Nice has recommended wider use of licensed nicotine replacement therapy (NRT) for smokers who struggle to quit, in what it has called a "massive departure" from previous guidance.

Although setting an abrupt quit date was still the best option, healthcare professionals should recommend NRT patches and gum to smokers who want to cut down their intake but feel unable to give up in one step, Nice said in guidance released today (June 5).

Nice centre for public health director Mike Kelly said the recommendations were a world first and marked a "massive departure" in its approach to smoking cessation.

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	Smokers die from tar in tobacco rather than nicotine and therefore NRT was much safer than smoking and could reduce overall levels of tobacco-related harm, he argued.

"In the past the message has been simple – stop smoking, period," Professor Kelly told a press conference yesterday (June 4). "Now we're recognising there's a group of people for whom that's not possible."

This could be smokers who wanted to take a gradual approach to quitting or those who simply wanted to reduce their cigarette intake, said Nice guidance development group chair Linda Bauld. She argued the fresh approach could help address the high number of failed quit attempts in the UK and boost long-term success.

"We know about 40 per cent of smokers try to stop every year in the UK but very few succeed and one of the reasons could be that we're not offering enough options," Professor Bauld highlighted.

Rakesh Patel, pharmacy manager at Mr Pickford's Pharmacy, Leicester, broadly welcomed the guidance. His pharmacy regularly offers smoking cessation services and his team already advises patients to gradually cut down with the help of NRT.

But all smokers should set a final quit date, Mr Patel argued, even if the transition period was longer. "There should be some sort of quit date set because otherwise people don't get there," he told C+D.

Nice does not recommend e-cigarettes in its guidance, as the MHRA is yet to license the products. But it advised that e-cigarettes were likely to be less harmful than cigarettes.

The MHRA is due to make an announcement on e-cigarettes in spring next year, Nice said.

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