The new advice issued by Nice on Tuesday means that for the cost of a prescription charge, smokers should be able to receive licensed "nicotine replacement therapies" (NRTs) such as gum from their doctor even if they do not intend to quit completely.  WIthout a prescription a person smoking 20 cigarettes a day would spend an average of £860 a year on such products while trying to quit, Nice said.  Previous advice has simply told smokers to quit the habit altogether and use NRTs instead, but research shows that people who cut down on their smoking while using NRTs such as gum are more likely to quit altogether in future.  Prof Mike Kelly, director of the Nice Centre for Public Health, said smokers would still be better off kicking the habit for good, but claimed the new guidelines offer an alternative for people who are either unable or unwilling to quit completely.  NRTs are considered safe for smokers to use because they provide the addictive ingredient without the other harmful substances contained in tobacco.  "Put simply, people smoke for the nicotine but die because of the tar in tobacco," Prof Kelly explained.  He added that smokers who try to cut down without using NRTs may not gain any benefit because they tend to "smoke more deeply", hold the smoke in their body for longer and smoke further down the cigarette in order to compensate.  An estimated 10 million people in England smoke, or one in five adults, but two thirds say they would like to quit. Between April 2011 and March 2012 some 800,000 people contacted stop smoking services for help in giving up.  The NHS spends an estimated £2.7 billion per year treating smoking-related illnesses making NRTs "a good investment", Prof Kelly said.  He added that electronic cigarettes were not officially recommended because they are unregulated and have "no guarantees".  But Prof Paul Aveyard, Nice guidance developer, claimed that "the guidance is clear that using an e-cigarette is safer than smoking".  The guidance states: "Advisers should tell people who smoke that some nicotine-related products (for example, electronic cigarettes and topical gels) are not currently regulated by the Medicines and Healthcare products Regulatory Agency and so their effectiveness, safety and quality can't be assured. Also advise them that these products are likely to be less harmful than cigarettes."  Prof Dame Sally Davies, the Chief Medical Officer, said: "The best thing smokers can do for their health is quit, but if they're not able or ready to then using safer sources of nicotine instead of smoking is much better".  Martin Dockrell of Action on Smoking and Health said: "For many years the only advice given to smokers has been to quit completely and for good.  "Now there is good evidence that smokers who are unable to quit abruptly can take an important step along the way by cutting down or switching to non-tobacco sources of nicotine. That can help them quit in the long run."
Some smokers are simply unable to quit and should instead be encouraged to cut   down, the public health watchdog has advised for the first time.