Development of a smoking cessation decision aid for smokers in Wales

Principal / Lead Investigator
Type of study



Many smokers attempt to quit unaided which is the least effective method to quit smoking. Evidence consistently shows that combining a licensed stop smoking medication with behavioural support from a NHS smoking cessation service significantly increases the chances of a successful quit attempt. However, there are numerous treatment options to aid a smoker to quit. Some are available via the NHS and are free of charge others are available for the smoker to purchase. 

Patient decision aids are a means of helping people make informed choices about healthcare. They are designed to be used as part of a shared decision making process, encouraging active participation by patients in healthcare decisions. Many are designed to take into account their personal values and preferences. Currently, there is an All Wales Guide: Pharmacotherapy for Smoking Cessation providing information on stop smoking medications, however this guide primarily for a healthcare professional audience and is neither a patient decision-making aid nor a treatment algorithm.

Additionally, a smoking cessation decision aid was published in 2017 by NHS RightCare (a national NHS England supported programme). Although this tool describes the various options for quitting smoking from unassisted cutting down to help with a professional, it is very focussed on medication to support the quit attempt. It only briefly touches on the effectiveness of quitting options and describes the different types of products available and pros and cons of these. It does not attempt to fully describe the effectiveness of different treatment or medication options. There is currently no nationally agreed tool to inform smokers in Wales in choosing support from a range of services and medications to help them quit smoking.


The aim of this project is to develop an evidence-based patient decision aid to help smokers decide on service and smoking cessation pharmacotherapy to aid their quit attempt that will give them the best chance of a successful quit. 


  • Scope existing decision aids for smokers to make an informed choice of treatment options.
  • Identify and synthesise evidence of effectiveness of different smoking cessation options (including unassisted quitting, self-help and NHS behavioural support services, as well as complimentary medicine options, such as hypnotherapy and cutting down).
  • Identify and synthesise evidence of effectiveness of licensed smoking cessation pharmacotherapy and e-cigarettes.
  • Identify and synthesise evidence of effectiveness of combining smoking cessation options and pharmacotherapy.
  • Produce algorithms for different smoking cessation options (behavioural support, pharmacotherapy individually and combined).
  • Develop a prototype decision aid tool to help smokers and health care professionals and service providers to identify the most effective and appropriate support to help individual smokers quit.
Potential benefit to patients

Smoking is the leading cause of preventable illness and death in the UK (Ash, 2015) and continues to be a huge public health problem with 19% of the adult population reporting that they currently smoke (National Survey for Wales 2016-17). The Tobacco Control Action Plan for Wales set a challenging target to reduce smoking levels to 16 per cent by 2020 with an ultimate aim of a smoke-free Wales. Development of a smoking cessation aid for smokers in Wales will facilitate efforts to meet this target by motivating smokers to quit using the most effective treatments that fit with their personal values and preferences.

Existing studies of this type of intervention have provided preliminary evidence for increased motivation to quit smoking, initiation of smoking cessation treatment, increased quit attempts and continuous abstinence (Brunette, 2011; 2015; Cupertino, 2010; Willemsen, 2006).

Who is the study sponsor?

Cardiff University


Public Health Wales

Total grant value

£ 22,000

Start date


End date


Further information 

To follow

Outputs generated (Reports / Publications / Impact)

To follow