Varenicline and Cytisine Toolkit for London 

Clinically proven stop smoking prescription treatments

Varenicline and Cytisine are both clinically proven, first-line prescription treatments for tobacco dependence and are recommended by NICE. 

Ensuring that local smoking cessation services can offer these medications equitably and efficiently is essential to improving quit outcomes and tackling health inequalities across London. 

Download the Varenicline and Cytisine Toolkit for London as a ZIP file 

Varenicline and Cytisine – background

In 2024, Varenicline was reintroduced to the UK market after being temporarily withdrawn due to manufacturing issues in 2021.  

Cytisine, which works in a similar way and has been used safely for decades in parts of Europe, was granted a UK licence that same year. 

In November 2024, NHS England Chief Executive Amanda Pritchard highlighted the return of generic Varenicline as a key public health milestone. However, concerns were soon raised about local barriers to access, including limited prescribing capacity in primary care settings. 

Expanding treatment access in London with simplified pathways

Recognising the importance of expanding access to these effective treatments, the London Tobacco Alliance escalated these concerns to London’s Clinical Executive Group, who supported the development of simplified supply pathways, particularly via community pharmacy services.  

These routes should avoid overburdening GP practices and ensure people who want to quit smoking are not delayed or discouraged by medication access issues. 

Unpacking the Toolkit

This toolkit is designed to support local authorities, Integrated Care Boards (ICBs) and stop smoking service commissioners across London in re-establishing local supply pathways for Varenicline and Cytisine. It includes a practical set of resources that can be adapted for local use. 

What’s included in the toolkit?

The toolkit provides: 

• Background briefings on Varenicline and Cytisine 

• Editable community and hospital patient pathways for local adaptation 

• Education and training considerations 

• Guidance on Patient Group Directions (PGDs) 

• Funding and delivery costs 

• Options for commissioning and delivery 

• Answers to frequently asked questions 

Additional supporting documents include: 

• Editable community and hospital pathways – easily tailored to local arrangements 

• Case Study: North East Regional PGD Supply Service – how one area successfully implemented community pharmacy-led supply 

• Sample: Varenicline PGD and Pharmacy SLA – practical documents to support local delivery and governance 

You can download the full Varenicline and Cytisine Toolkit as a ZIP file here. 

If you have any questions or would like to discuss implementation options in your area, please contact the London Tobacco Alliance team.