The Pan American Health Organization (PAHO) has released a new clinical booklet aimed at strengthening tobacco and nicotine cessation services in primary health care, as countries in the Americas face shifting consumption patterns, rising chronic disease burdens and renewed policy efforts to reduce preventable health risks.
“Tobacco dependence is a chronic, relapsing condition that requires ongoing, patient-centered care,” said PAHO when announcing the publication, The organization emphasizes that primary care settings remain critical to closing gaps in access to cessation services and reducing avoidable deaths linked to tobacco and nicotine use.
PAHO published Tobacco and nicotine cessation: Booklet for healthcare professionals on Jan. 30, presenting an evidence-based, practical guide designed for physicians, nurses, and other primary care providers. The document aligns with World Health Organization (WHO) clinical treatment guidelines and focuses on interventions that can be delivered during routine consultations, even when time is limited. Tobacco use remains the leading preventable cause of premature death worldwide, responsible for more than 7 million deaths each year, including 1.6 million from exposure to secondhand smoke. Despite this burden, more than 60% of adult tobacco users report wanting to quit, while nearly 70% lack access to comprehensive cessation services.
Primary health care is positioned to address this gap because of its role as the first point of contact for most patients and its integration into long-term management of noncommunicable diseases. PAHO’s booklet promotes the systematic identification of tobacco and nicotine use as a “vital sign” and underscores evidence showing that brief interventions lasting from 30 seconds to three minutes can increase quit attempts and long-term abstinence. The guide outlines the use of the 5As model — ask, advise, assess, assist, and arrange — and the 5Rs — relevance, risks, rewards, roadblocks, and repetition — approach for patients not yet ready to quit.
The release comes amid broader public health efforts in the region to address risk factors for noncommunicable diseases. In Mexico, recent data from the National Survey on Drug, Alcohol, and Tobacco Consumption shows that while smoked tobacco use declined from 17.6% in 2016 to 15.1% in 2025, the use of electronic cigarettes more than doubled over the same period. These trends highlight the need for cessation strategies that address all forms of tobacco and nicotine products, a focus reflected in PAHO’s guidance.
The booklet covers counseling strategies, motivational interviewing techniques, pharmacotherapy options, follow-up care, and relapse prevention. It also includes tailored approaches for specific populations, such as pregnant women, adolescents, people with mental health conditions, and patients living with chronic diseases. PAHO says all recommended interventions can be integrated into existing primary care workflows without adding unnecessary burden, reinforcing the feasibility of routine cessation support.
The guide contributes to PAHO’s Better Care for Noncommunicable Diseases Initiative by reinforcing the role of primary health care in preventing and managing tobacco-related illnesses, including cardiovascular disease, diabetes, chronic respiratory diseases, cancer, and mental health conditions. By embedding cessation support into routine visits for these conditions, health systems can reduce morbidity and mortality while improving overall care outcomes.
Policy developments in Mexico illustrate how clinical guidance is unfolding alongside fiscal and regulatory measures. As of Jan. 1, 2026, Mexico increased excise taxes on tobacco products, raising the ad valorem rate on cigarettes sold in packs from 160% to 200%. Federal authorities say the changes aim to discourage consumption linked to chronic disease, including tobacco-related illnesses associated with more than 63,000 deaths annually in the country. International organizations such as the WHO and World Bank have identified tobacco taxation as one of the most cost-effective tools for reducing harmful consumption when combined with prevention and treatment services.
At the same time, health systems are adopting new technologies to address diseases closely linked to tobacco use. Mexico’s National Institute of Respiratory Diseases (INER) recently implemented AI software to support the interpretation of chest X-rays and strengthen 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. These efforts underscore the importance of combining prevention, early detection, and treatment in addressing tobacco-related disease burdens.
Mental health considerations further reinforce the need for integrated approaches. Mexico’s national survey data show higher levels of psychological distress and suicidal behavior among adolescents compared with adults, alongside changing patterns of substance use. PAHO’s booklet addresses tobacco dependence as a chronic condition requiring sustained, patient-centered care, an approach that aligns with calls from public health officials to integrate mental health services into addiction prevention and treatment strategies.
PAHO says the booklet is intended to serve as a practical resource to make tobacco and nicotine cessation a routine component of primary care. By equipping 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 across the Americas.