Tobacco control success stories in Tunisia

The training of trainers (ToT) seminar on TDT, led by the team from the King Hussein Cancer Center of Jordan and by an expert from Egypt, brought together 20 participants from the following specialties: pulmonology, oncology, occupational medicine and responsible for tobacco control of the Ministry of Health. The training produced many general recommendations for strengthening tobacco control in Tunisia. These recommendations include:

Duplication of training:

Two training sessions were held; one for occupational physicians in the context of continuing education of these professionals, and the other for pulmonologists in the annual program of the Society of Pulmonology and Allergology. Both sessions were led by trained participants who had passed the assessment test.

Smoke-free health and education structures:

The Faculty of Medicine of Tunis: a meeting with the dean and the head of continued training took place following the two activities carried out: an open day organized by the management of basic health care in collaboration with Associamed (Association of medical students) in which educational materials related to tobacco control have been distributed and a statement from the dean was posted mentioning the ban on smoking in the grounds of the faculty; a monitoring and control committee has been formed and some violations have been reported.

Salah Azaiez Institute of Cancer: a meeting with the Director General and the oncology surgeon (attending the seminar) took place with agreement on an action plan to make this institute a smoke-free structure; and two open days were held with the attendance of the doctors responsible for environmental health and environmental protection (thus responsible for monitoring and tickets) and featured the presentation of the action plan, the principles of a smoke-free structures and measurement of CO in smokers. A note prohibiting smoking in the premises of the institute was posted on all floors, a smoking ban in the buvette, and some tickets were issued.

Strengthening of the components of tobacco control: During the seminar organized by the management of basic health care on the occasion of the World No Tobacco Day on 31/05/2016, compounds workgroups with stakeholders from multi-sectors that studied the shortcomings of the tobacco control identified during the seminar of ToT, and solutions to offer namely enrichment of the list of cessation medications, reviewing the legislation with the FCTC, strengthening the training of health professionals and strengthening of multi-sector participation. In this connection, a multi-sector action plan is being prepared. A report of these proposals was sent to the health minister and a monitoring committee has been formed.

Strengthening of smoking cessation / mobile cessation: Tunisia joined the Be Healthy Be Mobile initiative of WHO and ITU in order to combat non-communicable diseases by the mobile tobacco cessation project. It is an additional tool for smoking cessation remotely available to the Tunisian population through a series of telephone messages that assist the smoker in the weaning process called “Yezzi.” These messages are received for free at any smoker wanting to quit smoking. The Tunisian project is the first French-language adaptation of mCessation. This project consists of three phases:

  • A preparatory phase during which there has been creation of a project management unit, a steering committee and a committee of experts. A programming and implementation document has been prepared by the Committee of Experts, presented and discussed in the steering committee and validated during a national seminar. The messages were translated from English into French, tested and adapted to our situation. The platform was installed by the informatics center of the Ministry of Health and project evaluation indicators prepared.
  • A start-up targeting 3,000 smokers of four governorates (governorates of Tunis, Ariana, Ben Arous and Manouba) being launched
  • A generalization phase in all governorates targeting 10,000 smokers.

Many opportunities are provided to Tunisia to ensure the success of this program:

  • A national committee for prevention and fight against NCDs (diabetes, cardiovascular diseases and cancer) by order of the Minister of Health (22 November 1996)
  • A Tobacco control national program established since 2000 (Tunisia has ratified the WHO FCTC since 2010)
  • Political commitment
  • The commitment by the three operators (Ooredoo, TunisieTelecom and Orange)
  • The proven effectiveness of this tool in other countries (Costa Rica: + 72% success in stopping smoking)