This document constitutes the Institute’s formal guidance on brief interventions and referrals for smoking cessation in primary care and other settings.

The Public Health Interventions Advisory Committee (PHIAC) considered the evidence of effectiveness and cost effectiveness and comments from stakeholders. The original referral from the Department of Health made particular reference to pregnant women and vulnerable groups. However, PHIAC considered that the evidence was insufficient to make specific recommendations for these groups. The resulting recommendations apply to all smokers.

1.1 Brief interventions in health and community care
Brief interventions involve opportunistic advice, discussion, negotiation or encouragement. They are commonly used in many areas of health promotion and are delivered by a range of primary and community care professionals.

For smoking cessation, brief interventions typically take between 5 and 10 minutes and may include one or more of the following:
• simple opportunistic advice to stop
• an assessment of the patient’s commitment to quit
• an offer of pharmacotherapy and/or behavioural support
• provision of self-help material and referral to more intensive support such as the NHS Stop Smoking Services.

The particular package that is provided will depend on a number of factors, including the individual’s willingness to quit, how acceptable they find the intervention on offer and the previous ways they have tried to quit. Diagram 1 summarises this care pathway.