New Guide for Primary Care

Posted 29th January 2019 by Dave Cross
The Primary Care and Respiratory Society (PCRS) has released a new tobacco dependency guide for healthcare professionals. It calls it “a practical, immediately implementable, evidence-based framework to enable healthcare professionals to … encourage a quit attempt,” but support for vaping is limited.

The PCRS is the UK’s professional society supporting any health professional working in or with primary care “to deliver high value patient-centred respiratory care.”

The guide was produced by a team of 15, “with expertise in supporting smokers to quit in primary, community, acute physical and mental health settings, and in tobacco dependence research, teaching, public health and policy.” This included ASH UK’s Hazel Cheeseman.

They write: “The guide is a practical, immediately implementable, evidence-based framework to enable healthcare professionals to routinely identify smokers, encourage a quit attempt and support that quit attempt within the real-world context of their own professional sphere.”

The team believes, “Healthcare providers and their commissioners must now consider a new approach to sustain and build on the good progress made by local authorities, public health interventions and legislation.”


While the guide might be pushing a new approach to engage smokers into thinking about quitting, the advice on how to quit remains entrenched in the old paradigm. The suggested conversation is: “Did you know the most effective way to stop smoking is with a combination of support and medication? Both are available on the NHS, and this combination makes you much more likely to success in quitting.”

Given the multitude of smokers who have attempted quitting in the past, a 2016 study found that “for many smokers it may take 30 or more quit attempts before being successful”, and the misunderstandings held by smokers and primary care staff about vaping, the superficial support for switching runs counter to any “new approach” claim; it is very light on harm reduction.

The advice sticks to guidance put out by NICE: “Nicotine containing e-cigarettes have been shown to be effective for smoking cessation but none are currently available with a license,” and focuses mainly on prescribing medication and traditional NRT products in conjunction with counselling.

It’s a missed opportunity, and the links provided do not make up for the limp support given to a tobacco harm reduction that has helped tens of thousands of POTV members switch away from cigarettes.




 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker