This guideline covers the risk of early death from heart disease and other smoking-related illnesses. It aims to reduce the number of people who are disadvantaged dying prematurely by ensuring people have better access to flexible, well-coordinated treatment and support.


This guideline includes recommendations on:

Who is it for?

  • Health and social care practitioners
  • Organisations planning, providing or supporting services that support disadvantaged people
  • Adults with a high risk of heart disease (including smokers and people with high cholesterol), their families and carers and the general public

Is this guideline up to date?

We checked the guideline in January 2014. We found no new evidence that affects the recommendations in this guideline.

Next review: To be scheduled

Guideline development process

How we develop NICE guidelines

The guideline was previously called identifying and supporting people most at risk of dying prematurely.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.