This Stoptober Sarah Keeling, Strategic Lead for Tobacco Dependence Treatment Services, shares why she works in this field, her aspirations for a smoke free future and why she’s on a mission to help people quit, one cigarette at a time.
Sarah Keeling, Strategic Lead for Tobacco Dependence Treatment Services
“I’ve been at the trust since 2014, previously as a midwife specialising in public health, and working in tobacco dependence treatment services since January this year. It’s challenging but I see it as a commitment to improving lives. I’m known as ‘the smoking lady’ or ‘the one with the pens’, as I always have a pen with a stop smoking slogan to give out. I know it’s a cliché, but honestly, everyone loves a free pen! I will talk to anyone who will listen about the service, and even those who won’t, because every cigarette smoked chips away at someone’s health.
“Tobacco is still the leading cause of preventable illness and death worldwide, and helping people quit is one of the most impactful things I can do. I chose this field because I have seen how addiction to tobacco can control lives, diminish health and burden families and healthcare systems. But I’ve also seen the powerful transformation that happens when someone takes control, quits smoking, and starts to reclaim their future.
“Hospitals, by their very nature, are places of healing. Yet, for decades, tobacco use – whether through the provision of designated smoking areas or in overlooked relapses – has quietly persisted in healthcare settings. An inpatient stay is often a teachable moment, a critical point where people are acutely aware of their health and mortality. It’s a time when patients may be more receptive to change, particularly when faced with a health event directly related to smoking. That’s why ensuring a comprehensive, supportive and structured smokefree service is essential.
“The idea of helping someone stay smokefree during a hospital admission isn’t only about enforcing policy or keeping hospital grounds tidy. It’s about clinical excellence and evidence-based care. Nicotine dependence is a chronic relapsing condition, and sudden withdrawal during an admission without support can cause agitation, poor recovery and people leaving our wards against medical advice. These behaviours increase clinical risk and reduce the chance of recovery. By offering NRT, behavioural support and clear pathways to ongoing care, we aren’t just helping someone manage cravings, we are supporting better outcomes, reducing length of stay and improving overall patient experience.
“From a societal perspective, smoking related illness costs healthcare systems billions each year. They cause widespread disability, increase poverty through long-term illness and disproportionately affect the most vulnerable populations. Every quit attempt we support helps reduce that burden. A smokefree inpatient environment also sends a clear public health message: that health services lead by example and are serious about addressing tobacco harm.
“Moreover, the ripple effect of our work extends far beyond hospital walls. A successful quit attempt during admission can inspire families and communities, especially when supported with continuity of care after discharge. This is how cultural shifts happen – not just through policy, but through meaningful, individual change.
“Ultimately, I work in tobacco dependence treatment services because I believe in second chances and in the power of support during critical moments. Helping someone stay smokefree in hospital isn’t a side issue – it’s central to compassionate, holistic and effective healthcare. It aligns with our duty to do no harm, to promote health and to empower every patient to take steps towards a longer, healthier life.”
For more information about how we can support you during your inpatient stay with us, email esht.tobaccodependencereferrals@nhs.net.