For years, Britain has encouraged people who wanted to kick the habit to simply stop, with various supports available, including counselling and nicotine products. But nicotine replacement therapies were not recommended for people who still wanted to cut down but not quit immediately.
But in advice issued Wednesday, the National Institute for Health and Care Excellence said people unable to give up cigarettes in a single attempt should switch to licensed nicotine products, including gum, sprays and patches to at least reduce how much they smoke. The advice doesn't recommend e-cigarettes, which aren't yet regulated in Britain. Recommendations made by NICE are typically adopted by the government.
"People smoke because of the nicotine, but they die because of the tar in tobacco," said Mike Kelly, director of NICE. When people smoke fewer cigarettes without using nicotine replacement therapies, they typically inhale more deeply and ingest more tar, he said. By using nicotine products such as gum or patches, they can smoke less without any acute withdrawal symptoms. Kelly said smokers were still encouraged to quit entirely but that this new advice gives them another option.
According to NICE's assessment of past research, nicotine replacement products can be safely used with cigarettes for at least five years. NICE advised heavy smokers that they may need more than one product if they do try to quit.
The agency also said nicotine replacement therapies can be used for as long as they curb the urge to smoke and in the long term to prevent relapses. About one in five people in the U.K. smoke, and tobacco is estimated to cost the health system nearly >3 billion ($4.6 billion) every year.
"Since tobacco is by far the most harmful available source of nicotine, switching to alternatives ... is the obvious healthier choice," John Britton, chairman of the Royal College of Physician's Tobacco Advisory Group, said in a statement. "This guidance has the potential to change millions of lives for the better."
In the U.S., the Food and Drug Administration advises people to use nicotine replacement therapies when they want to quit. The agency says the products should be used as part of an attempt to quit smoking and should not be used indefinitely.
AP Medical Writer Mike Stobbe contributed to this report from Atlanta.