Smoking: support and treatment (all patients)

Indicator type

General practice indicator suitable for use in the Quality and Outcomes Framework.

Rationale

The most effective method of stopping smoking is by using a combination of behavioural support (one-to-one or group) from a trained stop smoking advisor and one or more of the pharmacotherapies licensed for smoking cessation (including nicotine replacement therapy) or nicotine-containing e-cigarettes. In practice, it is common for pharmacotherapy to be used without support but rare for people to use support without pharmacotherapy. However, the efficacy of behavioural support approximately doubles the continuous abstinence rate, with or without pharmacotherapy treatment.

"Offer of support and treatment" therefore means offering referral or self referral to a local NHS stop smoking adviser (who might be a member of the practice team) plus pharmacotherapy (including nicotine replacement therapy) or nicotine-containing e-cigarettes. Where such support is not acceptable to the patient an alternative form of brief support such as follow up appointments with a GP or Practice Nurse trained in smoking cessation should be offered. Allen Carr's Easyway in-person group seminar is another intervention that is recommended for smoking cessation.

Source guidance

Tobacco: preventing uptake, promoting quitting and treating dependence. NICE guideline NG209 (2021), recommendations 1.11.1, 1.11.2, 1.11.6 and 1.13.1

Specification

Numerator: The number of patients in the denominator who have a record of an offer of support and treatment within the preceding 24 months.

Denominator: The number of patients aged 15 years and over who are recorded as current smokers.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions: None

Minimum population: The indicator would be appropriate to assess performance at individual general practice level.

ISBN: 978-1-4731-6058-3