SNP recommendation guidelines

Medical organizations in some countries have provided recommendations on which tobacco treatment cases might benefit from safer nicotine products as cessation pathway.

Canada

Lower-Risk Nicotine Use Guidelines (LRNUG)

Link	https://www.nicotinedependenceclinic.com/en/lower-risk-nicotine-user-guidelin-es
Audience	GPs
By	CAMH, Pharmacists for a Smoke-Free Canada (NGO)
Considerations	E-cigarettes combined with behavioural are a suitable cessation aid. Complete switch should be advised. No specific device type recommended. Advise that there's no long-term risk quantification yet. Continued use reduces relapse risk.

UK

NICE guidelines (NG209)

Link	https://www.nice.org.uk/guidance/ng209
Audience	GPs
By	Gov UK / OHID
Considerations	E-cigarettes are applicable for nicotine substitution. Devices regulated according to EU TDP, notified to MHRA, covered under GPSR. Not currently licensed as medicines. People who smoke but can't/won't quit. can reduce harm by smoking less or substituting temporarily. Harm reduction benefits are uncertain, but may inspire full quitting.
See also	Nicotine vaping in England: 2022 evidence update

Using e-cigarettes to stop smoking

Link	https://www.nhs.uk/live-well/quit-smoking/using-e-cigarettes-to-stop-smoking/
Audience	PWS
By	National Health Service
Considerations	Growing evidence e-cigarettes can be effective. Using it as much as you need to and with the right strength of nicotine in your e-liquid. Full benefit from vaping requires to stop smoking cigarettes completely. Expert help from local stop smoking service advised. While nicotine is the addictive substance in cigarettes, it's relatively harmless. For pregnancy, licensed NRT is advised, e-cigs only as fallback option.

New Zealand

Vaping products: Information for health care workers and stop-smoking services

Link	https://www.health.govt.nz/our-work/preventative-health-wellness/tobacco-control/tobacco-control-information-practitioners/vaping-products-information-health-care-workers-and-stop-smoking-services
Link	https://www.health.govt.nz/our-work/preventative-health-wellness/tobacco-control/vaping-smokefree-environments-and-regulated-products/position-statement-vaping
Audience	GPs
By	NZ Ministry of Health
Considerations	Ministry of Health encourages smokers who want to use vaping products to quit smoking to seek the support of local stop smoking services. Vaping products are a less harmful way of delivering nicotine than conventional tobacco cigarettes. Expert opinion is that vaping products are much less harmful than smoking tobacco but not completely harmless. Toxicants have been found in vapor, but in general, at levels much lower than found in cigarette smoke or at levels that are unlikely to cause harm. When used as intended, vaping products pose no risk of nicotine poisoning to users. Short-term risks appear to no different than NRT, long-term quantification still unknown. Combining vaping with behavioural support is likely to have comparable success rate to stop-smoking medication. Stop smoking services should be ‘vaping friendly’, provide accurate information about benefits and risks, and advice about obtaining a suitable vaping product. Anyone who is switching from smoking to vaping should stop smoking tobacco as soon as possible. There is no international evidence that vaping products are undermining the long-term decline in cigarette smoking among adults and youth, and may in fact be contributing to it.

VapingFacts

Link	https://vapingfacts.health.nz/vaping-to-quit-smoking/
Audience	PWS
By	NZ Ministry of Health
Considerations	No device approved as an official stop-smoking medicine. Has helped many people quit smoking. Addresses the sensory, behavioural and social aspects. NRT and medical options still exist. Vaping is almost twice as effective as NRTs. Goal: reducing the strength of your nicotine.

Australia

Nicotine vaping products: Information for prescribers

Link	https://www.tga.gov.au/resources/resource/guidance/nicotine-vaping-products-information-prescribers
Audience	GPs / PWS
By	Therapeutic Goods Administration
Considerations	NVPs are Schedule 4 (prescription only) medicines, but remain 'unapproved'. Their potential efficacy for smoking cessation is currently mixed. RACGP guideliness apply, and NVPs are not first line treatment for smoking cessation. Availability hinges on authorised prescriber, special access, or personal importation scheme. TGA has a list of authorised prescribers (GPs).

US

PRI: Position on Vaping / Harm Reduction

Link	https://www.physiciansresearchinstitute.org/harm-reduction/
Audience	GPs
By	Physicians Research Institute
Considerations	Today’s cigarattes are more difficult to quit. Standard treatment has a noticeable failure rate. Physicians misperceive the relative risks of nicotine in comparison to combustion. NVPs are a legal alternative, 20 times less harmful than continued smoking. Switching measurably reduces harm, and might even help even those not intending to quit.