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Smoking cessation — CCFP MCQ

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ModeratePreventive care and screeningSmoking cessationCCFP

A 45-year-old man who smokes 20 cigarettes daily has tried quitting with willpower alone twice and relapsed both times. He has stable depression treated with sertraline. What is your best management approach?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: EOffer behavioural support plus pharmacotherapy (e.g. varenicline or nicotine replacement), tailored to preferences and contraindications

Option E is correct because Canadian authorities (CTFPHC 2025) recommend offering both behavioural support and pharmacotherapy for all adults who smoke, including those with well-managed depression. Pharmacological aids (varenicline, NRT) improve quit rates, and depression is not a contraindication if stable. Option A is incorrect as unaided attempts have already failed and are inferior to supported strategies. Option C is wrong: depression on stable therapy is not a contraindication, but monitoring is advisable. Option D has no evidence for cessation and could foster antibiotic overuse. Option B is incorrect as switching to cigars does not reduce—and may increase—overall health risk.

Reference: Canadian Task Force on Preventive Health Care. Recommendations on interventions for tobacco smoking cessation in adults in Canada. CMAJ 2025;197(28):E846–E861. https://www.cmaj.ca/content/197/28/E846