Smoking: support and treatment for people with long-term conditions or SMI
Indicator
The percentage of patients with any or any combination of the following conditions: CHD, PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who are recorded as current smokers who have a record of an offer of support and treatment within the preceding 12 months.
Indicator type
General practice indicator suitable for use in the Quality and Outcomes Framework.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
NICE guidance recommends smoking cessation treatment and support for people with the conditions outlined in the indicator wording. People with these conditions face increased risks from smoking (for example, increased risk of cardiovascular disease) compared with the general population. In addition, there is evidence that people who smoke are receptive to smoking cessation advice in all healthcare settings and that healthcare professionals are effective in helping people to stop smoking.
Source guidance
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Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN). NICE guideline NG245 (2024) recommendations 1.13.2 and 1.14.1
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Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE guideline NG238 (2023), recommendation 1.3.11
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Tobacco: preventing uptake, promoting quitting and treating dependence. NICE guideline NG209 (2021, updated 2025), recommendations 1.11.1, 1.11.2, 1.11.6 and 1.13.1
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Chronic kidney disease: assessment and management. NICE guideline NG203 (2021), recommendation 1.4.6
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Hypertension in adults: diagnosis and management. NICE guideline NG136 (2019, updated 2023), recommendation 1.4.7
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Chronic obstructive pulmonary disease in over 16s: diagnosis and management. NICE guideline NG115 (2018, updated 2019), recommendation 1.2.3
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Type 1 diabetes in adults: diagnosis and management. NICE guideline NG17 (2015, updated 2022), recommendation 1.12.5
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Psychosis and schizophrenia in adults: prevention and management. NICE guideline CG178 (2014), recommendations 1.1.2.3 and 1.1.2.4
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Peripheral arterial disease: diagnosis and management. NICE guideline CG147 (2012, updated 2020), recommendation 1.2.1
Specification
Numerator: The number of patients in the denominator who have a record of an offer of support and treatment within the preceding 12 months.
Denominator: The number of patients with any or any combination of the following conditions: CHD, PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who are recorded as current smokers.
Calculation: Numerator divided by the denominator, multiplied by 100.
Exclusions: None.
Expected population size: Quality and Outcomes framework data for 2023 to 2024 (indicator SMOK005) shows that 3.1% of people in England with any or any combination of the relevant conditions (CHD, PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses) are recorded as current smokers: 313 patients for an average practice with 10,000 patients. To be suitable for use in QOF, there should be more than 20 patients eligible for inclusion in the denominator, per average practice with 10,000 patients, prior to application of personalised care adjustments.