Sussex patients on surgical waiting lists are successfully giving up cigarette smoking and improving their outcomes from surgery thanks to a national initiative called Swap2Stop.
Delivered locally by UHSussex clinicians, the positive impact of Swap2Stop in Sussex recently received national recognition during a visit to Worthing Hospital from senior NHS England leaders.
The service works by providing tobacco smokers who are awaiting surgery at our hospitals with support to quit. This includes a free reusable vape starter kit with a four-week supply and targeted advice, which is now one of the most popular and effective ways for adult cigarette smokers to transition to a smoke-free life.
The service is offered through the trust’s pre-operative assessment units and patients are supported by a trained team of pre-operative nurses and anaesthetists.
How does Swap2Stop work?
Swap2Stop aims to help patients quit cigarette smoking to improve their outcomes from surgery. Being on a waiting list for surgery often provides patients with additional motivation to make positive health changes and quit cigarette smoking. Delivered in partnership with West Sussex Public Health and software provider Netcall, the service has been designed to make these healthier choices easier for patients.
Alongside long-term health benefits, stopping smoking before surgery reduces complications and speeds up recovery. It reduces the risk of post-operative complications such as infections and delayed wound healing. It reduces the likelihood of an ICU admission, prolonged hospital stays and the need for future emergency treatment. Additionally, it reduces the risk of procedures needing to be cancelled, which can happen when patients are not in an optimal condition for surgery.
The initiative is particularly significant as tobacco smoking is disproportionately prevalent in the most deprived communities and is a major driver of health and economic inequalities. Swap2Stop has been designed so that it can be widely accessed by patients digitally via the NHS App. This means that support can reach patients across Sussex, including those experiencing deprivation.
Early results from the service are encouraging. 65 per cent of patients that register attempt to quit smoking tobacco. Of those that make an attempt, 45 per cent successfully quit ahead of their surgery.
Dan Rennie-Hale, Director of Clinical Outcomes & Effectiveness at University Hospitals Sussex NHS Foundation Trust, said:
“Swap2Stop is making a real difference for patients because it offers support at a point when it can have a direct impact on their treatment and recovery. Smoking before surgery increases the risk of complications and can make recovery slower and more difficult, so helping people to quit ahead of their operation is an important way to improve outcomes. It has also been really encouraging to see how positively patients have responded. The support is simple, practical and offered at the right time, when patients can see the value of making a change that will help them through surgery and beyond.”
Brighton mum gives up smoking for good thanks to Swap2Stop
Jade Spence, a 33-year old mum from Brighton, has quit smoking with support from Swap2Stop as she prepares for upcoming gallbladder removal surgery.
Jade was placed on a waiting list for surgery after experiencing acute gallbladder pain. During her initial consultations, she was offered support to stop smoking, including access to a vape and online support services via the NHS App designed to help her quit ahead of her procedure.
Jade says accessing the vape online was straightforward and that it has played a key role in helping her transition away from cigarettes. Jade recognises that using the vape is as a healthier alternative, particularly in the lead-up to her surgery, and sees it as a stepping stone towards becoming completely nicotine-free in the future.
The scheme has already had a significant impact. Jade has now stopped smoking entirely and says cigarettes no longer appeal to her.
“It was really easy to get started, and the support has made a big difference,” she said.
“I’ve completely stopped smoking now – I actually think cigarettes taste awful. I’m hoping I’m off them for good.
“I feel optimistic about the whole process and using the vape has really helped me get to this point.”
NHS England leaders visit Swap2Stop at Worthing Hospital
The growing impact of the service in Sussex was recently recognised during a visit to Worthing Hospital by NHS England leaders, Dr Dianne Addei, Director of Healthcare Inequalities Improvement, and Sarah Price, Director of Public Health. Dianne and Sarah met UHSussex staff delivering Swap2Stop and heard how the model is helping patients before surgery while also tackling wider health inequalities.
Swap2Stop is also part of the government’s ‘Smokefree’ campaign. It aims to reach people in communities most affected by health inequalities, where smoking remains one of the biggest causes of preventable ill-health.
NHS England’s Director of the National Healthcare Inequalities Improvement Programme, Dr Dianne Addei, said: “Smoking cessation is a central element of our national Core20PLUS5 approach to reducing healthcare inequalities, so I was delighted to visit Worthing Hospital to see first-hand how the innovative Swap2Stop service is making a real difference, helping patients quit smoking through practical support and tailored advice.
“This scalable approach not only improves surgical outcomes and recovery but also strengthens long-term health in the communities most affected by inequality. It also demonstrates how digital tools, such as the NHS App, can drive prevention.”
The service also reflects the NHS’s wider shift towards prevention and earlier intervention, and a focus on care pathways that support healthier lives. That approach has been set out in the government’s plans for the NHS, which include a greater focus on prevention and use of digital tools to support patients earlier. Swap2Stop in Sussex is a local example of how that can work in practice.