Authors' objectives:

This publication provides guidance on brief interventions and referrals to specialist services to help people who smoke to stop, in particular, pregnant women and people from disadvantaged groups.

Authors' recommendations: Recommendation 1 Everyone who smokes should be advised to quit, unless there are exceptional circumstances. People who are not ready to quit should be asked to consider the possibility and encouraged to seek help in the future. If an individual who smokes presents with a smoking-related disease, the cessation advice may be linked to their medical condition. Recommendation 2 People who smoke should be asked how interested they are in quitting. Advice to stop smoking should be sensitive to the individual's preferences, needs and circumstances: there is no evidence that the 'stages of change' model is more effective than any other approach. Recommendation 3 GPs should take the opportunity to advise all patients who smoke to quit when they attend a consultation. Those who want to stop should be offered a referral to an intensive support service (for example, NHS Stop Smoking Services). If they are unwilling or unable to accept this referral they should be offered pharmacotherapy, in line with NICE technology appraisal guidance no. 39, and additional support. The smoking status of those who are not ready to stop should be recorded and reviewed with the individual once a year, where possible. Recommendation 4 Nurses in primary and community care should advise everyone who smokes to stop and refer them to an intensive support service (for example, NHS Stop Smoking Services). If they are unwilling or unable to accept this referral, they should be offered pharmacotherapy by practitioners with suitable training, in line with NICE technology appraisal guidance no. 39, and additional support. Nurses who are trained NHS stop smoking counsellors may 'refer' to themselves, where appropriate. The smoking status of those who are not ready to stop should be recorded and reviewed with the individual once a year, where possible. Recommendation 5 All other health professionals, such as hospital clinicians, pharmacists and dentists, should refer people who smoke to an intensive support service (for example, NHS Stop Smoking Services). If the individual is unwilling or unable to accept this referral, practitioners with suitable training should offer a prescription of pharmacotherapy, in line with NICE technology appraisal guidance no. 39, and additional support. Those who are trained NHS stop smoking counsellors may 'refer' to themselves. The smoking status of those who are not ready to stop should be recorded in clinical records and reviewed with the individual once a year, where possible. Recommendation 6 Community workers should refer people who smoke to an intensive support service (for example, NHS Stop Smoking Services). Those who are trained NHS stop smoking counsellors may 'refer' to themselves. Recommendation 7 Strategic health authorities, NHS hospital trusts, PCTs, community pharmacies, local authorities and local community groups should review smoking cessation policies and practices to take account of the recommendations in this guidance. Recommendation 8 Smoking cessation advice and support should be available in community, primary and secondary care settings for everyone who smokes. Local policy makers and commissioners should target hard to reach and deprived communities, including minority ethnic groups, paying particular attention to their needs. Recommendation 9 Monitoring systems should be set up to ensure health professionals have access to information on the current smoking status of their patients. This should include information on: a) the most recent occasion on which advice to stop was given, b) the nature of advice offered, and c) the response to that advice.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.nice.org.uk/page.aspx?o=300201

Year Published: 2006

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: National Institute for Health and Care Excellence

Contact Address: Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BT

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Health and Clinical Excellence (NICE)