BACKGROUND: FCTC Article 14 obligates Parties to support tobacco cessation and implement effective measures to help people quit smoking; cessation advice from healthcare professionals (HP) is a key component. We examined whether adults who regularly smoke reported receiving cessation advice from an HP, and whether advice varied across a range of equity dimensions.
METHODS: Data are from the 2022 ITC Four Country Smoking and Vaping Survey of adults who smoke cigarettes ≥weekly. A descriptive weighted analysis estimated prevalence of self-reported receipt of any advice about quitting smoking among those who visited an HP in the last two years (Australia:n=735; Canada:n=717; England:n=795; United States (US):n=669). An adjusted regression model was fit to examine whether advice differed by age, sex, income, education, high-risk alcohol use, and treatment for depression, anxiety, or lung disease, adjusting for country and smoking frequency. We also tested for country differences in HPs recommending approved cessation aids (NRT/Varenicline/Bupropion).
RESULTS: 46.8% of adults who regularly smoke reported receiving cessation advice from an HP, differing by country (p<0.0001): US was highest (60.7%), followed by Australia (57.1%), Canada (40.7%), and England (32.0%). In the adjusted model, females were less likely to receive cessation advice (p=0.01), and those being treated for depression (p=0.03) and lung disease (p<0.001) were more likely to receive advice. Country differences remained significant (p<0.0001). Advice did not differ by age, income, education, or high-risk alcohol use. Among those who received cessation advice, there were country differences in HPs recommending NRT/Varenicline/Bupropion (p=0.009): highest in Canada (66.9%) and lowest in England (47.4%).
CONCLUSIONS: Across all four countries, about half of adults who regularly smoke reported receiving advice about quitting after visiting a healthcare professional, with few differences across equity dimensions. These results highlight the missed opportunities for HPs to deliver cessation advice, including the recommendation to use an approved cessation aid.