Governments, pay for smoking cessation

• Published in: Canadian Medical Association journal (CMAJ) Vol. 182; no. 18; p. E810
• Main Authors: Penz, Erika D, Manns, Braden J, Hébert, Paul C, Stanbrook, Matthew B
• Format: Journal Article
• Language: English
• Published: Canada CMA Joule Inc 14.12.2010; CMA Impact, Inc; Canadian Medical Association
• Subjects: Canada; Care and treatment; Control; Cost-Benefit Analysis; Government finance; Government Programs - economics; Health care policy; Humans; Laws, regulations and rules; Medical care, Cost of; Prospective payment systems (Medical care); Public health; Smokers; Smoking; Smoking cessation; Smoking Cessation - economics; Smoking Cessation - legislation & jurisprudence; Smoking cessation programs; Canada
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.101140

Most important, perhaps policy-makers fail to understand how the cost of smoking cessation products acts as an insurmountable barrier or a powerful disincentive for smokers. A 2009 Cochrane review showed that full financial reimbursement of smoking cessation medications significantly improved one-year abstinence rates among all smokers (relative risk 2.45, 95% confidence interval 1.17-5.12).4 When considered with evidence that people who quit smoking long term gain an average of four years of life,5 full coverage of smoking cessation products among the 5.5 million Canadian smokers might be expected to result in 1.9 million life-years gained, at a cost of $220 for every life-year gained - a bargain compared with most other health interventions. Given the high cost of tobacco addiction and our inability to decrease the rates of smoking in Canada below 19% in recent years, governments should complement population-level public health strategies against tobacco with a marked increase in investment in individual-level smoking cessation programs. As an immediate first step, all provincial drug formularies should begin reimbursing evidence-based smoking cessation therapies. This will provide coverage to smokers receiving social assistance and to those over 65 years of age. To treat the rest of Canada's smokers, we should follow the lead of other countries and reimburse smoking cessation therapies for everyone. An appropriate source of funding for this is obvious - the substantial tax revenues collected with the sale of every tobacco product.