Management of Smoking in primary Care

Many people with illness caused by smoking continue smoking despite being regularly offered help to quit by their GPs. They have tried and exhausted regular medication and so their health deteriorates because of smoking. Electronic cigarettes, known as ‘e-cigarettes’, are increasingly used by smokers who are not seeking treatment, many of whom reduce smoking and go on to quit without initially intending to do so. Research tells us that people smoke for nicotine but it is the tar not the nicotine that damages health. Providing nicotine by e-cigarettes, which feel like smoking, probably reduces harm and the evidence suggests it helps people reduce the number of cigarettes they smoke and stop smoking.

This research will show whether GPs and nurses can be trained to offer advice about e-cigarettes to smokers who do not want to stop but have illnesses caused by smoking. We will also see whether smokers who have refused other treatments for stopping smoking would be happy to take part in the study and use e-cigarettes if they are recommended to do so by their GP or nurse. The aim of this study is to investigate these questions and, if that is shown, to assess whether more people stop or halve their smoking in the short-term.

If we find that we can recruit people and follow them up, that doctors and nurses give good advice and enough people use e-cigarettes and reduce or stop smoking in the short-term, we can be confident that it would be worthwhile to do a larger study to investigate whether GPs promoting e-cigarettes to smokers with smoking-related diseases helps people stop smoking in the long-term.