Smoking is the main cause of preventable illness and premature death in England. In 2015/16, an estimated 474,000 NHS hospital admissions in England were linked to smoking-related conditions. An estimated 16% (79,000) of all deaths in 2015 were attributed to smoking (Statistics on smoking Health and Social Care Information Centre).

Treating smoking-related illness is estimated to cost the NHS £2.5 billion a year (Statistics on smoking) and the wider cost to society is around £12.7 billion a year (The local costs of smoking in England – 2017 Action on Smoking and Health).

The number of people using stop smoking services has declined (Statistics on NHS stop smoking services in England – April 2016 to March 2017 Health and Social Care Information Centre). Reasons for this are not clear. The number of prescriptions of stop smoking medications has also fallen by over 50% since 2011 (Statistics on smoking in England – 2017).

This guideline updates and replaces NICE's guideline on smoking: brief interventions and referrals and recommendations 1, 2, 3, 4, 6 and 10 of NICE's guideline on stop smoking services.

This guideline incorporates recommendation 7, and recommendations 11 to 16 of NICE's guideline on stop smoking services. Recommendation 5 of that guideline was replaced by NICE's guideline on smoking: harm reduction, and recommendations 8 and 9 were updated by NICE's guideline on smoking: stopping in pregnancy and after childbirth.


Local authorities are responsible for commissioning tobacco control and stop smoking services. They are guided by the Public Health Outcomes Framework, as well as their local joint strategic needs assessment, sustainability and transformation plans, and joint health and wellbeing strategy.

This guideline will help local authorities and the NHS to meet smoking-related outcomes within the 'health improvement' domain in the Public Health Outcomes Framework 2016 to 2019 (Department of Health and Social Care).

More information

You can also see this guideline in the NICE Pathway on stopping smoking.

To find out what NICE has said on topics related to this guideline, see our web page on smoking and tobacco.

See also the evidence reviews and information about how the guideline was developed, including details of the committee.

  • National Institute for Health and Care Excellence (NICE)