Tobacco - harm reduction: call for evidence - effectiveness review

The National Institute for Health and Clinical Excellence (NICE) has been asked by the Department of Health to develop public health guidance on the use of tobacco harm reduction approaches to smoking cessation. See the final scope for this guidance.

To inform the development of the guidance, NICE has commissioned a number of reviews of the evidence and an economic analysis. Three of  the reviews focus on effectiveness of tobacco harm reduction approaches and the barriers and facilitators to their implementation, specifically:

  • A review of the effectiveness of tobacco harm reduction approaches with the intention of quitting (ie ‘cutting down to quit’ or ‘reduction to stop smoking’), with and without assistance (Review 2)
  • A review of the effectiveness of long-term tobacco harm reduction approaches without the prior intention of quitting (ie reducing consumption without the aim of quitting), with and without assistance (Review 3)
  • A review of the barriers and facilitators to implementing smoking cessation and tobacco harm reduction approaches, including user and provider perspectives (Review 4)

We are interested in a broad range of different types of evidence. This includes quantitative or qualitative research, published or unpublished.

We would like to receive details of evidence that relates to the effectiveness of harm reduction approaches with the intention of quitting (Review 2), specifically addressing the questions set out below:

Question 1 How effective and cost effective are pharmacotherapies in helping people cut down smoking before quitting? How effective and cost effective are different combinations of Nicotine Replacement Therapy (NRT) products in helping people cut down smoking before quitting?

Question 2 How effective are ‘nicotine-containing products’ in helping people cut down smoking before quitting?

Question 3 Is there an optimal period for helping people cut down smoking with the aim of quitting?

Question 4 Is it more or less effective to draw up a schedule to help someone cut down smoking with the aim of quitting?

Question 5 Which kinds of behavioral support, counselling, advice or self-help (with or without pharmacotherapy) are effective and cost effective in helping people cut down smoking before quitting?

Question 6 Do some tobacco harm-reduction approaches have a differential impact on different groups (for example, people of different ages, gender, socioeconomic status or ethnicity)?

Question 7 Are there any unintended consequences from adopting a tobacco harm-reduction approach, for example, does it deter people from trying to stop smoking?

We would like to receive details of evidence that relates to the effectiveness of long-term harm reduction approaches without the prior intention of quitting (Review 3), specifically addressing the questions set out below:

Question 1  How effective and cost effective are pharmacotherapies in helping people cut down or abstain from smoking, temporarily or indefinitely without the aim of quitting? How effective and cost effective are different combinations of NRT products in helping people cut down or abstain from smoking, temporarily or indefinitely without the aim of quitting?

Question 2  How effective are ‘nicotine-containing products’ in helping people cut down or abstain from smoking, temporarily or indefinitely without the aim of quitting?

Question 3 Is there an optimal period to help people cut down or abstain (temporarily or indefinitely) from smoking without the aim of quitting?

Question 4 Is it more or less effective to draw up a schedule to help people cut down or abstain from smoking, temporarily or indefinitely, without the aim of quitting?

Question 5  Which kinds of behavioral support, counselling, advice or self-help (with or without pharmacotherapy) are effective and cost effective in helping people to cut down or abstain from smoking, temporarily or indefinitely, without the aim of quitting?

Question 6 Do some tobacco harm-reduction approaches have a differential impact on different groups (for example, people of different ages, gender, socioeconomic status or ethnicity)?

Question 7 Are there any unintended consequences from adopting a tobacco harm-reduction approach, for example, does it deter people from trying to cut down or abstain from smoking, temporarily or indefinitely?

We would also like to receive details of evidence that addresses the barriers and facilitators to implementing harm reduction approaches (Review 4), specifically addressing the questions set out below:

Question 1 What factors might act as barriers or facilitators to tobacco harm-reduction approaches?

Question 2 How can practitioners deliver messages about tobacco harm reduction without weakening the impact of advice about the benefits of stopping smoking?

Question 3 Do some tobacco harm-reduction approaches (including behavioural support, counselling, advice or self-help) have a differential impact on particular groups (i.e. by age, gender, socio-economic status or ethnicity)?

Question 4 Are there any unintended consequences from adopting a harm-reduction approach, for example does it deter people from trying to stop smoking?

Please note we not need to receive evidence on the following as they will not be covered by the guidance:

  • Pregnant women
  • Any products containing tobacco. This includes products which are claimed to deliver reduced levels of toxicity (such as 'low tar' cigarettes) or which reduce exposure to tobacco smoke, for example, by warming instead of burning it.
  • Products that are smoked that do not contain tobacco, such as herbal cigarettes.
  • Smokeless tobacco products such as gutka or paan. (These products are associated with a number of health problems and are the focus of NICE guidance in development – see section 6.)
  • ‘Snus’ or similar oral snuff products as defined in the European Union’s Tobacco Product Directive (European Parliament and the Council of the European Union 2001).
  • Alternative or complementary therapies, such as hypnotherapy or acupuncture. (Note: non-NHS services, including complementary therapies, were reviewed for NICE public health guidance 10 on ‘Smoking cessation services’.)

In terms of published material, we are interested in identifying studies that have been published since 1990 that relate to the questions outlined above.  The studies may be published in journals, texts or monographs.  

In terms of unpublished material, we are interested in identifying unpublished manuscripts relating to research conducted since 1990, or any ongoing research that is being conducted, and which relates to the review questions outlined above. 

Please note that the following material is not eligible for consideration:

  • Promotional material
  • Undocumented assertions of effectiveness.
  • Opinion pieces
  • Forms with electronic attachments of published material, or hard copies of published material.   For copyright reasons, we cannot accept these copies.   However, if you give us the full citation, we will obtain our own copy.

Instructions for Published material

Please send full reference details (which are to include author/s, title, date, journal or publication details including volume and issue number and page numbers), - NOT a PDF/WORD attachment or hard copy - using this form  by 5pm on 12 September to tobaccoharmreduction@nice.org.uk   

Instructions for Unpublished material

If you are aware of trials/ongoing research relevant to our questions which are in progress please could you help us to identify that information by providing relevant information such as a link to a trial registered with the Cochrane Central Register of Controlled Trials (Clinical Trials), or with the US National Institutes of Health trials registry

If you wish to submit academic in confidence material (i.e. written but not yet published) or commercial in confidence (i.e. internal documentation), please could you highlight which sections are confidential by using the highlighter function in Word.  Such content will not be made public.  Please refer to section 4.4 of the Process Manual for further information on submissions of confidential material.

Please use this form to send in details  of any relevant evidence by 5pm on 12 September 2011 to tobaccoharmreduction@nice.org.uk

We look forward to receiving information on this and thank you in advance for your help.

This page was last updated: 11 August 2011

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.