Quality statement 4: Pharmacotherapy

Quality statement

People who seek support to stop smoking and who agree to take pharmacotherapy are offered a full course.

Rationale

Pharmacotherapy interventions act as an aid to help people to stop smoking, and it is important that people who seek support to stop smoking receive the full course of their chosen pharmacotherapy to increase the chances of success.

Quality measures

Structure

Evidence of local arrangements to ensure that people who seek support to stop smoking and who agree to take pharmacotherapy are offered a full course.

Data source: Local data collection.

Process

Proportion of people who seek support to stop smoking and who agree to take pharmacotherapy who receive a full course.

Numerator – the number of people in the denominator who receive a full course of pharmacotherapy.

Denominator – the number of people who seek support to stop smoking and who agree to take pharmacotherapy.

Data source: Local data collection. Statistics on NHS Stop Smoking Services: England, April 2011 to March 2012 from the Health and Social Care Information Centre reports on smoking cessation interventions.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers ensure that systems are in place so that people who seek support to stop smoking and who agree to take pharmacotherapy are offered a full course.

Healthcare practitioners offer a full course of pharmacotherapy to people who seek support to stop smoking and who agree to take pharmacotherapy.

Commissioners ensure that they commission services that offer a full course of pharmacotherapy to people who seek support to stop smoking and who agree to take pharmacotherapy.

What the quality statement means for patients, service users and carers

People who seek support to stop smoking and who agree to take pharmacotherapy are offered a full course of drug treatment.

Source guidance

Definitions of terms used in this quality statement

Pharmacotherapy

Pharmacotherapies for smoking cessation are nicotine replacement therapy (NRT), varenicline or bupropion.

It is important that people who smoke who receive pharmacotherapy receive a full course, which will vary depending on the individual smoker. A full course for NRT is at least 8 weeks, for varenicline it is at least 12 weeks and for bupropion it is at least 8 weeks.

NICE's technology appraisal guidance on varenicline for smoking cessation states that varenicline should normally be prescribed only as part of a programme of behavioural support.

NICE's guideline on stopping smoking in pregnancy and after childbirth states that there should be a discussion about the risks and benefits of NRT with pregnant women who smoke. Nicotine replacement therapy should be offered if smoking cessation without NRT fails, or practitioner judgement should be used if women express a clear preference for NRT. Neither varenicline nor bupropion should be offered to pregnant or breastfeeding women.

Equality and diversity considerations

There should be a discussion about risks and benefits of using NRT with young people aged 12–17 and pregnant or breastfeeding women.