The Department of Health (DH) asked the National Institute for Health and Clinical Excellence (NICE or the Institute) to produce guidance on brief interventions and referrals to specialist services to help people who smoke to stop, in particular, pregnant women and people from disadvantaged groups. It asked the Institute to look at the most effective ways that professionals, both within and outside the NHS in England, can achieve this.

The Public Health Interventions Advisory Committee (PHIAC) considered both a review of the evidence and an economic appraisal before developing these recommendations.

This guidance only examines brief smoking cessation interventions. Although important, these must be seen in the context of a rapidly changing environment.

Publication of the tobacco white paper 'Smoking kills[1]' set out a comprehensive tobacco control policy for the UK that has seen increased spending on mass media anti-smoking campaigns, a ban on tobacco advertising and promotion, more prominent health warnings and wider access to stop smoking services and treatments. In addition, the public health white paper, 'Choosing health[2]' confirmed that all NHS premises and government departments would be smoke-free from the end of 2006. It also paved the way for legislation for a ban on smoking in enclosed public spaces in England by summer 2007.

In light of these changes, the effectiveness of brief interventions should be revisited. In addition, it will be crucial to monitor the impact of this guidance to determine if it is likely to narrow health inequalities or, at least, to ensure that it does not widen them.

The impact of wider policy and practice on smoking cessation is already being examined by the Smoking Cessation Programme Development Group at NICE. Coupled with this guidance on brief interventions, it will provide both practitioners and policy makers with a comprehensive evidence-based approach to delivering smoking cessation services in England.

[1] Department of Health (1998) Smoking kills: A white paper on tobacco. London: HMSO.

[2] Department of Health (2004) Choosing health: Making healthier choices easier. London: Department of Health.