Time to rethink tobacco dependence treatment in Australia

Despite, widespread success and reductions in smoking prevalence rates, tobacco use remains the leading modifiable risk factor for ill health in Australia accounting for 22% of the cancer burden, 12% of cardiovascular disease and 41% of respiratory illness.1 The forthcoming National Preventive Health Strategy identifies reducing tobacco use as a priority for all Australian Governments and cites “increased provision and access to evidence-based cessation services and support to help people who use tobacco to quit “as a key policy area.2 Australia, as a signatory to the Framework Convention on Tobacco Control (FCTC), has an obligation to provide evidence-based tobacco dependence treatment (TDT) as part of routine health care. Article 14 of the FCTC requires signatories to ensure cessation access and develop and implement a national cessation strategy, national treatment guidelines and a consistent approach to training health practitioners to provide brief advice, all of which must be free from conflicts of interest and integrated with comprehensive population level tobacco control measures.3 The recent TGA decision on liquid nicotine and the introduction of smoking cessation via telehealth together with the aspiration of increasing cessation in the new National Preventive Health Strategy provides an opportune moment for a commitment to improving the provision of TDT. In this commentary, we argue that TDT is an overlooked component of Australia’s comprehensive national tobacco strategy and must be implemented urgently to complement population level actions that prevent uptake and encourage cessation.