By MONICA KAYOMBO/Zambia/ Lusaka
A NEW global report has called on governments to strengthen tobacco cessation services by integrating them into national health systems, warning that millions of tobacco users who want to quit are being denied access to effective support.
For countries such as Zambia, the report suggests that integrating tobacco cessation into existing primary healthcare and disease management programmes could significantly reduce tobacco-related illnesses while lowering future healthcare costs.
The report comes at a time when global tobacco use has declined from 22.3 per cent in 2007 to 16.4 per cent in 2023, largely due to implementation of proven tobacco control measures. However, tobacco remains one of the world’s leading preventable causes of death, particularly in low- and middle-income countries where most tobacco users live.
The report dubbed: “Strengthening the Tobacco Cessation Ecosystem,” released by Vital Strategies, says more than 60 per cent of the world’s 1.25 billion tobacco users want to stop using tobacco, but nearly 70 per cent have no access to comprehensive cessation services.
According to the report, countries should move away from fragmented cessation programmes and instead build what it describes as a “tobacco cessation ecosystem” a coordinated system that brings together governments, healthcare providers, communities, digital technologies and civil society organisations to make quitting easier and more successful.
The report says tobacco use continues to claim more than seven million lives every year while costing the global economy an estimated US$1.4 trillion annually through healthcare expenditure and lost productivity.
It notes that helping tobacco users quit should become a routine part of healthcare, with doctors, nurses, pharmacists, dentists and community health workers consistently asking patients about tobacco use, advising them to quit and referring them to appropriate cessation services.
The report says even brief counselling lasting less than three minutes has been shown to increase quit attempts when delivered consistently across health systems.
China successfully incorporated brief cessation advice into routine outpatient care, while India and Indonesia integrated tobacco treatment into tuberculosis services.
The report further highlights that HIV treatment programmes in parts of Africa have also demonstrated improved smoking cessation outcomes when counselling and medication were incorporated into routine care.
It recommends expanding access to evidence-based interventions, including behavioural counselling, quitlines, mobile phone-based cessation programmes, digital applications and approved cessation medications such as nicotine replacement therapy.
The report also encourages governments to ensure stable financing for cessation services, include cessation medicines on national essential medicines lists, strengthen workforce training and integrate tobacco treatment into primary healthcare, hospitals, tuberculosis and HIV programmes, maternal health services and other routine health services.
It further urges policymakers to strengthen broader tobacco control measures such as smoke-free public places, higher tobacco taxes, graphic health warnings and sustained public education campaigns, saying these measures encourage more tobacco users to attempt quitting when combined with accessible cessation support.
Vital Strategies warns that tobacco industry marketing continues to undermine cessation efforts by promoting tobacco and nicotine products while attempting to influence public health policy. It says governments should remain vigilant in protecting tobacco control policies from industry interference.
The report cites examples from several countries where integrated cessation programmes have improved access to treatment.
The report says countries with limited resources do not necessarily require expensive specialised clinics but can achieve substantial progress by strengthening existing healthcare systems, training frontline health workers and expanding low-cost digital cessation services.
Vital Strategies says the report provides a framework for strengthening national tobacco cessation systems by improving coordination, expanding access to treatment and ensuring that every tobacco user who wants to quit can obtain the support needed to do so.
