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There are many routes to smoking cessation. We explore the different approaches to helping people quit and stay smoke-free

Public support for government action to limit smoking has risen over the last 16 years, according to the “Public Support for a Smokefree Society” report published by Action on Smoking and Health (ASH) in May 2025. 

The new data on public attitudes in England revealed that 68 per cent of adults support the Smokefree Generation measure in the Tobacco and Vapes Bill, which will permanently prohibit the sale of tobacco products to anyone born in 2009 or later, and 65 per cent support the goal to make Britain a country in which no one smokes. 

However, 45 per cent of adults surveyed by ASH feel that the government still isn’t doing enough to limit smoking. According to ASH, the Tobacco and Vapes Bill is a major step forward towards a smoke-free society, but there is still much to do to support existing smokers to quit and to reduce the harm of tobacco. 

The latest Office for National Statistics data on adult smoking habits in the UK in 2023 revealed that around 6 million people aged 18 and over (11.9 per cent of UK adults) smoked cigarettes in 2023.

In addition, around 5.1 million adults aged 16 and over (9.8 per cent) used an e-cigarette daily or occasionally in Great Britain in 2023, based on the Opinions and Lifestyle Survey. Of the people who smoked in 2023, 55.9 per cent intended to quit smoking. 

In May 2025, Community Pharmacy England (CPE) and the Taskforce for Lung Health backed a greater role for pharmacies in supporting lung health. New YouGov polling revealed that four out of five people across England would support increasing the range of respiratory health services offered by pharmacies.

“The historic Tobacco and Vapes Bill will make the UK the first place in the world to take a whole generation out of tobacco dependency and ban cigarettes for everyone born after 2009 forever,” says Jonathan Blades, director of external affairs at Asthma + Lung UK, which is a member of Taskforce for Lung Health.

“But we also need to help the six million people who already smoke – and pharmacies, who see 1.6 million people through their doors every day, are well placed to do that. To do this, we want to see a nationally commissioned Community Pharmacy Smoking Cessation Service, which any smoker can access without needing a referral.”

Disposable vape ban 

It’s too early to assess whether the recent ban on single-use, disposable e-cigarettes (vapes), which began on 1 June, will have an impact on smoking cessation rates in the UK – and whether it will encourage more smokers to use pharmacy stop smoking services.

The accessibility and low price of single-use vapes have appealed to young people, in particular, so the ban on these devices is seen as an opportunity to address the concerning levels of vaping among teenagers. It is hoped that the ban will also help to reduce environmental waste. 

A population study conducted at University College London (UCL), in February 2024, estimated that a ban on disposable e-cigarettes would affect one in 20 adults in Britain (around 2.6 million people).

Young people would be affected the most, including 18- to 24-year-olds who use disposables but have never regularly smoked tobacco. This may then discourage the uptake of vaping in this age group. 

However, a ban would also affect 1.2 million people who currently smoke and a further 744,000 who previously smoked. This would have a disproportionate impact on disadvantaged groups that have higher rates of smoking and typically find it harder to quit. 

In February 2024, Professor Jamie Brown, at the UCL Institute of Epidemiology & Health Care, said that although action is required to try to minimise vaping among young people who have never previously smoked, a balancing act is required to avoid deterring people from using e-cigarettes to give up smoking. 

“Banning disposables is unlikely to fix the issue as popular brands have already launched reusable products with very similar designs and prices,” he says.

“A sensible next step would be to introduce stricter regulation around product appearance, packaging and marketing, as those are less likely to reduce the effectiveness of e-cigarettes for smoking cessation – unlike, for instance, flavour bans.”

Many people switch to vaping from smoking cigarettes, and non-disposable e-cigarettes are still available for people looking to quit smoking. 

“Vaping products are one of several harm reduction options for short-term use to encourage smokers to stop using tobacco products,” says community pharmacist Jonathan Burton, chair of the Royal Pharmaceutical Society (RPS) in Scotland. 

“They should be accessible to adults who smoke and wish to stop, but the ultimate aim should be to support people to stop using vapes and to be free of nicotine addiction all together. Although considered to be less harmful than tobacco, vapes are not risk-free.” 

Traditional NRT products

According to Blades, some people would prefer to use a more pharmacotherapy-driven route to quitting. “Traditional stop smoking aids such as nicotine replacement therapy (NRT), and the advice community pharmacies can provide, remain a very important part of helping people to quit smoking,” he says.

“Pharmacies should work with their patients to understand which route to quitting smoking will be the most effective for them, and support them to try as many methods as needed until a successful quit attempt is made.”

Research at UCL on “Prevalence of Popular Smoking Cessation Aids in England and Associations with Quit Success”, published online in January 2025, revealed that the most-used quitting aids in England in 2023 to 2024 were e-cigarettes (used by 40.2 per cent) and over-the-counter (OTC) NRT (used by 17.3 per cent), although 40.8 per cent of quit attempts were unaided. Other aids positively associated with quitting success included websites (used by 4.6 per cent), prescription NRT (used by 4.5 per cent) and varenicline (used by 1.1 per cent).

