• This advice replaces LGB1.



This briefing is an update of NICE's local government briefing on tobacco published in July 2012. It includes additional information from NICE's guidelines on smokeless tobacco cessation in South Asian communities, tobacco harm-reduction approaches to smoking and smoking cessation in secondary care (acute, maternity and mental health services). It also includes links to NICE's quality standard on smoking cessation: supporting people to stop smoking. In 2015 NICE will be publishing quality standards on smoking – reducing tobacco use in the community and smoking – harm reduction.

This briefing summarises NICE's recommendations for local authorities and partner organisations on tobacco. It is particularly aimed at health and wellbeing boards.

The recommendations cover: how to prevent people from taking up smoking and helping them to stop; reducing tobacco use in the community; reducing the harm caused by smoking; and helping South Asian communities to stop using smokeless tobacco.

All of the recommendations can be found in NICE's smoking pathway (note: this covers all types of tobacco use). Some of the recommendations have been used to develop quality standards and links to these can also be found in the pathway.

This briefing does not cover electronic cigarettes because NICE only recommends the use of licensed nicotine‑containing products and currently no electronic cigarettes have been licensed by the Medicines and Healthcare Regulatory Agency (MHRA). See the MHRA website for further details.

Key messages

Smoking costs local authorities more than £600 million a year in terms of social care services (Costs of smoking to the social care system Action on Smoking and Health [ASH]). Treating diseases caused by smoking costs the NHS approximately £2.7 billion a year (Estimating the cost of smoking to the NHS in England and the impact of declining prevalence Callum et al.).

Local authorities have a responsibility to address health inequalities and smoking is the primary reason for the gap in healthy life‑expectancy between rich and poor (Fair society healthy lives The Marmot Review).

Tobacco use is the single greatest cause of preventable deaths in England – killing over 80,000 people per year. This is greater than the combined total of preventable deaths caused by obesity, alcohol, traffic accidents, illegal drugs and HIV infections (Statistics on Smoking England 2014 HSIC [page 46]).

One in two regular smokers is killed by tobacco and half of them will die before the age of 70, losing an average 10 years of life (Mortality in relation to smoking: 50 years' observations on male British doctors Doll et al.).

Two-thirds of smokers say they began smoking before the age of 18. Nine out of ten started before the age of 19 (Statistics on Smoking England 2014 HSIC).

The National Institute for Health and Care Excellence (NICE) is an independent organisation providing guidance and advice to improve health and social care.

For further information on how to use this briefing and how it was developed, see About this briefing.