Overall decision

The surveillance process for NICE guideline PH45 and NICE guideline PH48 highlighted a body of evidence on electronic cigarettes, which is likely to directly impact upon recommendations within PH45. The feedback from experts indicated that electronic cigarettes are an important omission, particularly for PH45, which undermines the guideline in practice.

The surveillance process also highlighted that the update of NICE guideline PH1 and NICE guideline PH10 includes a consideration of evidence on electronic cigarettes, which may impact upon both PH45 and PH48, as well as other tobacco guidelines. It was also noted that NICE guideline PH14, NICE guideline PH23 and NICE guideline PH26 have recently had some form of partial update decision.

As such, the following decisions were made:

  • Tobacco sub-theme suite of guidelines

    Amalgamation by committee of tobacco sub-theme guidelines following publication of PH1 and PH10. This will reduce the cross-referring and duplication of work going forwards. As part of the amalgamation process, rescoping should be undertaken to prioritise and plan the partial updates of PH14, PH23 and PH26, as well as considering further work on electronic cigarettes that would update PH45. This process will also be an opportunity to identify and plan to manage other potential gaps within and across guidelines, such as:

    • Reducing exposure to second-hand smoke (environmental tobacco smoke), updating recommendations already in place within PH26

    • Services and pharmaceutical aids and new technologies (for example mobile phone texting, internet, new media interventions to deliver tailored/personalised support)

    • Interventions for preventing weight gain during smoking cessation/reduction

  • Smoking: harm reduction (PH45)

    Refresh as part of tobacco sub-theme amalgamation. Consideration will need to be given to how recommendations are affected by the update of PH1 and PH10, which is currently in progress and includes electronic cigarettes. As part of the amalgamation process, rescoping to consider further work on electronic cigarettes that might be needed for PH45 and other tobacco guidelines should also be undertaken.

  • Smoking: acute, maternity and mental health services (PH48)

    Refresh as part of tobacco sub-theme amalgamation. Consideration will need to be given to how recommendations are affected by the update of PH1 and PH10, which is currently in progress, as well as any further work on electronic cigarettes.

Date of next surveillance

The timing of the next check to decide whether the guideline should be updated is to be confirmed.

NICE Surveillance programme project team

Kay Nolan
Associate Director

Beth Shaw
Senior Technical Adviser

Katy Harrison
Senior Technical Analyst

Victoria Axe
Technical Analyst

Claire Mcleod
Senior Technical Analyst

Charlotte Haynes
Senior Technical Analyst

The NICE project team would like to thank the topic experts who participated in the surveillance process.

ISBN: 978-1-4731-2481-3


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