Quality statement 2: Stopping smoking
Adults with suspected or confirmed lung cancer who smoke receive evidence-based stop‑smoking support. [new 2019]
People with suspected or confirmed lung cancer who smoke should be encouraged to stop smoking to reduce the risk of treatment‑related complications and other smoking‑related conditions and increase their life expectancy. They should be provided with evidence-based support to help them to stop smoking.
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
a) Evidence of local arrangements to ensure that adults with suspected or confirmed lung cancer who smoke are given advice about why it is important to stop smoking.
Data source: Local data collection, for example, service protocols.
b) Evidence of local arrangements to provide evidence-based support for adults with suspected or confirmed lung cancer to help them to stop smoking.
Data source: Local data collection, for example, service specification and protocols.
Proportion of adults with suspected or confirmed lung cancer who smoke who receive evidence-based support to stop smoking.
Numerator – the number in the denominator who receive evidence-based support to stop smoking.
Denominator – the number of adults with suspected or confirmed lung cancer who smoke.
Data source: Royal College of Physicians' National Lung Cancer Audit (measure in development). Data on smoking status and whether treatment for tobacco addiction was given from National Cancer Registration and Analysis Service Cancer Outcomes and Services Dataset.
a) Smoking rates in adults with lung cancer having treatment with curative intent.
Data source: Local data collection, for example, audit of patient records.
b) 1‑year survival rate for adults with lung cancer treated with curative intent.
Service providers (such as primary care, community services, secondary and tertiary care) ensure that processes are in place to provide advice to adults with suspected or confirmed lung cancer who smoke about why it is important to stop smoking. Providers ensure that they can provide evidence-based support to help people with suspected or confirmed lung cancer to stop smoking. This may also include referral pathways to evidence-based stop‑smoking support.
Healthcare professionals (such as GPs, pharmacists, clinical nurse specialists, consultants and radiographers) provide advice to adults with suspected or confirmed lung cancer who smoke about why it is important to stop smoking. They arrange for them to access evidence-based stop‑smoking support if they want to stop.
Commissioners (such as clinical commissioning groups, NHS England and local authorities) ensure that they commission services which provide evidence-based stop‑smoking support to adults with suspected or confirmed lung cancer who smoke.
Adults with suspected or confirmed lung cancer who smoke are told that it is important to stop smoking to avoid complications during treatment and prevent other smoking‑related illnesses. They are told that stopping smoking may improve how long they live, and they are given help if they want to give up.
Tobacco: preventing uptake, promoting quitting and treating dependence. NICE guideline NG209 (2021), recommendations 1.12.1, 1.14.1, 1.14.5, 1.14.6, 1.14.10, 1.14.13 to 1.14.15, 1.14.21, 1.14.26 and 1.22.4
Lung cancer: diagnosis and management. NICE guideline NG122 (2019), recommendations 1.4.1 to 1.4.3
Adults with symptoms and signs of lung cancer who are referred for investigation. [Expert opinion]
Interventions and support to stop smoking, regardless of how services are commissioned or set up.
The following should be accessible to adults who smoke:
behavioural support (individual and group)
very brief advice
medicinally licensed products:
In November 2021, varenicline was unavailable in the UK. See the Medicines and Healthcare products Regulatory Agency (MHRA) alert on varenicline. [NICE's guideline on tobacco, recommendation 1.12.2 and terms used in this guideline; stop‑smoking support]
Information about stopping smoking should be in a format that suits the person's needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate. People should have access to an interpreter or advocate if needed. For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard.