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To begin, you refer him to substance use counselling, and suggest: acamprosate for AUD (NNT~11 for abstinence over 12-52 weeks) 51 nicotine replacement and varenicline (NNT~13 over 6-12 months for smoking cessation) 44 If he develops troublesome withdrawal or struggles with ongoing substance use despite your assistance, you could refer him for support through an addiction medicine clinic or obtain additional support from telemedicine resources including British Columbias 24/7 Addiction Medicine Clinician Support Line: www.bccsu.ca/24-7

I know the risks and I don't want to stop,' is probably less than 1 in 10," he said

[] Management of withdrawal symptoms and craving control is very difficult in such patients

What has changed noticeably in 2026 is that smoking in busy, visible public spaces is much rarer than it used to be