The National Institute for Clinical Excellence have recommended the use of bupropion (Zyban) and nicotine replacement therapy (NRT) for smokers who wish to quit.
The guidance states that NRT or bupropion should normally only be prescribed when smokers have made a commitment to stop smoking on or before a certain date (target stop date), in conjunction with advice and encouragement to help them quit.
First prescriptions of NRT or bupropion should only be enough to last until 2 weeks after the target stop date. Normally, this will be 2 weeks for NRT. For bupropion it will be 34 weeks, because bupropion should be taken for about 1 week before the target stop date. Smokers should only be given a second prescription for NRT or bupropion if they can show they are still trying to stop smoking.
In deciding which of the available therapies to use and in which order they should be prescribed, doctors should take the following factors into account:
The smokers intention and motivation to quit, and how likely it is they will follow the course of treatment as prescribed.
Whether counselling and support are available.
Whether the smoker has used treatments to attempt to stop smoking in the past.
Whether there are medical reasons why the smoker should not be prescribed NRT or bupropion, and whether they are likely to experience adverse effects with either treatment.
Which treatment the smoker would prefer to use.
Anne-Toni Rodgers, Communications Director at NICE, said, On average 300 people a day die as a result of smoking and each year the NHS spends about £1.5 billion treating smoking related illnesses. Todays guidance means that the NHS will be supporting smokers who are motivated to quit with a choice of clinically and cost effective treatments. The guidance also makes it clear that smokers have to be really committed to quitting and taking up the support and advice on offer and if they are unsuccessful, another course of treatment should not usually be prescribed within 6 months. Doctors, in discussion with the patient, will decide which treatment will be the most appropriate to prescribe."
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