Pharmacy teams need to be aware of NICE public health guidance on smoking cessation, particularly the section on prescribing and advising on pharmacotherapies, as well as guidance on stopping smoking in pregnancy and after childbirth. NICE guidance states that there is mixed evidence on the effectiveness of NRT in helping women to stop smoking during pregnancy and that it should be used only if smoking cessation without NRT fails. It also recommends that pregnant women using NRT patches should remove them before going to bed and that liquorice-flavoured products should be avoided.

The Commission on Human Medicines states that while it is important to be clear that pregnant smokers should, where possible, try to stop smoking without the use of NRT, it is also recognised that NRT can increase the chances of a successful quit attempt.

Evidence shows that a combination of behavioural support from a stop smoking adviser and pharmacotherapy can increase a smoker’s chances of stopping by up to four times and that purchasing NRT over the counter without behavioural support has no greater effect on success rates than stopping without the assistance of medicines or support.

The Department of Health’s guidance recommends that stop smoking advisors establish whether clients are taking any medicines that may be affected when they stop smoking. You can find up-to-date information about clinically significant drug interactions with smoking and smoking cessation products in the Medicines and Healthcare products Regulatory Agency (MHRA) publication, Drug Safety Update.