NICE guidance gives boost to smoking cessation drugs

Thursday 11 April 2002

ASH news release:  Embargo: 11:00 Thursday 11th April 2002


New guidance by NICE [1] will bring the treatment of addiction to tobacco into the NHS mainstream.  The review shows that the main smoking cessation treatments – nicotine replacement therapy and bupropion (Zyban) – are incredibly cost effective and represent extremely good value for money for the NHS.  As the guidance says (4.3.1): Both bupropion and NRT are considered to be among the most cost effective of all healthcare interventions.  The cost-effectiveness is at least 15 times better than the threshold of £30,000 per life-year saved that NICE generally applies.

Many of the recommendation made by ASH, Cancer Research UK and the British Lung Foundation to NICE [2] have been incorporated into the guidance and health campaigners now believe that smoking cessation must move further into the NHS mainstream.   The review also reaffirmed the confidence of the regulators in Zyban following highly misleading press coverage of supposed adverse effects.

Clive Bates, Director of the anti-tobacco campaigning group ASH, said:

This should end any doubts or hesitation about prescribing these life-saving drugs that still persist in the NHS.  When a doctor treats smoking he or she is effectively tackling 50 different diseases before they can develop, and that saves a lot of life and lot of money in the long term.

The government has already given a great boost to smoking cessation by funding specialist clinics for smokers and by making the drugs available on prescription, and that has been one of the highlights of the public health and tobacco programme introduced in 1998.

But some health authorities and trusts are still too short term in their approach and reluctant to spend drugs budgets on treating nicotine dependence.  The new guidance send a clear signal to all NHS budget-holders that these products combined with the support and counselling that goes with them are extremely good value for the NHS.

GPs now have the means to really help smokers to quit, but without taking on a massive new workload.  Doctors can give some brief advice, prescribe the drugs, and refer the patient on to a specialist clinic, telephone help-line, web site or increasingly for a proper discussion with pharmacist or practice nurse.  But if the smoker isn’t hearing a clear message from the doctor, then the danger is that they are not going to take it that seriously.

ASH added particular support for the Zyban product, which has been the subject of highly misleading media reports.

Clive Bates added:

One of the best products we have for smoking cessation is Zyban, but confidence in the product has been almost undermined by media scare stories based on a simple misunderstanding of routine surveillance data.

The fact that 54 people have died suddenly while taking Zyban does not mean that they have died because of taking Zyban.  When 500,000 people have used a product, some are likely to die anyway – especially if they are smokers. The danger is that people will turn away from Zyban and end up smoking instead, thus facing risk 100,000 times greater.



[1]  National Institute for Health and Clinical Excellence (NICE) – guidance on smoking cessation

[2] ASH, Cancer Research and British Lung Foundation joint submission to NICE [summary – pdf]


Contact: Clive Bates 020 7739 5902 (w) 077 6879 1237 (m) ISDN available