Stop smoking interventions and services. NICE NG92, March 2018
New guidance from NICE aims to ensure that everyone who smokes is advised and encouraged to stop and given the support they need. It emphasises the importance of targeting vulnerable groups who find smoking cessation hard or who smoke a lot. The guidance is aimed not only at those responsible for commissioning services but healthcare professionals delivering stop smoking interventions in primary and community care settings.
NICE wants to see evidence-based interventions and services are provided for everyone who smokes, especially those in priority groups.
The priority groups are those people who are at high risk of tobacco-related harm, including:
The aim should be to treat at least 5% of the estimated local population who smoke each year, with a target quit rate of at least 35% at 4 weeks.
The evidence-based interventions that should be available for adults who smoke include:
ENGAGING WITH PEOPLE WHO SMOKE
At every opportunity, ask people if they smoke and advise them to stop smoking in a way that is sensitive to their preferences and needs.
Encourage people who are being referred for elective surgery to stop smoking before their surgery. Refer them to local stop smoking support.
Discuss any stop smoking aids the person has used before, including personally purchased nicotine-containing products.
Offer advice on using nicotine-containing products on general sale, including NRT and nicotine-containing e-cigarettes.
EVIDENCE-BASED STOP SMOKING INTERVENTIONS
For adults, prescribe varencline, bupropion or NRT before they stop smoking (varencline should normally only be offered as part of a programme of behavioural support).
Agree a quit date set within the first 2 weeks of buproprion treatment and within the first 1 – 2 weeks of varencline treatment. The smoker should be reassessed shortly before the prescription ends.
Agree a quit date if NRT is prescribed, and ensure that the smoker has NRT ready to start the day before the quit date.
Consider NRT for young people over 12 who are smoking and dependent on nicotine. If prescribed, it should be offered with behavioural support.
IF A SMOKER WANTS TO QUIT
IF A SMOKER IS NOT READY TO QUIT
National Centre for Smoking Cessation and Training (NCSCT) Very Brief Advice training module. http://www.ncsct.co.uk/publication_very-brief-advice.php
NCSCT Online training http://elearning.ncsct.co.uk
NICE PH45. Smoking: harm reduction, 2013. https://www.nice.org.uk/guidance/ph45
PRACTICE NURSE FEATURED ARTICLES
Tobacco: Reducing the harm Dr Ed Warren
Smoking cessation: Tailoring your approach to the individual smoker Darush Attar-Zadeh
NICE NG92. Stop smoking interventions and services, March 2018 https://www.nice.org.uk/guidance/ng92
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