Quit Smoking Medications and Coverage in Canada

Quit aids all do one of two jobs. Some put a controlled dose of nicotine in your body so withdrawal is bearable. Others change how your brain responds to nicotine. Health Canada’s quit guide groups them as follows, and says that combining different types of support gives the best chance of success.

Nicotine replacement therapy (NRT)

NRT delivers nicotine without the smoke. Health Canada lists a long-acting form, the patch, which it says is the only long-acting form available, and several short-acting forms: gum, spray, inhaler and lozenge. A patch delivers a steady dose for as long as you keep it on, for up to 24 hours.

• Using a single form of NRT can double your chance of quitting.
• Combining a long-acting form with a short-acting form nearly triples it.
• Health Canada says NRT products are the safest way to use nicotine.
• During pregnancy and breastfeeding, short-acting forms are preferred over the patch.

Prescription medications

The two prescription medications available in Canada are varenicline and bupropion. Neither contains nicotine, and both require a prescription. Health Canada’s figures: bupropion alone can almost double your chances, and varenicline combined with counselling can nearly triple them. The department refers questions about side effects to a health care provider.

Who can prescribe? Ontario’s quit-smoking page tells people to talk to a doctor, nurse practitioner or pharmacist about prescriptions, and in some provinces pharmacists can start treatment themselves; see pharmacy smoking cessation programs.

Cytisine

Cytisine is a natural health product that mimics the effects of nicotine. Health Canada says that as a natural health product it can be purchased without a prescription in Canada, that it follows a specific dosing schedule, and that it is available online and in certain stores and pharmacies. Because it is sold without a prescription, there is no provincial drug plan to cover it that we found.

Nicotine pouches

A few nicotine pouches are authorized in Canada, only as a quit aid for adults. The rules are in nicotine pouches in Canada.

Counselling and quitlines

Health Canada says counselling can almost double your chance of quitting, and that talking to a trained quit coach can raise it. The department lists 1-866-366-3667 for a quit coach. Programs by province are in free quit smoking help by province.

What provinces cover

Coverage rules change, and each plan has its own conditions. The lines below are what we read on official pages. A province not listed here means we did not find a readable official page, not that coverage does not exist.

• British Columbia. Under the BC Smoking Cessation Program, residents enrolled in MSP can get the full cost of nicotine gum, lozenges or patches for one continuous course of up to 12 weeks (84 days) per calendar year, without a prescription. PharmaCare also covers bupropion and generic varenicline for smoking cessation, paying some or all of the cost depending on the plan; Plans B, C, G and W pay the full cost.
• Ontario. The Ontario Drug Benefit formulary limits varenicline for adult smoking cessation to 12 weeks (168 tablets) per 365 days, alongside smoking-cessation counselling. Ontario’s quit-smoking page also lists up to a year of pharmacist-assisted counselling for ODB recipients.
• Prince Edward Island. The PEI Smoking Cessation Program covers one 12-week course of treatment per year of either nicotine replacement (gum, lozenges, inhalers or patches) or bupropion or varenicline. Residents who smoke or use other tobacco and are ready to quit make an appointment with a nurse at a primary care network office.
• Manitoba. The Tobacco Quit Card and Counselling Program provides nicotine replacement therapy and counselling to low-income Manitobans through a primary care provider.
• Alberta. AlbertaQuits is free, and nicotine replacement products are bought at a pharmacy without a prescription. We could not confirm from an official page which Alberta benefit plans cover quit medication.
• First Nations and Inuit. Under the Non-Insured Health Benefits program, eligible clients pay no deductibles or co-payments, and products must be prescribed or recommended by a health professional.

For anyone paying out of pocket, prices vary by store and product, and we have not published a price table because we could not source one from an official page.