Daily pill to help smokers quit to be rolled out on NHS

A pill to help people give up cigarettes is being rolled out on the NHS and has the potential to prevent almost 10,000 smoking-related deaths each year, health experts have said.

Amanda Pritchard, chief executive of NHS England, has called the drug, varenicline, a “game-changer” and described it as “another vital step in shifting our NHS further towards prevention”.

The once-a-day tablet was previously used in the UK under the brand name Champix but this was recalled in 2021 after it was found to contain carcinogenic chemical compounds.

Researchers from University College London have estimated that the recall saw 4,200 fewer people a year giving up smoking for good.

But the relaunched version of varenicline has been approved as safe by the Medicines Health and Regulatory Authority (MHRA).

It works by tackling nicotine cravings and helping withdrawal symptoms such as irritability and trouble sleeping.

NHS England has found that, when used alongside behavioural support, it can help about one in four people stop smoking for at least six months.

A spokesperson for NHS England told i that the rollout is initially in England only and is available immediately as part of local NHS stop smoking services.

Officials estimate it could help more than 85,000 people a year give up smoking over the next five year and prevent up to 9,500 smoking-related deaths.

The National Institute for Health and Care Excellence (NICE) is currently reviewing another drug, cytisine, which tricks the brain in to thinking someone has a cigarette by attaching to the same receptors as nicotine.

Smoking is one of the biggest public health issues facing the NHS and affects the lungs, heart, blood and brain as well as increasing risk of cancer, diabetes and stroke.

Hilary Scott, 45, a copy editor from Croydon, started smoking at 16, thanks to peer pressure. It took her two serious attempts to quit in her late twenties. “I celebrated my third non-smoking anniversary by having a cigarette at a work do – and that was it for another two years,” she says.

She quit again at 29 and hasn’t smoked since.

Ms Scott’s unusual tactic was to go on holiday and allow herself unlimited access to cheese, chocolate and red wine instead of cigarettes.

“We grow up with the idea that we should be able to do things on willpower alone, but it only got me so far – and that was in my twenties without caregiving responsibilities or a stressful job.

“The pill is a great idea. It’s really, really difficult to stop smoking and it’s so bad for you. I never felt guilty eating lots of cheese and chocolate on order to not smoke. Some people will resist the pill and for some it won’t work but others it could really help.”

There has been concern about an increase in 18- to 24-year-olds taking up smoking cigarettes, after years of a sustained fall in numbers tailed off during lockdown.

The Tobacco and Vapes Bill was introduced in Parliament last month to prevent anyone born after 1 January, 2009 from legally smoking by gradual raising the age at which tobacco can be bought.

Recent figures from the Office for National Statistics suggest about 11.9 per cent of people in the UK aged 18 or over (around six million) smoked cigarettes in 2023.

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Scientists have welcomed the news that an evidence-based treatment like varenicline will be rolled out on the NHS in England to help people stop smoking – especially as the UK remains off target to become “smoke free” by the end of the decade.

Nick Hopkinson, Professor of Respiratory Medicine at Imperial College London, called it “the most effective smoking cessation medication”.

Evidence suggests that varenicline is one of the most effective ways to quit smoking especially when combined with behavioural support, such as counselling. Quitting smoking is difficult and by using the once-a-day pill people are increasing their chances of successfully stopping smoking in the long-term.

Varenicline is the generic version of a previously used branded pill called Champix, which was withdrawn in 2021 after an impurity was discovered. However, the relaunched generic product has now been approved as safe by the Medicines Health and Regulatory Authority (MHRA).

Its return should also result in further economic benefits for the health service. Analysis by the health spending watchdog showed that for every £1 spent on Champix alongside behavioural support, £1.65 was saved through preventing smoking-relating illnesses and hospitalisations – with the economic benefit set to be far greater with the cheaper generic version of the drug.

It is another weapon in the Government and NHS’s armoury – alongside the Tobacco and Vapes Bill – to try and bring smoking rates down again after a recent plateau. That Bill is largely aimed at younger smokers and vapers whereas long-term smokers will be targeted with this treatment.

Officials will be hoping it addresses the imbalance between smoking rates between deprived and wealthy areas, especially as research by Cancer Research UK shows the most deprived 10 per cent of the population in England will not be smoke free until after 2050 – some 20 years beyond the Government’s target.

The reintroduction of varenicline has been greeted positively by UK charities and researchers.

Dr Sarah Jackson, a principal research fellow at the UCL Tobacco and Alcohol Research Group, called it “excellent news”, adding: “Large evidence reviews have consistently found it to be one of the most effective treatments for helping people to stop smoking.”

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Henry Gregg of Asthma + Lung UK, said it was a positive step to see help for existing smokers: “While the Tobacco and Vapes Bill will protect younger generations from the harms caused by this deadly addiction, the hundreds of thousands of current smokers who want to give up must also be supported.

“It is incredibly difficult to quit smoking without help.”

Dr Ian Walker, executive director of policy at Cancer Research UK, said: “Along with funding for cessation services, making tools like this available will help more people stop smoking.

“Around 160 cases of cancer are caused by tobacco every day in the UK, so it’s essential that action is taken to prevent people from smoking in the first place.”

The Government’s 10-year plan for the NHS, which is expected to be published in spring, will also include a greater focus on sickness prevention.

Health Secretary Wes Streeting said the Government and the NHS were “building a healthy society to help power a healthy economy”, and added: “Prevention is better than cure.

“The rollout of this pill can save the NHS millions of pounds, save appointments to help other patients be seen faster, and save lives.

“Taken alongside our Tobacco and Vapes Bill, the Government and NHS are building a healthy society to help power a healthy economy.”

i has approached NHS Wales and NHS Scotland to establish whether they will also be using the drug.

Scotland’s Public Health Minister Jenni Minto said Scotland welcomed the reintroduction of varenicline in the UK: “Once supplies are available, they will again be an important component of smoking cessation services offered by community pharmacists, other prescribers and specialist services in Scotland.”