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3+ smoking cessation support strategies

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The Bottom Line

  • The majority of people who smoke want to quit.
  • Research suggests a range of strategies can or may help people quit smoking, including behavioural approaches such as different types of counselling, education, and financial incentives, and mailing out supports like nicotine replacement therapy.
  • Work with your healthcare team to develop a tailored quit plan that incorporates one or more smoking cessation support strategy.   

Most people who smoke and are aware of the risks have a desire to quit (1). To help increase the chances of successfully quitting, researchers have spent decades investigating different support strategies. We’ve previously discussed individual and combined approaches like medication, telephone counselling, and peer support, but the list of strategies at our disposal is diverse (1). With a range of options to choose from, people looking to quit can tailor their smoking cessation journey and explore approaches that best meet their needs and preferences. Next, let’s talk about the effectiveness of behavioural strategies, beyond just telephone counselling, and supports delivered by mail (2-4).


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1. Counselling, education, and text message support

Behavioural strategies work to reduce or stop smoking by building awareness and knowledge of our thoughts, feelings, motivations, skills, values, and coping techniques (2;5-8). Examples of these strategies include text message support, telephone counselling, health education, motivational interviews, self-help materials paired with telephone counselling, video counselling, and face-to-face cognitive education. Research suggests that these specific behavioural strategies may help healthy adults quit smoking. More high-quality research is needed to increase our confidence in the results.


2. Financial incentives

Incentive-based programs motivate people to quit smoking by providing financial rewards. Examples of rewards include grocery vouchers, cash, or gifts handed out once or multiple times over the course of a set schedule. Though financial incentives are a behavioural strategy, they can be controversial with some questioning whether they remain effective once the reward is no longer being provided. Research focusing on this strategy specifically shows that incentive-based programs do help people quit smoking for six months or longer. More research is needed on what type of financial reward is best and potential negative side effects (3).


3. Mailout support  

While quitting supports are available, they aren’t always easily accessible to everyone. For example, stigma and limited mobility are just a few barriers that can prevent a person who smokes from going out to buy evidence-backed nicotine replacement therapies (NRT) like patches and gums or accessing in-person counselling. That’s where mailout support that delivers NRT, educational materials, and information on accessing helplines via mail comes in handy. Research suggests that mailout support can increase the chances of quitting smoking successfully with benefits seen at 6 to 12 months, but more research is needed to further confirm these preliminary results (4).


Want to quit smoking, but unsure of where to seek support? Start by discussing your desire to quit with your healthcare team. Ask about support options and developing a tailored quit plan that meets your needs. Additionally, visit the Government of Canada website for links to various smoking cessation support services across the country, some of which include mailout support, helplines, online and text-message support, and access to trained specialists that can help you find programs and services within your community. 


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References

  1. World Health Organization. Tobacco and nicotine. [Internet] 2026. [cited September 2026]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco
  2. Xu M, Guo K, Shang X, et al. Network meta-analysis of behavioral programs for smoking quit in healthy people. Am J Prev Me. 2023; 65(2):327-336. doi: 10.1016/j.amepre.2023.02.032.
  3. Notley C, Gentry S, Livingstone-Banks J, et al. Incentives for smoking cessation. Cochrane Database Syst Rev. 2025; 1:CD004307. doi: 10.1002/14651858.CD004307.pub7.
  4. Mersha AG, Bryant J, Booth K, et al. Evaluating the effectiveness of mailout smoking cessation support: A systematic review and meta-analysis. Prev Med. 2024; 189:108162. doi: 10.1016/j.ypmed.2024.108162.
    1. Somerville LH, Jones RM, Casey BJ. A time of change: Behavioral and neural correlates of adolescent sensitivity to appetitive and aversive environmental cues. Brain Cogn. 2010; 72(1):124-133.
    2. Richards JM, Plate RC, Ernst M. Neural systems underlying motivated behavior in adolescence: Implications for preventive medicine. Prev Med. 2012; 55(suppl):S7-S16 suppl.
    3. Krishnan-Sarin S, Cavallo DA, Cooney JL, et al. An exploratory randomized controlled trial of a novel high-school-based smoking cessation intervention for adolescent smokers using abstinence-contingent incentives and cognitive behavioral therapy. Drug Alcohol Depend. 2013; 132(1-2):346-351.
    4. Matkin W, Ordonez-Mena JM, Hartmann-Boyce J. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2019; 5:CD002850. 

    DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for professional medical advice. The summaries may be reproduced for non-profit educational purposes. Any other use must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).