Synopsis
Deliver measurable UK cardiovascular lifestyle intervention and evidence-based treatment of tobacco dependence.
- Ask and record current tobacco and nicotine use at every relevant encounter; offer treatment rather than advice alone.
- Combine behavioural support with an effective stop-smoking medicine when acceptable and suitable.
- Adults should aim for at least 150 minutes of moderate or 75 minutes of vigorous activity weekly plus strength work on at least 2 days.
Key red flags
Exertional syncope, chest pain, disproportionate breathlessness or sustained palpitations requires cardiovascular assessment before vigorous exercise.
Investigation priorities
Define products, daily use, dependence, previous attempts and triggers.
Management branches
Routine prevention, chronic disease review or a teachable clinical moment.
- Ask permission and assess smoking, diet, activity, alcohol, sleep, weight context and cardiovascular symptoms.
- Agree one personally meaningful SMART goal and specify how it will be measured.
Key medicines
VareniclineDays 1 to 3: 0.5 mg orally once daily; days 4 to 7: 0.5 mg twice daily; from day 8: 1 mg twice daily, usually for 12 weeks.
Combination nicotine replacement therapyTypical high-dependence regimen: 25 mg/16-hour nicotine patch once daily plus 2 mg gum or lozenge when cravings occur, within the selected product's maximum dose.