Smoking Cessation

Key points

• NICE first-line options: nicotine replacement therapy (NRT), varenicline, or bupropion — with behavioural support.
• Varenicline: partial agonist at α4β2 nicotinic receptors — most effective monotherapy; side effects nausea, vivid dreams; avoid in pregnancy.
• Bupropion: contraindicated in epilepsy and eating disorders (lowers seizure threshold).
• NRT: safe and effective; combination (patch + short-acting) increases quit rates.
• All smokers should be offered support to quit at every opportunity.

Decision points in this pathway

• Choose pharmacotherapy:

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.