To improve customers chances of quitting, a combination of pharmacy advice and support, alongside OTC options, is vital.

1. Nicotine replacement therapy

Nicotine replacement therapy (NRT) products contain nicotine, but at a much lower level and without all the other harmful chemicals that are present in tobacco smoke, such as carbon monoxide and tar. NRT helps to control cravings and reduces withdrawal symptoms such as moodiness, irritability and difficulty concentrating.

There are lots of different formulations available, including patches, gum, microtabs, lozenges, inhalators and sprays for the mouth or nose. There is no evidence that any one form is more effective than another, so it really comes down to personal preference.

Someone who thinks they will miss the hand-to-mouth action of smoking might do well with a cigarette-like inhalator device, whereas patches that can be put on and not thought about for the rest of the day might be better for someone who works in an environment where it is difficult to take breaks. Combining products can also be helpful for some people, particularly very heavy smokers. For instance, a patch can be worn for a gradual dose of nicotine and a spray can provide rapid craving relief.

The idea is to reduce the dose of NRT after eight to 12 weeks and then stop altogether, although it is better for health and wealth to continue on NRT for as long as the person feels it is necessary rather than going back to smoking.

2. POM products

Pharmacies may be able to supply Champix (varenicline) or Zyban (bupropion) if there is a patient group direction (PGD) in place to support a smoking cessation service. Pharmacy staff can discuss options available with the pharmacist.

3. E-cigarettes

These simulate cigarette smoking and deliver nicotine, and have been shown to help some people successfully quit cigarette smoking.

E-cigarettes are not completely risk-free, but the NHS says they are far less harmful than cigarettes. They do not produce tar or carbon monoxide, although they do contain potentially harmful chemicals, albeit at lower levels than in cigarette smoke.

As of October 2021, the MHRA updated its guidance so that medically licensed e-cigarettes can be prescribed as a smoking cessation tool. No products have been medically licensed in the UK yet but this looks set to change. Look out for updates in 2024.

Currently, by law, e-cigarettes must not be supplied to people under the age of 18. If customers ask about e-cigarettes, explain the options available and refer to the pharmacist, if required.