Patients and visitors should be able to use e-cigarettes at NHS hospitals as part of a radical re-think of the way people are persuaded to ditch smoking, according to a new study.

Support for quitting tobacco helps save the health service about £1bn a year, but a disjointed approach means efforts are not as effective as they could be, the Royal College of Physicians said.

Smoking cessation should now be thought of as a “core NHS activity” and there should be a systematic “opt-out” service to which every patient in hospital has access, the college’s report suggests. 

As part of the effort, the report said e-cigarettes should be allowed to be used on NHS sites in an effort to support smokers to quit for good.

Professor John Britton, chair of the RCP’s Tobacco Advisory Group and lead editor of the study, said: “Treating the more than one million smokers who are admitted to hospitals every year represents a unique opportunity for the NHS to improve patients’ lives, while also saving money.

“For too long the NHS has failed to take responsibility for smoking, while prioritising other, less effective activity.

“Smoking, the biggest avoidable cause of death and disability in the UK, is hiding in plain sight in our hospitals and other NHS services; the NHS must end the neglect of this huge opportunity to improve our nation’s health.”

The report added that many hospitals and other NHS sites do not implement current guidelines regarding smoking, and so clearer rules should ban the use of tobacco products entirely.

Smoking contributes to 4,500 hospital admissions per day on average, according to the government. It remains the primary cause of premature death in Britain.

The report’s recommendations came despite another study last year suggesting e-cigarettes are not as harmless as once hoped.

Duncan Selbie, chief executive at Public Health England: “One in four hospital patients are smokers costing hospitals £1bn a year. We fully support the Royal College in saying by far the majority of the NHS could be doing more to help smokers to quit. This excellent RCP report is a timely reminder of how important prevention is to the long term sustainability of the NHS.”

A spokesperson for NHS England referred HuffPost UK to the government. The Department of Health did not respond to a request for comment.