This site is intended for health professionals only

NICE issue first public health guidelines

The first National Institure for Health and Care Excellence (NICE) public health guidance to be released recommends that licensed nicotine-containing products can be used to help people to reduce the amount they smoke, especially those who are highly dependent on nicotine.

This includes people who may not be able to stop smoking in one go, those who want to stop smoking without necessarily giving up nicotine, and those who might not be ready to stop but want to reduce the amount they smoke.

According to NICE, the best way to reduce the harm from smoking is to stop completely and the best chance of doing this is still to quit in one step.

This guidance recognises that for people who've been unable to stop using this standard method, the approaches recommended in this new guidance can help.

Professor Mike Kelly, director of the NICE Centre for Public Health, said: “This is the first time anywhere in the world that national guidance will endorse cutting down on smoking with the help of licensed nicotine products, such as patches or gum, as a way to help reduce the harm caused by tobacco.

“This guidance recommends harm reduction as an additional new option particularly for those who are highly dependent on smoking who want to quit, but can't just stop in one go.”

Linda Bauld, chair of the NICE guidance development group, and Professor of Health Policy at the University of Stirling, said: “The cost to the NHS in England of treating smoking-related illnesses is an estimated £2.7 billion a year. One in five adults in England smoke, and around two-thirds of people who smoke say they'd like to quit.

“Harm reduction approaches also provide an alternative choice for those who are not currently interested in quitting smoking. Although existing evidence isn't clear about the health benefits of smoking reduction, for some people this reduction can kick-start a gradual change in behaviour that eventually leads them to quit, especially if they use licensed nicotine-containing products.”

A recent study showed that many GPs believe nicotine is one of the harmful ingredients in tobacco products.

Chief medical officer, Professor Dame Sally Davies, said: "Smokers are harmed by the deadly tar and toxins in tobacco smoke, not necessarily the nicotine they're addicted to. The best thing smokers can do for their health is quit, but if they're not able or ready to then using safer sources of nicotine instead of smoking is much better.

Professor Paul Aveyard, NICE guidance developer, GP and Professor of Behavioural Medicine at the University of Oxford said: “Advisors should reassure people that licensed nicotine-containing products are a safe and effective way of reducing the harm from cigarettes, and that NRT products have been shown in trials to be safe for at least 5 years' use.

“Whatever approach people wish to try, they should be advised that there are no circumstances when it is safer to smoke than to use licensed nicotine containing products and experts believe that lifetime use of these products will be considerably less harmful than smoking.”

Professor John Britton, chair of the Royal College of Physicians (RCP) Tobacco Advisory Group, said: "We welcome this new guidance from NICE, which puts into practice many of the proposals put forward by the RCP in its report on harm reduction in nicotine addiction in 2007.
 
“This guidance has the potential to change millions of lives for the better. We commend it.”