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Smoking cessation — MCCQE Part 1 MCQ

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EasyPreventive MedicineSmoking cessationMCCQE Part 1

45-year-old woman presents with wanting to quit smoking. She smokes 20 cigarettes/day and failed cold-turkey attempts. Which of the following is the most appropriate next step?

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Correct answer: E — Offer behavioural support plus pharmacotherapy such as varenicline/NRT unless contraindicated

Offer behavioural support plus pharmacotherapy such as varenicline/NRT unless contraindicated is best because combined behavioural and pharmacologic support improves quit rates. Use a United States screening schedule instead of Canadian guidance is suboptimal because MCCQE questions expect Canadian preventive-care guidance; Defer all preventive care until symptoms develop is suboptimal because screening and immunisation aim to prevent disease before symptoms; Order the most invasive test as routine first-line screening is suboptimal because screening should balance benefit, harm and resource use; Screen at every visit regardless of interval or prior results is suboptimal because over-screening causes avoidable false positives and harm. Relapse is part of treatment, not failure.

Reference: CAN-ADAPTT smoking cessation guideline