On World No Tobacco Day, reflections on treatment

This year, the tobacco control community is celebrating the 10th anniversary of the Framework Convention on Tobacco Control (FCTC), amidst a candid debate about whether sufficient progress had been achieved to warrant celebration. Initial progress on treatment (the “O” in MPOWER) has been especially slow. Although FCTC Article 14 guidelines were adopted in November 2010, a survey conducted two years later[1] found limited implementation.  This was attributed to various factors including conflicting priorities, resource limitations, lack of political will, lack of training, and other barriers.

Happily, however, the tide has begun to turn. At the recent World Conference on Tobacco OR Health in Abu Dhabi, we celebrated the first-ever Bloomberg Initiative “O” award to Uruguay; a richly deserving physician and tobacco dependence treatment leader, Dr. Eduardo Bianco, received the prestigious Luther Terry Award for Outstanding Individual Contribution to Global Tobacco Control; and the conference resolutions included a specific goal for at least 50% of FCTC Parties to have “developed and published an official national tobacco dependence treatment strategy, in accordance with Article 14 Guideline recommendations” by the next WCTOH in 2018.

Some countries are already leveraging treatment to reduce tobacco death and disease:

  • Uruguay’s award-winning and effective tobacco control program has always included cessation support. Tobacco use has decreased dramatically as a result of this work.
  • The Hong Kong Department of Health and Tung Wah Hospitals have worked with the Mayo Clinic Nicotine Dependence Center to develop a Chinese-language curriculum and train over 400 tobacco treatment specialists.
  • South Korea’s comprehensive tobacco control program includes provision of cessation support and training healthcare professionals, to help those who are inspired to quit by the country’s recent tobacco tax increase.
  • Governments in Turkey, Brazil, and elsewhere cover the cost of pharmacotherapy to assist citizens’ quit attempts.
  • Ministries of Health and civil society groups worldwide are using the World Health Organization training package “Strengthening health systems for treating tobacco dependence in primary care” and a new Article 14 implementation toolkit developed by Dr. Martin Raw which will soon be available on treatobacco.net.
  • Global Bridges grantees in every WHO region are building capacity by developing and delivering programs to expand the reach of evidence-based treatment. To date, Global Bridges partners have trained over 4,000 healthcare professionals from 63 countries.

Sharing the learning from these pioneering efforts will inspire other countries to develop their own plans and foster implementation, ultimately reducing death and disease from tobacco use.   Leaders in the tobacco control community can help by supporting and reinforcing the Article 14 guidelines, and connecting people across the global network who can collaborate on their implementation within the context of a comprehensive tobacco control program.

It’s an exciting time for tobacco dependence treatment – join us in the Global Bridges network to help contribute to this momentum!

Pine-Abata H, McNeill A, Murray R, Bitton A, Rigotti N, Raw M. A survey of tobacco dependence treatment services in 121 countries. Addiction. Mar 1 2013;doi: 10.1111/add.12172.