6 Glossary

Behavioural support for tobacco harm reduction

Practical advice and discussion about goal-setting, self-monitoring and dealing with the barriers to reducing the amount someone smokes or stopping altogether.

Closed institution

A secure environment where people are detained.

Compensatory smoking

Inhaling more deeply or smoking more of each cigarette to compensate for smoking fewer cigarettes.

Cutting down prior to stopping (cut down to quit)

Someone gradually reduces the amount of tobacco they smoke with a view to stopping smoking within the next few months.

Licensed nicotine-containing products

Nicotine-containing products that are licensed have been given marketing authorisation by the Medicines and Healthcare products Regulatory Agency (MHRA). At the time of publication (JuneĀ 2013), nicotine replacement therapy (NRT) products were the only type of licensed nicotine-containing product. Since publication the MHRA has issued a decision that all nicotine-containing products should be regulated and this is expected to come into effect in 2016. In the meantime, the UK government will encourage applications for medicines licences for nicotine-containing products and will make best use of the flexibilities within the existing framework to enable licensed products to be available. For further details, see the MHRA website.

Nicotine-containing products

Products that contain nicotine but do not contain tobacco and so deliver nicotine without the harmful toxins found in tobacco. Some, such as nicotine replacement therapy (NRT), are regulated by the MHRA (see licensed nicotine-containing products). Unlicensed products that are currently being marketed, such as electronic cigarettes, and products new to the market will need a medicines licence once the European Commission's revised Tobacco Products Directive comes into effect in the UK (this is expected to be in 2016). In the meantime, the UK government will encourage applications for medicines licences for nicotine-containing products and will make best use of the flexibilities within the existing framework to enable licensed products to be available. For further details, see the MHRA website.

Nicotine replacement therapy (NRT) products

Nicotine replacement therapy products are licensed for use as a smoking cessation aid and for harm reduction, as outlined in the British National Formulary. They include: transdermal patches, gum, inhalation cartridges, sublingual tablets and a nasal spray.

Pharmacotherapies

This includes medication such as varenicline or bupropion, as well as nicotine replacement therapy (NRT) products.

Point-of-sale

Point-of-sale interventions take place at the point where tobacco could be sold. Primarily, they aim to deter shopkeepers from making illegal sales. In this guidance, they aim to raise smokers' awareness of licensed nicotine-containing products as a replacement for cigarettes.

Quality

In this guidance, the quality of nicotine-containing products refers to the consistency of nicotine delivery, lack of defects and structural integrity of the product.

Safety

In this guidance, safety in relation to nicotine-containing products refers to the incidence of minor and major side effects.

Self-help materials

Any manual or structured programme, in written or electronic format, that someone can use to try to quit smoking or reduce the amount they smoke. These materials can be used without the help of health professionals, stop smoking advisors or group support. They can be aimed at anyone who smokes, particular populations (for example, certain age or ethnic groups), or may be tailored to individual need.

Smoking reduction

Smoking reduction generally involves the person smoking fewer cigarettes than they normally would without stopping, but it can involve smoking less of each cigarette. See also compensatory smoking.

Stopping in one step (abrupt quit)

Stopping in one step is the standard approach to smoking cessation currently adopted by the vast majority of NHS-commissioned stop smoking services. The person makes a commitment to stop smoking on or before a particular date (the quit date). This may, or may not, involve the use of nicotine replacement therapy (NRT) products or medication (varenicline or bupropion) in the lead up to the quit date and for a limited period afterwards.

Stop smoking services

Stop smoking services provide a combination of behavioural support and pharmacotherapy to aid smoking cessation. The behavioural support is free but pharmacotherapy may incur a standard prescription charge. The evidence-based treatment is based on the National Centre for Smoking Cessation and Training (NCSCT) standard programme and involves practitioners trained to its standards or the equivalent.

Temporary abstinence

Abstaining from smoking. This could be for a particular event or series of events, in a particular location, for specific time periods (for example, while at work, during long-haul flights or during a hospital stay), or even for the foreseeable future. (The latter might include, for example, abstinence while serving a prison sentence or while detained in a secure mental health unit.)

  • National Institute for Health and Care Excellence (NICE)