Want people to quit smoking? Cover the meds: CMAJ commentary

Provincial governments in Canada ought to provide universal coverage for smoking cessation medications, according to two authors commenting in the Canadian Medical Association Journal. As it stands within provincial drug benefit programs, coverage for prescribed smoking cessation medications, such as varenicline and bupropion, are time restricted, while coverage for nonprescription medications, like nicotine, is inconsistent, the editorial noted. “These time limits result in the differential treatment of people with tobacco use disorder compared with those with other chronic diseases,” authors Dr. Robert Kleinman and Dr. Peter Selby wrote in a news release. Both are affiliated with the Centre for Addiction and Mental Health as well as the University of Toronto. “Medications for most chronic diseases have unlimited coverage in the public drug formularies, with no restrictions on the number of treatment trials per year.”Current restrictions on coverage for smoking cessation pharmacotherapies are not reflective of the “relapsing-remitting nature of tobacco use disorder,” according to the editorial.“People often try to stop smoking many times . . . before they are able to stop smoking.”Removing these restrictions would yield several benefits for patients and the healthcare system more broadly, argued the authors.For one, smoking cessation medications are cost-effective, they wrote.Approximately 10% of healthcare costs in Ontario, for example, are attributable to smoking, the authors noted.“The costs of smoking cessation interventions are low compared with the costs of treating cancer, chronic obstructive pulmonary disease and other chronic diseases that are associated with smoking,” they wrote.Furthermore, patients would be supported through multiple attempts at quitting, and the “structural stigma” against people with tobacco use disorder would be reduced.Short of universal coverage, the provinces should at the very least lift the time restrictions on these medications under drug benefit plans, the authors argued.

Want people to quit smoking? Cover the meds: CMAJ commentary

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