The Pan American Health Organization (PAHO) has released a new clinical booklet designed to strengthen tobacco and nicotine cessation services within primary healthcare settings. The publication, Tobacco and nicotine cessation: Booklet for healthcare professionals, was made available on , and aims to equip physicians, nurses, and other primary care providers with evidence-based strategies to help patients quit using tobacco and nicotine products.
This initiative comes as countries across the Americas grapple with evolving patterns of tobacco and nicotine consumption, increasing burdens of chronic disease, and ongoing efforts to implement effective public health policies. PAHO emphasizes that primary care remains a crucial setting for expanding access to cessation services and reducing preventable deaths linked to tobacco and nicotine use.
According to PAHO, tobacco dependence is a chronic, relapsing condition that requires ongoing, patient-centered care. The booklet aligns with World Health Organization (WHO) clinical treatment guidelines and focuses on interventions that can be efficiently integrated into routine consultations, even when time is limited.
Despite the well-established health risks – tobacco use remains the leading preventable cause of premature death worldwide, responsible for over 7 million deaths annually, including 1.6 million from secondhand smoke exposure – a significant proportion of tobacco users desire to quit. More than 60% of adult tobacco users report wanting to quit, yet nearly 70% currently lack access to comprehensive cessation services.
The booklet highlights the importance of identifying tobacco and nicotine use as a “vital sign” during patient encounters. Evidence suggests that even brief interventions, lasting from 30 seconds to three minutes, can significantly increase quit attempts and long-term abstinence rates. The guide outlines the use of the “5As” model – Ask, Advise, Assess, Assist, and Arrange – and the “5Rs” approach – Relevance, Risks, Rewards, Roadblocks, and Repetition – to tailor interventions to patients’ readiness to quit.
The release of this guidance coincides with broader public health efforts to address noncommunicable diseases. Recent data from Mexico, for example, shows a decline in smoked tobacco use – from 17.6% in 2016 to 15.1% in 2025 – but a more than doubling in the use of electronic cigarettes over the same period. This shift underscores the need for cessation strategies that address all forms of tobacco and nicotine products, a key focus of PAHO’s new guidance.
The booklet covers a range of counseling strategies, motivational interviewing techniques, pharmacotherapy options, follow-up care, and relapse prevention methods. It also provides tailored approaches for specific populations, including pregnant women, adolescents, individuals with mental health conditions, and patients managing chronic diseases. PAHO asserts that all recommended interventions can be seamlessly integrated into existing primary care workflows without creating undue burden.
This initiative contributes to PAHO’s Better Care for Noncommunicable Diseases Initiative, reinforcing the role of primary healthcare in preventing and managing tobacco-related illnesses such as cardiovascular disease, diabetes, chronic respiratory diseases, cancer, and mental health conditions. By incorporating cessation support into routine visits for these conditions, health systems can potentially reduce morbidity and mortality and improve overall patient outcomes.
Policy changes are also playing a role in reducing tobacco consumption. As of , Mexico increased excise taxes on tobacco products, raising the ad valorem rate on cigarettes sold in packs from 160% to 200%. Federal authorities state that these changes are intended to discourage consumption and reduce the incidence of chronic diseases linked to tobacco use, which are associated with over 63,000 deaths annually in the country. International organizations like the WHO and World Bank have identified tobacco taxation as a cost-effective tool for reducing harmful consumption when combined with prevention and treatment services.
Alongside clinical guidance and policy changes, health systems are also adopting new technologies to address tobacco-related diseases. Mexico’s National Institute of Respiratory Diseases (INER) has recently implemented artificial intelligence (AI) software to aid in the interpretation of chest X-rays, strengthening the early detection of lung cancer and other respiratory conditions. The system assists physicians in identifying potential abnormalities and supports screening programs for high-risk populations, including individuals over 50 with a history of smoking.
Recognizing the link between tobacco use and mental health, PAHO’s booklet addresses tobacco dependence as a chronic condition requiring sustained, patient-centered care. This approach aligns with calls from public health officials to integrate mental health services into addiction prevention and treatment strategies. National survey data from Mexico indicates higher levels of psychological distress and suicidal behavior among adolescents compared to adults, alongside shifting patterns of substance use.
PAHO intends for the booklet to serve as a practical resource, making tobacco and nicotine cessation a routine component of primary care. By providing frontline health professionals with concise, evidence-based tools, the organization aims to support health systems in reducing preventable deaths, improving outcomes for noncommunicable diseases, and advancing health equity throughout the Americas.
