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Recommendations

Recommendations


  • Comprehensive evidence-based cessation interventions should be covered under all public and private health insurance plans, since they represent a good return on investment.
  • In places where cost is a barrier to access, effective population-based tobacco control interventions (e.g. higher tobacco taxes, smoke-free policies) and low-cost individual-level interventions (e.g. brief doctor’s advice, telephone counseling, SMS text messaging, self-help materials) should be utilized to help smokers quit and maintain abstinence.
  • Smoking cessation services should be made available and affordable to population groups with a higher prevalence of tobacco use (e.g. low income groups, the less educated, those with a history of mental illness). Such an approach would reduce the disparities in health attributable to tobacco use.
  • Interventions must be tailored to reach high-risk populations, including pregnant women, youth, itinerant workers, language minorities, those with a mental illness, and other groups for which recruitment into cessation programs is a challenge. In light of the obstacles that longer smoking duration poses to successful cessation, programs that prevent initiation and prompt early cessation are crucial.
  • Smoking cessation promotion is cost-effective when pharmacotherapy is used. For example, NRT combined with counseling is more cost-effective compared to NRT or counseling alone; therefore, the combination should be promoted when economically feasible.
  • As a viable and cost-effective treatment, NRT should be available and affordable for general sale.
  • Research should continue on factors affecting cessation among youth and the costs and cost-effectiveness of smoking cessation interventions, particularly in low- and middle-income countries. Very little is known about cessation interventions for non-cigarette forms of tobacco (smokeless tobacco, water pipe smoking). It is also important to evaluate the impact of strategies used by smokers to reduce their out-of-pocket expenses on their motivation to quit and their quit success rate.
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