Smoking cessation interventions and services [B] Evidence reviews for interventions to aid smoking cessation: behavioural support and pharmacotherapy

National Institute for Health and Care Excellence (2018)

NICE - ISBN: 978-1-4731-2873-6

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Evidence Categories

• Care setting: Healthcare Setting
• Care setting: Community setting
• Population group: Adults
• Population group: Children & Young adults
• Intervention: Bupropian
• Intervention: Multicomponent Interventions
• Intervention: Cognitive Behaviour Therapy
• Intervention: Self-Help Materials
• Intervention: Motivational Interviewing
• Intervention: Behaviour Support
• Intervention: Nicotine Replacement Therapy
• Outcome: Smoking cessation

Type of Evidence

NICE Underpinning Review

Overview

Behavioural support alone. Review question: Is behavioural support (delivered to a person or a group) effective and cost effective?

Pharmacotherapy alone. Review question: Are nicotine replacement therapy (established therapies, for example patch, gum or spray or newer, licensed e-cigarettes) or bupropion, on their own or combined with behavioural support, effective and cost-effective?

Pharmacotherapy with behavioural support. Review question: Are nicotine replacement therapy (established therapies, for example patch, gum or spray or newer, licensed e-cigarettes) or bupropion, on their own or combined with behavioural support, effective and cost-effective?

Recommendations

B1 Ensure the following evidence-based interventions are available for adults who smoke:

• behavioural support (individual and group)

• bupropion

• nicotine replacement therapy (NRT) – short and long acting

• varenicline

• very brief advice. [2018]

B2 Consider text messaging as an adjunct to behavioural support

B3 Offer varenicline as an option for adults who want to stop smoking, normally only as part of a programme of behavioural support, in line with NICE's technology appraisal guidance on varenicline. [2018]

B4 For adults, prescribe or provide varenicline, bupropion or NRT before they stop smoking. [2018]

B5 Agree a quit date set within the first 2 weeks of bupropion treatment and within the first 1 to 2 weeks of varenicline treatment. Reassess the person shortly before the prescription ends. [2018]

B6 Agree a quit date if NRT is prescribed. Ensure that the person has NRT ready to start the day before the quit date. [2018]

B7 Consider NRTc for young people over 12 who are smoking and dependent on nicotine. If this is prescribed, offer it with behavioural support. [2018] 

B8 Ensure behavioural support is provided by trained stop smoking staff (see the National Centre for Smoking Cessation and Training [NCSCT] training standard). [2018]

B9 Ensure very brief advice is delivered according to the NCSCT training module on very brief advice. [2018]