The UK’s cost effectiveness body, the National Institute for Health and Clinical Excellence, has drawn up the first comprehensive set of guidelines on how best to help patients stop smoking.

It is estimated that smoking costs the NHS a breath-taking £1.5 billion a year, and the Institute points out that it remains the main cause of preventable morbidity and premature death in England, from smoking-related illnesses such as cancer, respiratory and heart disease.

The guidance, which is designed to make smoking cessation services as effective as possible to better health and help reduce the substantial related burden on the NHS resources, endorses the use of nicotine replacement therapy Pfizer’s Champix (varenicline) or GlaxoSmithKline’s Wellbutrin (bupropion) for people who are planning to stop smoking on or before a particular date alongside proven behavioural counselling and group therapy.

It stresses that Champix or Wellbutrin should not be given to adolescents or pregnant/breastfeeding women, but, interestingly, has deemed the use of nicotine replacement therapy in patients aged over 12 who are clearly nicotine dependent an effective use of resources.

A spokeswoman for anti-smoking charity ASH (Action on Smoking and Health) told PharmaTimes UK News that some may find this aspect of the guidance a little controversial, but stressed that it is important to address the problem in the young, particularly as recent evidence suggests it can take as little as one cigarette for a child to get addicted.

Localised effort
The recommendations also advise primary care trusts to tailor their efforts to target “minority ethnic and socio-economically disadvantaged communities” in the population, and that personalised information, advice and support in giving up the cigarettes should be offered to pregnant smokers.

“We are asking all PCTs, strategic health authorities and commissioners to make it a priority to help people to quit smoking. Most smokers want to quit and in this guidance we aim to ensure that the right services are put in place to help them to stop,” commented Professor Peter Littlejohns, NICE Clinical and Public Health Director and Executive Lead for this guidance.

Stopping smoking is the most cost-effective health intervention, but too few practitioners are asking patients about their smoking habits, the ASH spokeswoman told PharmaTimes. But with this new guidance, they are now well equipped to give the necessary advice, she added.