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Canada Issues Smoking Cessation Guideline That Backs Proven Therapies, Warns Off Vapes as First Line

The task force steers clinicians to evidence-based therapies, calling e-cigarettes a last resort.

People trying to quit smoking should not reach for e-cigarettes or vapes as their first choice to butt out, a new Canadian guideline says.
FILE - In this April 23, 2014 file photo, a man smokes an electronic cigarette in Chicago. Food and Drug Administration officials on Friday, Feb. 24, 2023 pledged a reset in the agency’s tobacco program, responding to criticisms that a lack of direction has hampered federal efforts to regulate cigarettes, vaping devices and other industry products.(AP Photo/Nam Y. Huh, File)

Overview

  • Published Aug. 25 in CMAJ, the Canadian Task Force on Preventive Health Care released clinician and patient tools to guide shared decision-making on quitting.
  • Recommendations endorse behavioral supports and pharmacotherapy, including nicotine replacement therapy, varenicline, bupropion, and cytisine, with combinations encouraged.
  • The guideline makes a conditional recommendation against using e-cigarettes as a first-choice quit method due to unapproved products, inconsistent formulations, and uncertain long-term safety.
  • Vaping may be considered only for people unable to quit with other options or those who strongly prefer it.
  • Authors advise against alternative therapies such as acupuncture, hypnosis, laser therapy, electric head stimulation, ear acupressure, St. John’s Wort, and SAMe, and they exclude traditional or ceremonial Indigenous tobacco use from the scope.