Smoking cessation - bupropion and nicotine replacement therapy
The clinical effectiveness and cost effectiveness of bupropion (Zyban) and Nicotine Replacement Therapy for smoking cessation
| Guidance type: Technology appraisal |
| Date issued: March 2002 |
We will consult on our review plans for this guidance in March 2005. |
| Reference: TA39 |
SummaryIt is recommended that NRT and bupropion should be available to on prescription for smokers who have said that they want to quit smoking. NRT or bupropion should normally only be prescribed when the person has made a commitment to stop smoking on or before a certain date (the ‘target stop date’). Healthcare professionals should offer advice and encouragement to help the smoker quit. Ideally, the first prescription of NRT or bupropion should only be enough to last until 2 weeks after the target stop date. Normally, this will be 2 weeks for NRT. For bupropion it will be 3–4 weeks, because bupropion should be taken for about 1 week before the target stop date. The person should only be given a second prescription for NRT or bupropion if they can show that they are still trying to stop smoking. It is recommended that people who are under the age of 18 years, pregnant or breastfeeding, or who have unstable heart conditions, should discuss the use of NRT with a doctor or nurse before starting treatment. Bupropion is not recommended for smokers under the age of 18 years, because it is not licensed for use by people in this age group. Women who are pregnant or breastfeeding should not use bupropion. If the smoker’s attempt to quit is unsuccessful, the healthcare professional should not usually prescribe NRT or bupropion for another attempt within 6 months. However, if external factors interfere with the initial attempt to stop smoking, it may be reasonable to try again sooner. (For example, if a particularly stressful event occurred after the person had started your initial attempt to quit.) There is currently not enough evidence to recommend the use of NRT and bupropion together. In deciding which of the available therapies to use and in which order they should be prescribed, doctors should take the following factors into account:
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DocumentsFor healthcare professionals
For patients, carers and the publicBackground information |
Implementing this guidanceAny further information NICE has produced to help the NHS implement this guideline locally is linked to below:
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