WIREDGOV

A quality standard to help reduce tobacco-related harm for people who don’t feel able to stop smoking in one step was published recently by the National Institute for Health and Care Excellence.

Tobacco smoking remains the single greatest cause of preventable illness and early death in England, accounting for 79,100 deaths among adults aged 35 and over in 2011. Smoking causes the majority of lung cancer cases in the UK, as well as being linked to many other cancers, and also accounts for deaths from chronic obstructive pulmonary disease (COPD) and cardiovascular disease.

The new standard aims to support the provision of high-quality care for people who want to reduce the amount they smoke, especially those who are highly dependent on nicotine. This includes people who  may not be able to stop smoking in one go, those who want to stop smoking without necessarily giving up nicotine, people who want to reduce the amount they smoke without stopping, or who want to stop temporarily.

The quality standard is expected to contribute to improving outcomes in areas including smoking-related illness and hospital admissions, and life expectancy at 75.

Professor Gill Leng, Deputy Chief Executive of NICE, said: “The best way to reduce the harm from smoking is to stop completely and the best chance of doing this is still to quit in one step. However, nicotine inhaled from smoking tobacco is highly addictive, which is why people find it so difficult to stop smoking – but the main harm from smoking is from the tar in tobacco. For people who’ve been unable to stop in one step, reducing how much they smoke with the support of licensed nicotine-containing products such as patches or gum, and advice from stop smoking services, can help.  This approach was recommended in NICE’s guidance on tobacco harm reduction, which informed this new standard.  The standard’s quality statements set out what should be offered to ensure that the best care is given to people wanting to reduce their harm from smoking.”

The quality statements are:

• People who are unwilling or not ready to stop smoking are offered a harm-reduction approach to smoking
• People who are unwilling or not ready to stop smoking are advised that health problems associated with smoking are caused primarily by components in tobacco smoke other than nicotine
• People who are unwilling or not ready to stop smoking are advised about using nicotine-containing products and supported to obtain licensed nicotine-containing products
• ‘Stop smoking’ services offer harm-reduction approaches alongside existing approaches to stopping smoking in one step.

Notes to Editors

About the NICE guidance

1. The standard is available at: /guidance/qs92.
2. Advice given about nicotine-containing products should: reassure people who smoke that licensed nicotine-containing products are a safe and effective way of reducing the amount they smoke. Advise them that these products can be used as a complete or partial substitute for tobacco, in either the short or the long term. Reassure them that it is better to use these products and reduce the amount they smoke than to continue smoking at their current level. Nicotine-containing products are products that contain nicotine but do not contain tobacco. They deliver nicotine without the harmful toxins found in tobacco. Nicotine-containing products that are licensed have been given marketing authorisation by the Medicines and Healthcare products Regulatory Agency (MHRA), such as nicotine replacement therapy (NRT; examples include transdermal patches, gum, inhalation cartridges, sublingual tablets and nasal spray). Nicotine-containing products that are not regulated by the MHRA, such as electronic cigarettes, are also available (unlicensed nicotine-containing products). For further details, see the MHRA website. If alternative nicotine‑containing products (such as electronic‑cigarettes) gain licensing authorisation in the future, this quality statement will be reviewed.
3. The quality standard does not cover pregnant women or maternity services. Quality statement 5 in the NICE quality standard on antenatal care sets out the high-quality requirements for ensuring that pregnant women who smoke are referred to an evidence-based ‘stop smoking’ service.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

Our products and resources are produced for the NHS, local authorities, care providers, charities, and anyone who has a responsibility for commissioning or providing healthcare, public health or social care services.

To find out more about what we do, visit our website:www.nice.org.uk and follow us on Twitter: @NICEComms.