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Stop smoking services
National Institute for Health and Care Excellence
Prescribing and advising on pharmacotherapies
When to prescribe
Offer NRT, varenicline or bupropion, as appropriate, to people who are planning to stop smoking
NRT, varenicline or bupropion should normally be prescribed as part of an abstinent-contingent treatment, in which the smoker makes a commitment to stop smoking on or before a particular date (target stop date). The prescription of NRT, varenicline or bupropion should be sufficient to last only until 2 weeks after the target stop date. Normally, this will be after 2 weeks of NRT therapy, and 3–4 weeks for varenicline and bupropion, to allow for the different methods of administration and mode of action. Subsequent prescriptions should be given only to people who have demonstrated, on re-assessment, that their quit attempt is continuing
Varenicline or bupropion may be offered to people with unstable cardiovascular disorders, subject to clinical judgement
Consider offering a combination of nicotine patches and another form of NRT (such as gum, inhalator, lozenge or nasal spray) to people who show a high level of dependence on nicotine or who have found single forms of NRT inadequate in the past
Management of asthma in adults over 65 years of age
Development group: Gruffydd-Jones, McArthur, Murphy, Russell & Wise. This management algorithm was developed by a multidisciplinary expert panel: Gruffydd-Jones K et al with the support of a grant from Teva UK Limited.