Introduction: scope and purpose of this guidance

Introduction: scope and purpose of this guidance

What is this guidance about?

Nicotine inhaled from smoking tobacco is highly addictive. But it is primarily the toxins and carcinogens in tobacco smoke – not the nicotine – that cause illness and death. The best way to reduce these illnesses and deaths is to stop smoking. In general, stopping in one step (sometimes called 'abrupt quitting') offers the best chance of lasting success (see NICE guidance on smoking cessation). However, there are other ways of reducing the harm from smoking, even though this may involve continued use of nicotine.

This guidance is about helping people, particularly those who are highly dependent on nicotine, who:

  • may not be able (or do not want) to stop smoking in one step

  • may want to stop smoking, without necessarily giving up nicotine

  • may not be ready to stop smoking, but want to reduce the amount they smoke.

This guidance recommends harm-reduction approaches which may or may not include temporary or long-term use of licensed nicotine-containing products. (See box 1 for details.)

The recommendations cover:

  • Raising awareness of licensed nicotine-containing products.

  • Self-help materials.

  • Choosing a harm-reduction approach.

  • Behavioural support.

  • Advising on licensed nicotine-containing products.

  • Supplying licensed nicotine-containing products.

  • Follow-up appointments.

  • Supporting temporary abstinence.

  • People in closed institutions.

  • Staff working in closed institutions.

  • Commissioning stop smoking services.

  • Education and training for practitioners.

  • Point-of-sale promotion of licensed nicotine-containing products.

  • Manufacturer information on licensed nicotine-containing products.

This guidance does not cover pregnant women or maternity services. (See Related NICE guidance for other recommendations that may be relevant to tobacco harm-reduction among this group.)

In addition, this guidance does not cover 'reduced exposure cigarettes', 'smokeless tobacco' or any other products containing tobacco that may be used as a means of 'harm reduction'.

The guidance complements but does not replace NICE guidance on smoking cessation. (For further details see Related NICE guidance.)

See About this guidance for details of how the guidance was developed and its current status.

Who is this guidance for?

The guidance is for: commissioners, managers and practitioners with public health as part of their remit, organisations that provide education and training, manufacturers and retailers of licensed nicotine-containing products. It is especially aimed at those involved in providing advice about stopping smoking, smoking cessation services within the NHS, local authorities and the wider public, private, voluntary and community sectors. The guidance may also be of interest to members of the public, especially people who want to stop or reduce the amount they smoke.

  • National Institute for Health and Care Excellence (NICE)