NICE NG209 — Tobacco: preventing uptake, promoting quitting and treating dependence
| Field | Value |
|---|---|
| Issuing body | National Institute for Health and Care Excellence (UK) |
| Year | 2021; last reviewed 4 February 2025 |
| Scope | Support to stop smoking for everyone aged 12 and over; harm reduction; prevention of uptake in children, young people and young adults (up to 24) |
| Source | nice.org.uk/guidance/ng209 |
Key positions
- Behavioural support: individual or group behavioural support should be offered to everyone who wants to quit; it should not be rationed by "readiness to quit".
- Medications: varenicline and NRT (alone or combined) are the principal options; bupropion and cytisine are also covered — the 2025 review added new recommendations on cytisinicline (cytisine).
- E-cigarettes: clinicians can offer nicotine-containing e-cigarettes as an aid for people interested in using them to quit smoking; users should be advised to stop smoking completely.
- Harm reduction: for people not ready to stop in one go, supports staged reduction, including temporary use of licensed nicotine products.
Notable differences
NG209 is the most e-cigarette-accommodating of the major guidelines: it treats nicotine-containing e-cigarettes as a legitimate offer, in contrast to WHO (insufficient evidence) and USPSTF (I statement). NG209 also explicitly addresses harm reduction and gradual approaches, and extends to people aged 12 and over.