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Smoking cessation - Management
How do I follow-up children over 12 years of age who have started treatment to stop smoking?
- Review children over 12 years of age using nicotine replacement therapy (NRT) within 2 weeks of their stop date:
- For those who continue to smoke, reassess their readiness to quit by asking them whether they would like help to continue with their quit attempt. Continue treatment if they demonstrate a continuing attempt to stop.
- For those with adverse effects from treatment, consider reducing the dose or changing the formulation.
- For those with significant nicotine withdrawal symptoms on treatment, the options include:
- Increasing the dose (up to the maximum licensed dose that is tolerated).
- For people using NRT patches, consider combining with a rapid-release NRT product to relieve breakthrough symptoms.
- Changing formulation of NRT e.g. people who experience withdrawal symptoms first thing in the morning after removing NRT at night could consider using a 24-hour patch.
- For those remaining smoke free and managing well, review each month and prescribe further medication for up to 12 weeks.
Basis for recommendation
- These are pragmatic recommendations that are consistent with guidance issued by the National Institute for Health and Clinical Excellence [NICE, 2008].
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