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CMAJ. 2010 October 19; 182(15): 1648.
PMCID: PMC2952018

Bravo and beware

Bravo for your Aug. 30 editorial, “Governments, pay for smoking cessation.”1 The only potential loser would be the tobacco industry, of whose influence we should be wary.

Clinical tobacco intervention is one of the top three preventive measures,2 and although, stop-smoking medication is one of the most effective, only Quebec has made it widely available to its citizens (since October, 2000).

Cigarette-smoking is not an equal-opportunity addiction. Two of its major determinants, genetics and years of education, are not evenly distributed across the population.

Furthermore, the short-term gain in terms of hospital and surgical complications avoided by stopping smoking is spectacular. Failure to invest in not only medication but also in paying for the systematic delivery of clinical tobacco interventon amounts to fiscal and administrative malpractice.

But one editorial in the CMAJ won't be enough. The resistance to doing the obvious is deeply entrenched.


Competing interests: Member, Varenicline Advisory Committee, Pfizer

For the full letter, go to:


1. Penz ED, Manns BJ, Hébert PC, et al. Governments, pay for smoking cessation. CMAJ. 2010 Aug 30; [Epub ahead of print] [PMC free article] [PubMed]
2. Maciosek MV, Coffield AM, Edwards NM, et al. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prev Med. 2006;31:52–61. [PubMed]

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