Canada's governments lag in confronting 'the major personal and public health consequences of tobacco use,' a Canadian Medical Association Journal editorial says. (CBC)

All provincial drug plans should pay for quit-smoking treatments, medical journal editors say.

Only Quebec publicly funds all smoking-cessation drug therapies, while Yukon and Prince Edward Island reimburse at least the cost of anti-tobacco products, according to the editorial in Monday's issue of the Canadian Medical Association Journal.

About 5.5 million Canadians, or 19 per cent of the adult population, currently use tobacco — a number that has not decreased in recent years.

But a 2009 review suggested fully reimbursing the cost of smoking cessation medications significantly improved one-year abstinence rates among smokers. Those who quit tobacco live, on average, an additional four years, the editorial said.

Canada's position contrasts with Australia and the United Kingdom, where drug insurance is provided to all citizens, and all quit-smoking products are available without restrictions. In the United States, users of anti-smoking products are reimbursed by Veterans Affairs and Medicare.

Canada 'lagging behind'

"Given the major personal and public health consequences of tobacco use, why are most of Canada’s governments lagging behind?" the editorial asked.

"Perhaps our policy-makers think we should not be subsidizing poor lifestyle choices. If so, we ought to deny public funding for heart surgery to patients who continue to smoke or stop paying for care of patients with smoking-related cancers."

However, few people follow perfect lifestyles, the editorial noted, and a 1996 study suggested that smoking-cessation drugs appear more cost-effective than other primary preventions such as those for high blood pressure and high cholesterol.

Provincial health ministries already reimburse the cost of methadone for heroin addiction and naltrexone for alcohol dependence.

The editorial — signed by Erika Penz and Braden Manns of the University of Calgary, Dr. Matthew Stanbrook, the journal's deputy scientific editor, and editor in chief Dr. Paul Hébert — proposed that smoking-cessation therapies be immediately included in all provincial drug plans so smokers over age 65 and those receiving social assistance could have free access.

Then, the editorial said, Canada should follow other countries and pay for the therapy for everyone, using tax revenues collected from the sale of tobacco products.

In 2007, Canada's Common Drug Review recommended that varenicline, the newest smoking cessation drug, be added to the list of drugs covered by provincial governments.