Medical education needed for smoking cessation

The editorial by Penz and colleagues rightly argues that governments can improve the health of populations by paying for smoking cessation. 1 Too often discussion of health care costs focuses on saving by reducing services to those who are sick, rather than by reducing the incidence of illness. Nevertheless, by concentrating on reimbursement for smoking cessation medications and products, Penz and colleagues ignore the need to pay for a more comprehensive approach to smoking cessation. All provinces have some tobacco control policies, such as restrictions on advertising and on smoking in public places, which help to reduce smoking rates.

But for smoking cessation, it is clear that advice and counselling on behavioural strategies is effective, alone or in combination with pharmacologic therapy. 2 Provincial funding of smoking cessation must include reimbursement of physicians’ time for counselling, as well as funding for other health professionals and programs to provide this service so that physicians do not carry this responsibility alone. However, physicians and other health professionals are not necessarily prepared by their education to provide smoking cessation counselling. 3^,4 Medical education, and education of other health professionals, must include training in counselling for smoking cessation and other preventive health behaviour.