Lung cancer screening in Canada, 2026
About this section
Helping people quit smoking is a critical part of lung cancer screening. Smoking is the leading cause of lung cancer, as well as many other cancers and chronic diseases. Quitting smoking reduces a person’s risk of getting lung cancer and lowers a person’s risk of dying. Learn more about the importance of smoking cessation.
Smoking cessation
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All lung cancer screening programs have incorporated or are planning to incorporate smoking cessation supports into their screening pathways. Jurisdictions vary in offering smoking cessation services only to participants who are eligible for screening or offering smoking cessation services to all patients who smoke.
The use of smoking cessation medications, including prescription medications and nicotine replacement therapy (NRT), can more than double quit rates. Learn more about increasing access to smoking cessation medications, and financial coverage of these medications. Many lung cancer screening pilots and studies offered participants pharmacotherapy to help them quit smoking.
Note: In this report, tobacco refers to commercial tobacco products, not traditional or sacred tobacco. Traditional or sacred tobacco is used by some First Nations or Métis communities in ceremonial or sacred rituals for healing and purifying.
Smoking cessation integration with lung cancer screening programs
| P/T | Who can access smoking cessation support? | What smoking cessation supports are available? Are they offered through the hospital/cancer centre or in the community? | Where are these supports offered? | How and when in the lung cancer screening pathway are patients referred to smoking cessation supports? |
|---|---|---|---|---|
| YT | ||||
| NT | ||||
| NU | ||||
| BC | All patients (including those ineligible for screening) | Brief smoking cessation counselling is provided over the phone by program navigators. Navigators provide information regarding cessation resources available in BC such as NRT and other quit strategies. Navigators email (or mail) information regarding smoking cessation resources such as QuitNow. PCPs receive cessation information in results letters and are encouraged to follow-up with their patients to provide pharmacotherapy such as varenicline, alone or in combination with NRT. | At point of contact with navigator or PCP | During intake and return to screening, program navigators discuss smoking cessation strategies and provide information regarding available smoking cessation supports. PCPs are informed of the patients’ smoking status and are asked to follow-up directly with the patient to provide pharmacotherapies or other resources. |
| AB | All patients referred to the Alberta Lung Cancer Screening Program (ALCSP) who currently smoke cigarettes or who quit recently | Behavioural counselling provided by Alberta Quits Counsellors who operate out of Primary Care Alberta (PCA) Health Link program. Counsellors complete baseline assessment with patient over the phone and conduct seven-month follow-up calls, one-to-one counselling if required, as well as relapse prevention. | Virtual — telephone or Zoom, Quitline, primary care network, and community | Patients are referred to the tobacco cessation program at intake into the ALCSP by the registered nurse. Patients may opt out when a Counsellor calls them. |
| SK | All clients who contact the lung screening program, including those ineligible for screening | Supports include educational materials, telephone-based behavioural counselling from a Certified Tobacco Educator, and referrals to PACT-trained pharmacists, Smokers’ Helpline, and/or Talk Tobacco. | Supports are delivered primarily through one-on-one phone counselling, quitlines, and community-based settings. | Smoking cessation is addressed at each point of contact with the screening program. Clients who do not meet screening criteria are offered quit resources, quitline referrals, and community-based supports. Clients assessed by a nurse navigator are additionally offered referral to the Smoking Cessation Case Coordinator. |
| MB | Screen-eligible patients with program implementation | Screening program will provide counselling, free pharmacotherapy and NRT. | In-person and virtually | At initial intake and throughout and following screening pathway |
| ON | Screen-eligible patients* | Minimum 10-minute hospital-based smoking cessation counselling with recommendation for behavioural counselling, pharmacotherapy (nicotine replacement therapy, varenicline or bupropion) and follow-up support delivered by established community-based smoking cessation services. | Behavioural counselling and NRT are offered at point of contact with navigator during 10-minute counselling. Follow-up supportive contact is provided through hospital or community-based programs. | Navigator provides brief advice during risk assessment phone call to all people who currently smoke.
Opt-out approach utilized for in-hospital counselling on day of LDCT screening scan. Follow-up arranged with hospital or community-based smoking cessation service (e.g., Smoking Treatment for Ontario Patients (STOP) on the Net online referral, Health811 fax referral). Participants who refuse follow-up services are encouraged to follow up with their primary care provider. At recall and six-month follow-up LDCT scan appointments, participants identified to be currently smoking will be given brief advice by the screening navigator and offered an appointment with a hospital-based smoking cessation counsellor, referral to STOP on the Net, or a fax referral to Health811. |
| QC | All patients | Referral to the I QUIT NOW helpline and Quit Smoking Centres (ongoing pilot project with a QSC). | Helpline and in-person support at the Quit Smoking Centres (ongoing pilot project with a QSC). | At intake, during eligibility assessment by coordination centre nurses and during each new screening cycle.
