight into Stop Smoking Policies prior to the implementation of the LTP. Findings indicate variety in the available services provided, and suggest that maternity settings appeared to be the most developed treatment pathway. Therefore, other settings may face challenges to implementing the LTP due to the resources required to establish this service (e.g., staffing pressures, localising treatment pathways). Moreover, limited information existed concerning indicators/markers of service effectiveness. We will use these findings to provide context and inform our interpretation of the evaluation of the new NHS-funded tobacco dependence services delivered in England.