Who this service is for
This smoking cessation consultation with a general practitioner is indicated for adults who:
- Currently smoke and want to quit with structured medical support
- Have tried to quit smoking before without success and want to explore approaches with stronger scientific evidence
- Want to understand which pharmacological treatment options exist and whether they are candidates for them — after a complete clinical evaluation
- Have health conditions — cardiovascular disease, diabetes, COPD, planned pregnancy — where quitting smoking is an urgent clinical priority
- Want support to quit smoking in English or Spanish without language barriers
- Smoke and have children at home — exposure to secondhand smoke in children is one of the main causes of childhood respiratory diseases in Brazil
Why medical support makes a difference
Tobacco dependence activates the same reward circuits in the brain as other addictions. Trying to quit on willpower alone ignores the biological basis of addiction — and that is why it fails in most cases.
Structured medical support acts on several levels simultaneously:
- Assessment of dependence level — not all smokers have the same profile. The most appropriate type of intervention depends on how many cigarettes you smoke, when you light the first one of the day, how you responded to previous attempts, and what other health conditions you have
- Adapted pharmacological plan — where clinically indicated, the physician evaluates pharmacological treatment options to support cessation, at the professional’s sole discretion after a complete evaluation
- Behavioral support — identifying the triggers that lead to smoking and developing alternative strategies is part of the plan
- Follow-up — regular monitoring during the cessation process significantly improves success rates
What is included in the consultation
Assessment of dependence level
The physician evaluates your tobacco dependence profile — using the Fagerström Test, the main validated instrument for assessing nicotine dependence. The assessment includes how many cigarettes you smoke per day, when you light the first one of the day, how you feel when you cannot smoke, and how you responded to previous attempts to quit.
Motivation assessment
Motivation is a relevant clinical factor in smoking cessation. The physician evaluates your reasons for wanting to quit smoking, the barriers you anticipate, and how to structure the plan to maximize your chances of success.
Personalized cessation plan
Based on the assessment, the physician designs a structured plan — which may include behavioral strategies to manage triggers and withdrawal syndrome, basic nutritional guidance to manage possible weight gain when quitting smoking, and recommendations for physical activity as a support tool.
Assessment of pharmacological treatment options — at the physician’s discretion
Where clinically indicated after a complete assessment of the clinical profile, the physician evaluates pharmacological treatment options to support smoking cessation. No pharmacological option can be confirmed or prescribed before the consultation.
Electronic prescription — at the physician’s discretion
Where clinically indicated, the physician issues an electronic prescription with ICP-Brasil digital signature, valid in pharmacies throughout Brazil.
Follow-up
Quitting smoking is a process — not a single event. Follow-up consultations are available to monitor progress, manage the highest-risk moments for relapse, and adjust the plan if needed.
Pharmacological treatment options for smoking cessation in Brazil
Brazil has a specific context for access to smoking cessation medications that is important to know before the consultation.
Nicotine Replacement Therapy (NRT)
Nicotine patches, gum, and lozenges are available in Brazilian pharmacies without a prescription. They reduce withdrawal symptoms by providing nicotine in a controlled way while the smoker leaves the habit. The physician guides you on the most appropriate formulation, dose, and duration for your profile.
Bupropion
Bupropion is an antidepressant with an approved indication for smoking cessation in Brazil. It requires a prescription and assessment of contraindications — including a history of seizures, eating disorder, and use of MAOIs. The physician assesses the indication during the consultation.
Varenicline
Varenicline (Champix) is the medication with the strongest evidence of efficacy for smoking cessation — it acts on nicotine receptors in the brain, reducing the pleasure from cigarettes and withdrawal symptoms simultaneously. It requires a prescription and assessment of contraindications. The physician assesses the indication during the consultation.
Access through SUS — specific program
Brazil has a National Tobacco Control Program (PNCT) coordinated by INCA — Instituto Nacional do Câncer — which offers free smoking cessation treatment through SUS, including nicotine replacement therapy and bupropion, for smokers who meet specific criteria. Free access to treatment through PNCT/SUS requires registration at a public health unit. The Global Health physician informs you during the consultation whether you may be eligible and guides you on how to access the public program — in addition to private care.
No pharmacological option can be confirmed or prescribed before a complete clinical evaluation. Treatment decisions are always at the physician’s sole discretion.
Quitting smoking and your health — why now
The benefits of quitting smoking begin within the first hours and accumulate over the years:
- 20 minutes — blood pressure and heart rate normalize
- 12 hours — carbon monoxide in the blood returns to normal levels
- 2 weeks to 3 months — circulation and lung function improve
- 1 year — the risk of coronary heart disease is cut in half
- 5 years — the risk of stroke equals that of a non-smoker
- 10 years — the risk of lung cancer is cut in half
For smokers with cardiovascular disease, diabetes, COPD, or who are planning a pregnancy, quitting smoking is one of the clinical interventions with the greatest impact on long-term health outcomes — often greater than any medication.
Smoking in Brazil — the context
Brazil has a particular history with smoking — for decades it was one of the world’s largest producers and exporters of tobacco. Today, the country has one of the most advanced anti-smoking policies in Latin America — with progressive tax increases, advertising bans, and smoke-free environments.
The result is visible: smoking prevalence in Brazil fell from approximately 34% in the 1990s to around 12% of the adult population today. But there are still approximately 20 million smokers in Brazil — and most want to quit but do not know where to start or do not have access to adequate support.
INCA coordinates the National Tobacco Control Program, which offers free treatment through SUS — but service capacity is limited and waiting lists are long in many cities. For those who want immediate support without relying on the SUS queue, teleconsultation is the fastest way to get started.
Smoking cessation during pregnancy
Smoking during pregnancy is one of the highest-risk exposures for the baby — associated with premature birth, low birth weight, placental abruption, and sudden infant death syndrome. Quitting smoking is the most important intervention a pregnant smoker can do for her baby’s health.
If you are pregnant or planning to become pregnant and want to quit smoking, inform the physician at the start of the consultation. The support options available during pregnancy are different — some pharmacological options are contraindicated — and the physician advises on the safest approach for your situation.
What if I have already tried to quit before and relapsed?
Relapse is a normal part of the cessation process — it does not indicate failure, but that the plan needs to be adjusted. Previous unsuccessful attempts are relevant clinical information that the physician uses to design a more effective approach.
Studies show that most people who successfully quit smoking made multiple attempts before succeeding. Each previous attempt — even if it ended in relapse — increases the chances of success next time. Structured medical support significantly increases that probability.