All patients are referred to smoking cessation support, whether they qualify for lung cancer screening or not. They receive the same support at their annual evaluation during the next screening cycle. |
| NB | All eligible participants* | Linkage to existing smoking cessation resources | Online (Quitline/portal) | At intake, during eligibility assessment and during each new screening cycle. |
| NS | All patients | Educational materials, referral to Tobacco Free NS (TFNS) for behavioural counselling, NRT for screening-eligible patients only, and information about other community-based cessation programming (e.g., Mental Health & Addictions) | Quitline (TFNS) for behavioural counselling. NRT to be mailed directly to eligible patients by CAMH. Educational materials and links to other services provided by lung screening program. | Nurse navigator will advise on NRT and counselling services for those who may benefit, including referral to TFNS and CAMH as appropriate. |
| PE | All patients | Provincial pharmacare program, Smokers’ Helpline, and counselling via screening program delivered by Respiratory Therapist navigator (proposed) | Provincially and across the health care spectrum | Tobacco use will be assessed at the time of initial interview. |
| NL | All patients | One-on-one phone support sessions/counselling, pharmacotherapy, and NRT. NRT distributed through mail or available for pickup. Smokers’ Helpline also available. | Provider initiates contact with cancer centre and NRT distributed via mail or pickup from cancer centre. | Opt-out approach. Tobacco use will be assessed early in program recruitment. |
Data are current as of February 2026.
*Footnotes:
ON: Patients ineligible for screening will be offered a referral to STOP on the Net, or Health811
NB: Anticipated approach under development.
Access to pharmacotherapy
| P/T | How screening participants access pharmacotherapy (nicotine replacement therapy or prescription smoking cessation medications) | Is pharmacotherapy available for free for screening participants? If so, please describe how this is offered. | Additional details about pharmacotherapy for screening participants |
|---|---|---|---|
| YT | – | – | – |
| NT* | |||
| NU | – | – | – |
| BC | At local pharmacy | Yes, BC residents can visit any pharmacy and register to access resources for up to three months’ time in any calendar year. Indigenous people can have up to 5 months of NRT. | NRT is free for three months a year without a prescription in a local pharmacy. Varenicline is partially covered by PharmaCare. |
| AB | The AB Quits Counsellor or Certified Tobacco Educator will work with the client to develop a quit plan and set a quit date. If the individual was identified as a candidate for financial support during the intake, they will then submit a request for a benefit card by submitting an intake form on RedCap. Intakes are uploaded once per week to Alberta Blue Cross. Once processed, the benefit card and an instruction letter will arrive by mail. | ✓ | When the client receives the benefit card, they will also receive a letter identifying each of the five types of Nicotine Replacement Therapy (NRT), and all brand names covered through this program. They will not be required to have a prescription for NRT (which is different from most benefit programs). They will need a prescription for Champix (varenicline) or Zyban (bupropion SR) from either the PCP or a prescribing pharmacist if this is identified as the best treatment option.
The client can take the benefit card to a community pharmacy/pharmacist of their choice and work with them to select the best products that help minimize withdrawal as they are making behaviour changes to reduce and stop smoking. The benefit card will cover a maximum of $500 of NRT, Champix, and/or Zyban. The card expires 14 weeks after the enrollment date. |
| SK | Clients are currently supported to access pharmacotherapy through PACT-trained pharmacists and/or primary care providers. The program is exploring additional mechanisms to facilitate direct access to pharmacotherapy for eligible participants. | The program is exploring options to provide free pharmacotherapy for eligible participants. | Planning is underway to establish a centralized provincial model for pharmacotherapy distribution for eligible screening clients. |
| MB | At point-of-care or by mail with program implementation | Yes. Free for screening participants. | No limits on coverage |
| ON | At point of care during screening visit | The Ontario Lung Screening Program (OLSP) does not provide free pharmacotherapy. However, some hospitals offer free nicotine replacement therapy (NRT) from their own budgets.
Additionally, if the OLSP counsellor cannot provide a prescription for pharmacotherapy, they must refer the participant to a provider or service that is able to offer pharmacotherapy (e.g., through a pharmacist or Smoking Treatment for Ontario Patients [STOP] on the Net). |
Ontario provides the following smoking cessation medication coverage options:
|
| QC | Via prescription from their family doctor or specialized nurse practitioner and/or a nurse or pharmacist | Yes, for three months. | Referring professionals and the Ligne J’Arrête informs participants about pharmacotherapy and sends a letter to their pharmacist indicating their interest. |
| NB* | |||
| NS | NRT received by mail (facilitated by CAMH) | Yes. Contract with CAMH for mailing of NRT to qualifying clients. | Those who are eligible for LDCT will be offered free NRT through a collaborative partnership with CAMH. |
| PE | At local pharmacy | Yes, provincially at all local pharmacies. | Those eligible for the PEI Smoking Cessation program can be covered for one complete course of treatment per year. They may choose one of the following two treatment options:
|
| NL | Received by mail | ✓ | The NP who is proposed as part of the program team will be able to prescribe NRT, or a clinical pharmacist could provide support and prescribe NRT. |
Data are current as of February 2026.
*Footnotes:
NT: Although the NT does not have a lung screening program, pharmacotherapy is available for free for all residents
NB: Under development
– No information was provided at the time data were collected.