Home > Tobacco: harm-reduction approaches to smoking.

National Institute for Health and Care Excellence. (2018) Tobacco: harm-reduction approaches to smoking. NICE public health guidance 45.

External website: http://pathways.nice.org.uk/pathways/smoking-tobac...

Nicotine inhaled from smoking tobacco is highly addictive. But it is primarily the toxins and carcinogens in tobacco smoke – not the nicotine – that cause illness and death. The best way to reduce these illnesses and deaths is to stop smoking. In general, stopping in one step (sometimes called 'abrupt quitting') offers the best chance of lasting success (see NICE guidance on smoking cessation). However, there are other ways of reducing the harm from smoking, even though this may involve continued use of nicotine.

This guidance is about helping people, particularly those who are highly dependent on nicotine, who:
• may not be able (or do not want) to stop smoking in one step
• may want to stop smoking, without necessarily giving up nicotine
• may not be ready to stop smoking, but want to reduce the amount they smoke.

This guidance recommends harm-reduction approaches which may or may not include temporary or long-term use of licensed nicotine-containing products.

The recommendations cover:
• Raising awareness of licensed nicotine-containing products.
• Self-help materials.
• Choosing a harm-reduction approach.
• Behavioural support.
• Advising on licensed nicotine-containing products.
• Supplying licensed nicotine-containing products.
• Follow-up appointments.
• Supporting temporary abstinence.
• People in closed institutions.
• Staff working in closed institutions.
• Commissioning stop smoking services.
• Education and training for practitioners.
• Point-of-sale promotion of licensed nicotine-containing products.
• Manufacturer information on licensed nicotine-containing products.

Item Type
Publication Type
International, Guideline, Web Resource
Drug Type
Tobacco / Nicotine
Intervention Type
Harm reduction
March 2018
Identification #
NICE public health guidance 45
20 p.
Corporate Creators
National Institute for Health and Care Excellence
Place of Publication
Accession Number
HRB (Electronic Only)

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