This guideline covers support to stop smoking for everyone aged 12 and over, and help to reduce people's harm from smoking if they are not ready to stop in one go. It also covers ways to prevent children, young people and young adults aged 24 and under from taking up smoking. The guideline brings together and updates all NICE's previous guidelines on using tobacco, including smokeless tobacco. It covers nicotine replacement therapy and e-cigarettes to help people stop smoking or reduce their harm from smoking. It does not cover using tobacco products such as ‘heat not burn’ tobacco.
In January 2023, in the section on identifying and referring pregnant women for stop-smoking support, we reduced the number of carbon monoxide tests recommended for women with low readings and no history of smoking.
In August 2022, varenicline was unavailable in the UK. See the MHRA alert on varenicline.
This guideline includes new and updated recommendations on:
- adult-led interventions in schools
- stop-smoking interventions
- support to stop smoking in secondary care services
- adherence and relapse prevention
- identifying pregnant women who smoke and referring them for stop-smoking support
- providing support for women to stop smoking during and after pregnancy
- commissioning and designing services
It also includes recommendations on:
- organising and planning national, regional or local mass-media campaigns
- campaign strategies to prevent uptake and denormalise tobacco use
- helping retailers avoid illegal tobacco sales
- coordinated approach to school-based interventions
- whole-school or organisation-wide smokefree policies
- peer-led interventions in schools
- using medicinally licensed nicotine-containing products
- promoting stop-smoking support
- promoting support for people to stop using smokeless tobacco
- identifying and quantifying people's smoking
- support to stop smoking in primary care and community settings
- supporting people who do not want, or are not ready, to stop smoking in one go to reduce their harm from smoking
- stopping use of smokeless tobacco
- following up pregnant women who have been referred for stop smoking support
Who is it for?
- Commissioners and providers of stop-smoking interventions and support, including those in the voluntary and community sectors
- Commissioners and providers of interventions and support for preventing uptake of smoking
- Health and social care professionals, including clinical leads in secondary care services and managers of clinical services
- People working in local authorities, education and the wider public, private, voluntary and community sectors
- Those commissioning, planning and delivering mass-media campaigns
- People with a remit to improve the health and wellbeing of children and young people aged 24 and under; this includes those working in the NHS, local authorities and tobacco control alliances
- Retailers of tobacco products
- Employers, estate managers and other managers
- Employee and trade union representatives
It may also be relevant for:
- Researchers and policy makers
- Manufacturers and retailers of medicinally licensed nicotine-containing products and nicotine-containing e-cigarettes
- Members of the public, including:
- children, young people, their parents and carers
- people using health and social care services, and their families and carers
- women who are pregnant or planning a pregnancy, or who have a child aged up to 12 months, and their families and carers
- people over 16 who smoke and are in paid or voluntary employment
Guideline development process
Engagement with tobacco industry organisations
The UK Government is a signatory and party to the World Health Organization Framework Convention on Tobacco Control (FCTC). The development of this guideline complies with NICE’s obligations under Article 5.3 of the FCTC.
NICE worked with Public Health England to develop this guideline.
This guideline updates and replaces the following NICE guidelines:
- smoking: workplace interventions (PH5, published April 2007)
- smoking: preventing uptake in children and young people (PH14, published July 2008)
- smoking prevention in schools (PH23, published February 2010)
- smoking: stopping in pregnancy and after childbirth (PH26, published February 2010)
- smokeless tobacco: South Asian communities (PH39, published September 2012)
- smoking: harm reduction (PH45, published June 2013)
- smoking: acute, maternity and mental health services (PH48, published November 2013)
- stop-smoking interventions and services (NG92, published March 2018).
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services 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 complying 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.