Update information

March 2018: This guideline is an update of NICE guidelines on smoking: brief interventions and referrals (PH1 published March 2006) and stop smoking services (PH10 published February 2008) and replaces them.

Updated or new recommendations have been made about brief advice (given typically in less than 10 minutes), very brief advice (given as the opportunity arises in less than 30 seconds), behavioural support (for example, delivered to a person or a group) and pharmacotherapies (nicotine replacement therapy, including licensed e‑cigarettes and bupropion).

Recommendations are marked as [2018] if the recommendation is new or the evidence has been reviewed.

NICE has deleted all the recommendations from the 2006 guideline and some recommendations from the 2008 guideline, because either the evidence has been reviewed and the recommendations have been updated, or NICE has updated other relevant guidance and has replaced the original recommendations.

Where recommendations end [2008] the evidence has not been reviewed since the original guideline.

Where recommendations end [2008, amended 2018], the evidence has not been reviewed but changes have been made to the recommendation. These may be:

  • changes to the meaning of the recommendation (for example, because of equalities duties or a change in the availability of medicines, or incorporated guidance has been updated)

  • editorial changes to the original wording to clarify the action to be taken.

Amended recommendation wording (change to meaning)

Recommendation in 2008 guideline

Recommendation in current guideline

Reason for change

Recommendation 3 bullet 3

  • Staff who offer counselling should be trained to at least level two (individual behavioural counselling) and preferably, they should hold an appropriate counselling qualification. Training should comply with the 'Standard for training in smoking cessation treatments' or its updates.

1.8.3 Staff who offer counselling should be trained to the NCSCT Standard (individual behavioural counselling) and preferably hold an appropriate counselling qualification. Training should comply with the Standard for training in smoking cessation treatments or its updates.

Amended to take account of change in training standards.

Recommendation 11

  • Ensure training complies with the 'Standard for training in smoking cessation treatments' or its updates.

1.9.2 Ensure training complies with the NCSCT training standard or its updates.

Amended to take account of change in training standards.

Recommendation 12

  • Train all frontline healthcare staff to offer brief advice on smoking cessation in accordance with NICE guidance ('Brief interventions and referral for smoking cessation in primary care and other settings'). Also train them to make referrals, where necessary and possible, to NHS Stop Smoking Services and other publicly funded smoking cessation services.

1.9.3 Train all frontline healthcare staff to offer very brief advice on how to stop smoking in accordance with recommendations 1.6.2 and 1.6.5. Also train them to make referrals, if necessary and possible, to local stop smoking services.

Amended to reflect that local authorities are responsible for commissioning stop smoking services and to include very brief advice as an option.

Recommendation 14, bullet 2

  • Develop and deliver communications strategies in partnership with the NHS, regional and local government and non-governmental organisations. The strategies should:

    • use the best available evidence of effectiveness, such as reviews by the Cochrane Collaboration and the Global Dialogue for Effective Stop Smoking Campaigns

    • be developed and evaluated using audience research

    • use 'why to' and 'how to' quit messages that are non-judgemental, empathetic and respectful. For example, testimonials from people who smoke or used to smoke can work well

    • involve community pharmacies in local campaigns and maintain links with other professional groups such as dentists, fire services and voluntary groups

    • ensure campaigns are sufficiently extensive and sustained to have a reasonable chance of success

    • consider targeting and tailoring campaigns towards low income and minority ethnic groups to address inequalities.

1.10.2 Develop and deliver communications strategies in partnership with the NHS, regional and local government and non-governmental organisations. The strategies should:

  • Use the best available evidence of effectiveness, such as Cochrane reviews.

  • Be developed and evaluated using audience research.

  • Use 'why to' and 'how to' quit messages that are non-judgemental, empathetic and respectful, for example testimonials from people who smoke or used to smoke.

  • Involve community pharmacies in local campaigns and maintain links with other professional groups such as dentists, fire services and voluntary groups.

  • Ensure campaigns are sufficiently extensive and sustained to have a reasonable chance of success.

  • Consider targeting and tailoring campaigns towards low income and some minority ethnic groups to address inequalities.

Amended to take into account changes in the external sources referred to and that smoking prevalence may be higher in some minority ethnic groups.

Recommendation 16

Negotiate a smokefree workplace policy with employees or their representatives. This should:

  • state whether or not smoking breaks may be taken during working hours and, if so, where, how often and for how long

  • direct people who wish to stop smoking to services that offer appropriate support, for example, the NHS Stop Smoking Services

  • implement the NICE public health guidance, 'Workplace interventions to promote smoking cessation'.

1.12.1 Negotiate a smokefree workplace policy with employees or their representatives. This should:

  • State whether or not smoking breaks may be taken during working hours and, if so, where, how often and for how long.

  • Direct people who wish to stop smoking to local stop smoking support.

  • Implement NICE's guideline on smoking: workplace interventions.

Amended to reflect that local authorities are responsible for commissioning stop smoking services and to take account of a change in the title of NICE guidance.

ISBN: 978-1-4731-2873-6

  • Public Health England – Alcohol and drug misuse prevention and treatment collection
  • National Institute for Health and Care Excellence (NICE)