The World Health Organization has published its “first-ever” clinical treatment guideline for people who want to quit tobacco use – which is on the decline in Canada and globally.
The recommendations released Tuesday are for all adults looking to give up any type of tobacco products, including cigarettes, waterpipes, smokeless tobacco products, cigars, roll-your-own tobacco and heated tobacco products (HTPs). The guidelines are designed to be used by health-care workers.
The agency recommends a series of clinical interventions from behavioural support and medication to digital strategies.
“This guideline marks a crucial milestone in our global battle against these dangerous products,” WHO director-general Tedros Adhanom Ghebreyesus said in a statement.
“It empowers countries with the essential tools to effectively support individuals in quitting tobacco and alleviate the global burden of tobacco-related diseases.”
The WHO has previously addressed measures to help countries support tobacco cessation and treatment for tobacco dependence, but these new guidelines build on that effort and other health recommendations made by the agency over the years.
“While this is the first time that there are these formal clinical guidelines available internationally, there’s many other things that have preceded it,” Rob Cunningham, senior policy analyst with the Canadian Cancer Society, said in an interview with Global News Tuesday.
“These guidelines provide recommendations that can be implemented Canada-wide in all provinces to strengthen cessation initiatives and the more we can do for tobacco cessation, the more we’re going to have an impact to reduce the devastating burden of tobacco use on health.”
What’s in the guidelines?
The WHO estimates that more than 60 per cent of the world’s tobacco users – roughly 750 million people – want to quit.
For tobacco users who smoke and are interested in quitting, the WHO strongly recommends varenicline, nicotine replacement therapy (NRT), bupropion and cytisine as effective treatments.
Varenicline and NRT are recommended for smokeless tobacco users interested in quitting.
The agency urged countries to provide these treatments at no or reduced cost to improve accessibility, particularly in low- and middle-income countries.
Behavioural support should also be combined with medication, the WHO says, such as through brief advice of 30 seconds to three minutes routinely coming from health-care providers and different counselling options offered to all tobacco users who are interested in quitting.
As a supplementary measure, digital interventions can also be used, through text messaging, smartphone apps, artificial intelligence and internet programs.
Cunningham said digital techniques “may be especially beneficial for younger people,” who are more tech-savvy.
He noted that the WHO did not recommend vaping products as a cessation strategy given the potential risks associated with them.
Most e-cigarettes and vaping products contain nicotine, which is a stimulant drug found in tobacco.
Health Canada has cautioned that vaping nicotine can “lead to physical dependence and addiction” and expose people to chemicals “that can be harmful to your health.”
The agency advises that young people and those who don’t use tobacco products not vape.
On top of the clinical measures, policy interventions, such as tobacco taxes and subsidizing nicotine replacement products, can make a difference toward curbing tobacco use, Cunningham said.
“What we need in Canada is a comprehensive series of measures to support tobacco cessation,” he said.
Last year, Canada became the first country in the world to require warning labels on individual cigarettes.
Health Canada has set a target of bringing tobacco use in the country to under five per cent by 2035.
Tobacco use on the decline
An estimated eight million people die because of tobacco use each year, according to the WHO.
Overall, tobacco use is on the decline in Canada and globally.
A WHO report published in January showed that an estimated 1.25 billion people aged 15 and older — or one in five people on the planet — used tobacco in 2022. This was down from 1.36 billion people, or one in three, in 2000.
In Canada, roughly 11.4 per cent of people aged 15 years and older, or 3.7 million, used tobacco in 2022.
That was down from 2010, when 18.8 per cent of that age group used tobacco. The global health agency predicted Canada will cut its tobacco use by 44 per cent next year compared with that year.
“The immense struggle that people face when trying to quit smoking cannot be overstated,” Rüdiger Krech, director of health promotion at the WHO, said in a statement.
“We need to deeply appreciate the strength it takes and the suffering endured by individuals and their loved ones to overcome this addiction.”
In another report published in May, the WHO warned that the global tobacco industry is using “manipulative” tactics to “aggressively” target and hook youth on smoking across the globe, calling for a ban on the sale of tobacco and nicotine-related products to minors.
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