Background: Systems First is a health-funded national coordination project provided by Education for Change. Its purpose is to support smokefree leadership in New Zealand hospitals, particularly the development of smokefree systems. Smokefree Essentials, a Systems First tool for aligning knowledge and understanding with strategic intent, is a short presentation designed to prepare a whole staff in a short time to implement smokefree systems. It is intended for all staff, clinical and non-clinical, and provides the bare essentials for understanding smoking and the value of intervention.

Discussion: Northland DHB systematically implemented Smokefree Essentials as part of their smokefree hospital development plan and overall smokefree education strategy. The presentation was offered within core educational frameworks with 425 staff participating between June and December 2006. Participant feedback has been overwhelmingly positive with staff demonstrating a commitment to act, eg. “… I will approach patients about intentions to stop smoking and begin implementing support for them”. Measures of smokefree practice demonstrate increases in assisting patients (50% increase April - November in utilisation of NRT to alleviate withdrawal symptoms) and in arranging referral (500% increase in referrals to hospital cessation service - average 7.6 per month in first quarter of 2006 to 38.5 per month in last quarter). Smokefree Essentials has played an important part in this change.

Conclusion: Smokefree Essentials, as policy implementation support, is shown to be an excellent means of strengthening the confidence and commitment of staff to address smoking with every patient in a practical and cost-effective manner.