There is some guidance and advice from health agencies, such as Public Health England, that support and treatment should be offered to all smokers, including those from priority groups with high smoking prevalence rates, though this is not always the case.27 There needs to be clear guidance around how to help those at risk of alcohol dependence who appear to be at increased risk of being excluded from smoking cessation support and may have complex and/or different treatment needs. This should include what services are best placed to provide support to those smokers at risk of alcohol dependence, which strategies work best, and how best to provide support in the community for people who may not be coming into substance use treatment. As with other areas of health (e.g. Housing First, substance harm reduction), the support offered potentially needs to be embedded within existing interventions or pathways of change, so to appreciate the wider determinants of health. For example, offering support for smoking cessation which both addresses the persons high levels of tobacco dependence (e.g. behavioural support and combination products,
