New Canadian Guidelines Present Multiple Strategies to Aid Tobacco Cessation

Tobacco use remains the leading cause of preventable illness and death in Canada, with over 11% of the adult population still smoking as of 2022. Recognizing the significant health risks associated with smoking—including cancers such as lung, mouth, throat, and bladder, respiratory diseases, and cardiovascular conditions—a new guideline from the Canadian Task Force on Preventive Health Care offers a comprehensive menu of evidence-based options to help individuals quit smoking.

This guideline emphasizes that quitting smoking is often challenging and requires multiple attempts. It underscores the importance of tailored approaches, combining behavioral strategies, medications, and natural health products to improve success rates.

The recommended interventions include behavioral counseling, primary care advice, self-help materials, and innovative tools like text messaging programs. Pharmacotherapy options such as nicotine replacement therapy (patches, gum, lozenges, inhalers, sprays), alongside medications like varenicline, bupropion, and the natural product cytisine, are also endorsed. Combining behavioral support with pharmacotherapy enhances quitting success.

Importantly, the guideline advises against alternative therapies such as acupuncture, hypnosis, laser therapy, ear acupressure, and supplements like St. John’s Wort or S-adenosyl-L-methionine (SAMe), citing lack of scientific support.

Regarding e-cigarettes, the guideline suggests they should be considered only for individuals who have been unable to quit using other methods or who have a strong preference for them, highlighting ongoing concerns about their safety and long-term effects. The evidence-based approach aims to support shared decision-making between clinicians and patients, empowering personalized treatment plans.

The guideline does not apply to traditional or ceremonial tobacco use among Indigenous peoples. It was developed with input from public smokers, health professionals, and subject matter experts, ensuring a balanced and credible set of recommendations.

As Dr. Donna Reynolds, vice-chair of the guideline working group, notes, "Using these practical, evidence-based options will help people achieve their goal to quit smoking." This initiative underscores Canada's ongoing commitment to reducing tobacco-related health burdens and supporting individuals on their path to cessation.