National Institute for Health and Clinical Excellence (NICE)
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NICE advice on the best way to quit smoking

NICE has today (27 February 2008) issued advice on the best way to encourage people to give up smoking. This is the first fully comprehensive guidance on smoking cessation issued by NICE to ensure that stop smoking services are as effective as possible. The guidance is aimed at all professionals who have a direct or indirect role in helping people to quit smoking including PCTs, local authorities and community and voluntary sectors.

Smoking is estimated to cost the NHS £1.5 billion a year and remains the main cause of preventable morbidity and premature death in England. A wide range of diseases and conditions are caused by cigarette smoking, including cancers, respiratory diseases, coronary heart and other circulatory diseases. It is also the primary reason for the gap in healthy life expectancy between rich and poor.

NICE recommendations include:

• PCTs, SHAs and commissioners should set minimum realistic targets for their
local populations with an aim to treat at least 5% of their population who smoke
each year and to aim for a success rate of at least 35% at 4 weeks

• NHS Stop Smoking Services should target minority ethnic and socioeconomically
disadvantaged communities in the local population

• NRT, varenicline or bupropion are recommended as treatment options for people
who are planning to stop smoking on or before a particular date (target stop date)
and alongside proven behavioural counselling and group therapy

• Varenicline or bupropion should not be offered to young people under 18 or to
pregnant or breastfeeding women


• Personalised information, advice and support should be offered to pregnant
women on how to stop smoking

• Young people aged 12–17 should be offered information, advice and support on
how to stop smoking. NRT may be used for young people over 12 years who
show clear evidence of nicotine dependence and as part of a supervised regime.

Professor Peter Littlejohns, NICE Clinical and Public Health Director and Executive Lead for this guidance said: “Smoking is still the main cause of preventable morbidity and premature death in England. This is the first fully comprehensive smoking cessation guidance published by NICE which provides all people responsible for smoking cessation advice on how to structure their services to help people quit smoking. We are asking all PCTs, SHAs and commissioners to make it a priority to help people to quit smoking. Most smokers want to quit and in this guidance we aim to ensure that the right services are put in place to help them to stop.”

Sir Alexander Macara, Chair of the Smoking Cessation Public Health Development Group said: “Although smoking prevalence has dropped sharply since the 1970s, the decline has been much slower in the last decade. Those people who are still smoking are at the greatest risk of harm to their own health and the people around them. Although NHS Stop Smoking Services have helped large numbers of people to quit smoking, smoking cessation rates are still lower among vulnerable groups, particularly pregnant women, people in routine and manual groups and those aged 20 or under. We have specifically targeted these groups as they often need additional support to help them give up smoking.”

Christine Owens, PDG member and Director of Tobacco Control, The Roy Castle Lung Cancer Foundation said: “We see the best results when Stop Smoking Services tailor their service to their local population. We are advising that all PCTs, SHAs and commissioners determine the characteristics of the local population of people who smoke or use other forms of tobacco and tailor their support around them.”


Notes to Editors

About NICE

1. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health
and the prevention and treatment of ill health.

2. NICE produces guidance in three areas of health:

public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector

health technologies – guidance on the use of new and existing medicines, treatments and procedures within the NHS

clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

About NICE smoking cessation guidance

• Full guidance on the optimal provision of smoking cessation services with particular reference to manual groups, pregnant smokers and hard to reach communities can be found at www.nice.org.uk/PH010 at 00:01 27 February 2008.

• Smoking is the main cause of preventable morbidity and premature deaths in England – annual average 86,500 deaths between 1998 and 2002.

• Smoking is the primary reason for the gap in healthy life expectancy between rich and poor.

• Smoking is estimated to cost the NHS £1.5 billion a year.

• In England 24% people aged 16 and over smoked (fig for 2006).

• In England 29% of those in routine or manual occupations smoked (fig for 2005).

• Among pregnant women smoking prevalence is highest for those under 35 and 45% of mothers aged under 20 smoke during their pregnancy.

• This guidance supersedes ‘Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation’ (NICE technology appraisal guidance 39). It crossreferences
and is consistent with ‘Brief interventions and referral for smoking cessation in primary care and other settings’ (NICE public health guidance 1), ‘Workplace health promotion: how to help employees to stop smoking’ (NICE public health guidance 5) and ‘Varenicline for smoking cessation’ (NICE technology appraisal guidance 123).

• No Smoking Day is on 12 March 2008 and is a health awareness day in its 25th year. Last year, 1.1 million smokers made a quit attempt on No Smoking Day. www.nosmokingday.org.uk .

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