The state of tobacco dependence treatment in Spain
Dr. Jiminez-Ruiz is a respiratory physician in Spain, currently head of the smoking cessation service in Madrid, who has been in the treatment of tobacco dependence since 1985 when he realised that many of his patients had lung conditions that were caused by smoking and that stopping smoking would significantly improve their health. Carlos is one of the first Global Bridges Europe National Adviser Mentors, and as such is willing to help support other countries who would like to implement evidence based policy and practice in tobacco dependence treatment services.
What has changed since you first began working in this area?
When I first got involved, there were not many researchers or practitioners working in the field. Now:
More health professionals are involved in tobacco control strategies, but not many Spanish health professionals consider smoking as a chronic disorder. The majority of the Spanish general population is concerned about the risk associated with tobacco consumption and the majority of the Spanish general population is concerned about the risk associated with passive smoking. We have also grown so that now Spain has strong legislation to regulate tobacco consumption in public places.
What do health care professionals routinely do for their smoking patients?
At this moment only 30-40% of Spanish Health Care Professionals (HCPs) are involved in tobacco control and in smoking cessation interventions. The most important thing for the future is to increase the number of Spanish Health Care Professionals who are involved in these fields – increasing the numbers who think of smoking as a chronic condition that needs treatment.
What are the main current barriers faced by HCPs and smokers in your Spain?
There are two important barriers:
The majority of HCP lack the knowledge and the appropriate skills for smoking cessation strategies and interventions. The second barrier mainly faces smokers who want to make an evidence-based and effective quit attempt – our health care insurance systems does not currently pay (via reimbursement) for licensed stop smoking medications.
What are the current opportunities for interventions for HCPs and smokers in Spain?
A new legislation to regulate tobacco consumption has been approved by the Government. This new regulation is very strict and this will be an opportunity for encouraging smokers to quit. For Health Care Professionals, we are working locally, at the European and at the global levels to try and help professionals to access evidence-based training and support so that they can identify and offer support programmes to their patients who smoke. The Global Bridges Europe project is an important part of making this happen.
What do you think the most important thing to do next is?
Without a doubt, we need to increase the number of HCPs with both the knowledge and competence based skills around smoking cessation strategies and interventions. We also need to work together as HCPs and as organizations and communities to lobby or put pressure on the system, the National Health Service policymakers, in order to facilitate timely clinical assistance to smokers. We need to work together, within our countries, within Europe and across the world to maximize the potential of our work. I am proud to be able to be part of the Global Bridges European team and I look forward to the benefits the work will bring!
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