Managing smoking cessation in primary care

Smoking remains a significant preventable cause of serious chronic diseases. Smokers should be advised about quitting at every opportunity, using very brief advice as a quick and reliable method to instigate empathetic support and understanding, which encourages smokers to consider quitting. Nicotine replacement therapy, especially combining a long-release and short-release formulae, should be the first step in the use of pharmaceutical aids. Ideally, heavily dependent smokers should also be prescribed varenicline, but this is currently unavailable in the UK. An alternative is bupropion, which should be a consideration. However, it is less effective, with more side effects. Electronic cigarettes have been recommended as a suitable quitting aid, and also for harm reduction in those who are not yet ready to stop smoking.