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A Smoking Cessation Policy for Scotland

Recommendations

Having reviewed the available evidence the expert working group made the following recommendations:

1. A regulatory framework such as that of the Medicines Control Agency should be established for all nicotine delivery systems including tobacco products. This would control nicotine as an addictive substance.
2. Nicotine replacement therapy should be available on prescription: nicotine patches for moderately dependent smokers and nicotine gum and/or nasal spray for more heavily dependent smokers.
3. Healthcare workers and medical coders should be encouraged to use the new ICD10 classification which enables recording of harm due to tobacco use as code F17.1 and tobacco dependence as code F17.2, and tobacco withdrawal state as F17.3.
4. Few medical interventions have the potential of smoking cessation to deliver such cost-effective health gains. Smoking cessation should be recognised as a core activity of the NHS in Scotland and should receive long-term funding.
5. A stepped-care approach to smoking cessation interventions should be adopted in the UK matching the intensity of the intervention to smoker's level of motivation and addiction. Guidelines on clinical practice should be established and implemented in Scotland.
6. A critical feature of making smoking cessation a core activity is setting up specialist cessation clinics in every health board to provide intensive support for smokers and permanent back up for primary care professionals.
7. In view of the harmful effects of smoking in pregnancy both for mother and child smoking cessation interventions in pregnancy should be a priority for health boards. Efforts should also be made to continue cessation interventions beyond pregnancy.
8. Smoking cessation initiatives aimed at young people, particularly those under 16, should be established and evaluated. This shouldlead to the development of a national cessation strategy for young people.
9. Further research and evaluation should be carried out on the effectiveness of community interventions, the role of different primary care professionals, their training needs, and interventions aimed at tackling inequalities in health
10. In light of the forthcoming White Paper on tobacco control, the Minister for Health at the Scottish Office should be invited to chair a Task Force to develop a tobacco control strategy for Scotland.


Summary
Introduction
Nicotine
Smoking Cessation Interventions
Approaches in Different Settings
Cost Effectiveness
Inequalities in Tobacco Use
Other Issues
Conclusions
Recommendations
References
Appendices

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Action on Smoking & Health (Scotland) (ASH Scotland) is a registered Scottish charity (SC 010412) and a
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