Every healthcare contact is a health improvement opportunity but how well do we embed lifestyle advice in our day‐to‐day encounters? Gain a greater awareness and understanding of the Health Promoting Health Service and how we can implement this activity in your workplace.

1. So You Think You Can Only Treat Illness? Dr Aileen Keel CBE Deputy Chief Medical Officer for Scotland

11. HEALTH IMPROVEMENT OPPORTUNITIES IN THE PRE-OPERATIVE ASSESSMENT CLINIC – NHS TAYSIDE Louise Bruce Senior Charge Nurse Pre-operative Assessment

21. Health Promoting Hospitals Quality in Action Dr A Hendry National Clinical Lead

22. Quality and Efficiency

23. Promoting health Enabling self management

25. Multiple Morbidity, Deprivation and Hospitalisation

26. Culture, Systems and Practice

30. Confidence and Capability Conversations that Matter

31. Clinical Champions Critical mass, momentum and pace

32. A National Survey of Smoking Cessation Provision in all Colposcopy Clinics in Scotland and a model for best practice Alexis Rumbles Hospital Nurse Adviser Stop Smoking Services

34. What is Colposcopy? A diagnostic procedure in which a specialist examines a magnified view of the cervix using a colposcope

37. Natural History of CIN

38. Treatment of CIN Within NHS Lothian The most common form of treatment is loop excision. This removes the cells using a small heated wire loop. The removed cells go to the pathology laboratory for testing.

39. CIN 1 Szarewski et al (1996) demonstrated that stopping smoking lead to a reduction in size of the cervical lesion over a six month period.

40. CIN 3 Alcadious et al (2002) established that smoking is an independent risk factor for treatment failure of CIN.

41. There is clear evidence that stopping smoking reduces the risk of abnormal smears and decreases treatment failure

42. A literature review revealed there is no evidence that smoking cessation services are integrated into colposcopy clinics as part of treatment.

50. New Leaflet Developed New leaflet developed outlining risks, benefits of stopping smoking and help available from specialist smoking cessation services. Marteau et al (2002), Boardman et al (2004) and Bishop et al (2005)

52. Working in partnership with the consultants from the colposcopy clinic

54. Clinicians wanted to know, what type of smokers do we meet? Addictive Habitual Psychological

57. Nicotine Replacement

58. Medication

63. Acknowledgements Dr Simon Nicholson, NHS Lothian Consultant Gynaecologist Dr Sarah Court, NHS Lothian Associate Specialist, Gynaecology Helena Connelly, NHS Lothian Stop Smoking Services Manager

64. Contact details Alexis Rumbles Hospital Nurse Adviser St John’s Hospital Livingston Tel: 01506 523871 Email: Alexis.Rumbles@nhslothian.scot.nhs.uk