International Tobacco Intervention

Published by the National Health Service of England

Recommendations for the primary care team

Assess the smoking status of patients at every opportunity; advise all smokers to stop; assist those interested in doing so; offer follow up; refer to specialist cessation service if necessary.

Recommend smokers who want to stop to use nicotine replacement therapy (NRT) and provide accurate information and advice on NRT.

Recommendations for all health professionals

Assess the smoking status of patients at every opportunity; advise all smokers to stop; assist those interested in doing so; refer to specialist cessation service if necessary; recommend smokers who want to stop to use NRT; provide accurate information and advice on NRT. 

Recommendations for smoking cessation specialists

Intensive smoking cessation support should where possible be conducted in groups, include coping skills training and social support, and should offer around five sessions of about one hour over about one month, and follow up.

Intensive smoking cessation support should include the offer of or encouragement to use NRT, and clear advice and instruction on how to use it.

Nicotine replacement therapy

Smokers should be encouraged to use NRT as a cessation aid. It is effective and safe if used correctly.

Health professionals who deliver smoking cessation interventions should give smokers accurate information and advice on NRT.

Other populations and topics

Hospital staff should assess the smoking status of patients on admission, advise smokers to stop, and assist those interested in doing so. Patients should be advised of the hospital's smoke free status before admission.

Hospital patients who smoke should be offered help in stopping smoking, including the provision of NRT.

Pregnant smokers should be given firm and clear advice to stop smoking throughout pregnancy, and given assistance when it is requested.

Cessation interventions shown to be effective with adults should be considered for use with young people, with the content modified as necessary.

Consideration should be given to ways of increasing the availability of NRT to low income smokers, including at a reduced cost or free of charge.

Smoking and smoking cessation should be part of the core curriculum of the basic training of all health professionals.

Training should be a core part of a smoking cessation programme in all health authorities. Protected time and funding should be built into this programme.

Recommendations for health commissioners

To produce cost effective significant health gain in the population, smoking cessation interventions should be commissioned.

Review current practice, identify needs, and provide core funding to integrate smoking cessation into health services; plan a cessation strategy with public health specialists; seek advice from smoking cessation specialists.

These plans should include a specialist cessation service.

Core fund smoking cessation training, or make sure that smoking cessation is prioritised within existing training budgets.

Make provision to ensure that NRT is available to hospital patients who need it, in conjunction with professional advice and cessation support.

Require all services, departments, and clinics to introduce systems to maintain an up to date record of the smoking status of all patients in their (paper or electronic) notes. It should be regarded as a vital sign.

Ensure that all health care premises and their immediate surrounds are smoke free.

Work with clinicians to put systems in place to audit smoking cessation interventions throughout the health care system.

Full Text of the Recommendations Available as Published in Thorax (the Journal the British Thoracic Society) available here

ASH (Action on smoking and health) is a campaigning public health charity working to eliminate the harm caused by tobacco.

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Department of Health in the United Kingdom offers a website that provides information about reducing exposure to second hand smoke, tobacco cessation and much much more.

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