Canadian Task Force Updates Smoking Cessation Recommendations
Table of Contents
On August 25, 2025, the Canadian Task Force On Preventive Health Care (CTFPHC) published in the Canadian Medical Association Journal (CMAJ)[1] An update of its clinical recommendations for the management of smoking cessation in adults. The text offers a range of validated options – behavioral interventions, drug treatments (nicotinic substitutes, Varénicline, bupropion) and Cytisine – to be combined according to patients and their history, while reserving a prudent and conditional place for electronic cigarettes.This approach is part of a shared decision -making and health equity perspective, with tools dedicated to caregivers and patients.
the recommendations have been made on the basis of a systematic review of scientific data concerning smoking withdrawal interventions in adults. The quality of the evidence was evaluated using standardized methods, and the priorities have been established in consultation with experts, partner organizations and smoky or ex-smokers. The working group has focused on taking into account the criteria deemed essential by patients, such as efficiency, side effects and impact on quality of life. Practical tools, intended to support the shared decision between health professionals and patients, support these new recommendations.
A Range of Validated Interventions
Canadian recommendations insist on the need to offer smoking people a wide choice of proven solutions, in order to maximize their chances of success. The approach is based on a combination of behavioral and pharmacological strategies, wich can be used separately but whose efficiency is reinforced when associated.
Behavioral interventions constitute the first stone of smoking cessation. They include brief council, delivered directly in primary care, which remains a simple and effective measure when it is indeed systematically proposed. To this are added structured or group support programs, led by trained professionals, as well as support telephone lines and digital programs by textual messages. The latter, accessible and inexpensive, provide regular monitoring and continuous motivation to patients. Self-assistance supports,such as scientifically validated online brochures or platforms,complete this panel.
On the pharmacotherapy side, nicotine substitution treatments (patches/stamps, gums, pastilles, sprays or inhalers) are confirmed as first -line options. They can be used alone or combined, such as by associating a continuous release patch with a rapid oral form, to better control the symptoms of lack. Varénicline and bupropion, two treatments on prescription, also benefit from solid efficiency data and are among the main recommendations for pharmacological care.
To these options is added Cytisine, presented in Canada as a natural health product. This medication, used for several decades in Eastern and Central Europe, now has a growing corpus of studies demonstrating its efficiency and good tolerance. Even though it is indeed not yet marketed in France, its integration into Canadian recommendations reflects the desire to expand the spectrum of available solutions.
All of these interventions are designed to be offered in a shared decision logic. the health professional must support the patient in the choice of the strategy most suited to his profile, his preferences and his previous stop. The recommendations recall that the association of behavioral monitoring and pharmacological treatment remains the most effective combination to support a lasting stop.
A Limited Place for Electronic Cigarettes
The working group adopts a measured position concerning the electronic cigarette. If the available data suggest that these devices can help some people quit smoking, many uncertainties remain as to their long -term safety and efficiency. Unlike nicotine substitutes and authorized drug treatments, electronic cigarettes have a great heterogeneity of products, formulations and modes of use, making the evaluation of their real effects on health.
The CTFPHC thus recommends that the interventions that have been the subject of robust proofs,both behavioral and pharmacological proofs,thus in first intention. The electronic cigarette should only be considered in the second line, in specific situations: when the smoking person has failed to stop with validated methods or when he expresses a clear and informed preference for this option. In this case, health professionals are encouraged to initiate an in -depth dialog with the patient, by transparently presenting the potential profits and the uncertainties and risks linked to the use of vaping.
this approach reflects a desire to meet the needs of certain smokers refractory to conventional methods, without legitimizing electronic cigarettes as a reference withdrawal tool. It is also part of a public health framework aimed at limiting the risks of maintaining nicotine dependence, or even double use, when the electronic cigarette is used in parallel with combustible cigarettes.
the experts highlight the need for regular monitoring of people with vaping in the context of withdrawal, in order to gradually support the reduction and then the complete stop of the use of nicotine, a central objective of any smoking cessation strategy.
Take Into Account Health Inequalities
The new recommendations of the CTFPHC stress that the use of tobacco remains marked by important social, economic and cultural disparities. Some populations have prevalence of smoking much higher than the national average, with direct consequences on their health and life expectancy. This is particularly the case for First Nations, Inuit and Métis, which face particularly high smoking rates, often in connection with unfavorable social determinants, limited access to health services and persistent structural inequalities.
Beyond indigenous communities, tobacco affects people more strongly living alone, separate or widowed, or from disadvantaged socio-economic environments. Workers occupying low -qualified jobs also have increased vulnerability, with greater exposure to smoking and a reduced probability of accessing appropriate prevention and support systems. Likewise, people with mental health disorders or dependence on other substances constitute a high -risk group, accumulating higher stop difficulties and morbidity.
The CTFPHC thus recommends increased vigilance of health professionals vis-à-vis these audiences. The proactive identification of smoking status and the systematic offer of effective options appear as essential levers to reduce differences. The report also emphasizes the importance of adapting support methods: use of digital tools or accessible telephone lines, taking into account cultural contexts, strengthening proximity services, and integration of specific support strategies for people living with psychiatric or addictive comorbidities.
This approach aims to strengthen public health equity, ensuring that the benefits of smoking cessation interventions are not reserved for the most favored populations but can extend to all smoking people.By acting on these disparities, the new recommendations intend to help reduce the weight of smoking as a factor of social inequalities in health, which remains today one of the most determining in Canada and internationally.
© Generation without Tobacco
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Frequently Asked Questions
What are the main recommendations for smoking cessation?
The recommendations emphasize a combination of behavioral interventions (counseling, support programs, digital tools) and pharmacological treatments (nicotine substitutes, varenicline, bupropion, cytisine).
What is the role of electronic cigarettes in smoking cessation?
Electronic cigarettes are considered a second-line option, only when validated methods have failed or when the smoker expresses a clear preference for them. Health professionals should discuss potential benefits, risks, and uncertainties with patients.
How do the recommendations address health inequalities?
The recommendations stress the importance of increased vigilance and adapted support methods for populations with higher smoking rates, such as First Nations, Inuit and Métis, people living alone, and those with mental health disorders.
[1] Brett D. Thombs, Gregory Traversy, Donna L. Reynolds, Eddy Lang, Stéphane Groulx and Brenda J. Wilson; for the Canadian Task Force on Preventive Health Care, CMAJ August 25, 2025 197 (28) E846-E861; DOI:
National Committee against smoking |