Face-to-face behavioural support (used by 2.2 per cent) was associated with higher odds of quitting success among those from less advantaged – but not more advantaged – socioeconomic positions. 

Reports by Mintel and Euromonitor last year predicted that the ban on disposable vapes could benefit the sales of the more traditional smoking cessation products, such as NRT. However, research shows that many people who were using disposable e-cigarettes were already switching to reusable vaping products before the ban was implemented.

According to Mintel’s “UK Smoking Cessation and E-Cigarettes Market Report 2024”, 46 per cent of UK adults think the cost of traditional smoking cessation products is too high, which is a potential barrier to quitting. 

The Euromonitor report “NRT Smoking Cessation Aids in the United Kingdom”, published in September 2024, specified that while the disposable vape ban is expected to have a significant impact on value sales of NRT smoking cessation aids, NRT smoking cessation aids could also face competition from prescribed smoking cessation medicines, such as cytisine.

“Pharmacies could well see an increase in demand for NRT products, such as patches, gum and lozenges, as people seek alternative ways to manage nicotine cravings now that disposable vapes are no longer available,” says Burton. “Certain NRT products are specifically designed to help people quit vaping and have been tested for this use, so it’s important people are advised in the pharmacy about all the smoking cessation options available to them to increase their chances of quitting for good.”

According to a Healthwatch blog in January 2025, smokers and vape users often struggle to access stop-smoking services and education. The promotion of these services and general attitudes towards smokers and their health could be improved.

The NHS smoking cessation role of pharmacy in England is currently limited to either the hospital smoking cessation service on discharge (the Smoking Cessation Service, which was commissioned as an Advance service from March 2022) or in some cases where a local authority commissions local pharmacies to deliver a smoking cessation service. Some pharmacies also offer private smoking cessation services. 

“Pharmacy-based smoking cessation services are highly effective at helping people to quit smoking,” says Blades. “Indeed, using stop smoking services is three times as effective as making an unassisted quit attempt.

"However, we know that not all pharmacies offer this service, which means there are disparities for patients in where they can access a ‘discharge from hospital’ pharmacy smoking cessation service.”

Joanna Feeney, stop smoking systems strategic manager at Fresh, says that subject to commissioning and capacity, there are opportunities for pharmacies to play a much wider role in smoking cessation. 

“Community pharmacies play a critical role in reducing smoking and increasing the impact whether this is delivering Very Brief Advice, enabling provision of stop smoking medications or providing smoking cessation support (whether on discharge from hospital, commissioned by local authorities or elsewhere),” she says. 

Alastair Buxton, director of NHS services at CPE, says that the current national NHS Smoking Cessation Service has been beneficial for patients, but it has limited scope – and referral numbers into the service have been low.

It is hoped that changes to the service will encourage more patients to access it. 

These changes involve allowing suitably trained and competent pharmacy staff to provide the service, alongside pharmacists and pharmacy technicians, who are currently able to undertake consultations, and enabling patients to access prescribed varenicline and cytisinicline directly through the service via a patient group direction.

“We were pleased to have gained agreement for skill-mix changes and enabled provision of varenicline and cytisinicline under the service as part of contract negotiations for 2025/26,” says Buxton.

“These changes will support pharmacy owners to better manage the workload across their teams, and offer a wider range of treatments.”

Rachel McIlvenna, the Smokefree NHS strategic manager at North East and North Cumbria ICB, says that when patients access the hospital pharmacy smoking cessation service, there are relatively reasonable outcomes at 28-days post-discharge, which means the service is likely to be effective. 

“Uptake is variable across the country as the number of pharmacies signed up and delivering is dependent on local arrangements, existing community pharmacy pressures and the preparedness of local trusts to use them as a discharge route for referrals to smoking cessation,” she says. 

Enhanced services

CPE would like to see the current NHS Smoking Cessation Service to be enhanced so that it becomes an open-access service open to all smokers and users of nicotine vapes who want to quit. “So many more people could be benefiting from stop smoking support through community pharmacies,” says Buxton.

“Pharmacy teams have always been a key part of local efforts to support people to stop smoking, but variability in local public health budgets has led to a postcode lottery in provision. We strongly recommend the commissioning of a national service from pharmacies, building on the existing limited Advanced service.”

Burton says that clinical trials provide strong evidence that community pharmacy smoking cessation services are effective. “We [the RPS] would also like to see the government invest in more consistent smoking cessation service availability in England, similar to the core-funded programmes already available in Wales and Scotland,” he says.

“Smoking cessation services are one of the building blocks for the recognition of the impact of community pharmacy teams on preventative and population health.”