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Overview of treatment provision at          national level                   Martin Raw     UK Centre for Tobacco Control ...
Survey of Article 14 implementation This presentation is based on the preliminary results of a survey conducted with colle...
Interests statementI do not accept funding from the manufacturers of stop                 smoking medications            M...
SampleAll Parties to the FCTC for which we have contacts so far         Parties                                174        ...
Sample by region and income level      Americas                41%      Europe                  56%      Africa           ...
Some key policy elements
Do you have specialised treatment           services?
Quitlines  (n=30)
Can tobacco users get help in the       following settings?               (%)
How medications are licensed             (%)
Three key policiesMandatory recording of tobacco use in            27%medical notesPromote brief advice in existing servic...
Reducing tobacco use in health                        professionalsTable 3.1: Selected studies of GP smoking prevalenceCou...
Guidelines                         (n=39)Have national guidelines               57%For whole healthcare system            ...
Are the guidelines for all healthcare          professionals?
Some key guideline characteristics
Year of guideline publication
Do guidelines recommend
Percent of guidelines that recommend         these medications
More key guideline characteristicsStress that HCPs should not use tobacco         69%Formally endorsed by national profess...
Other countries’ guidelines referenced
Based on other countries’ guidelines
Key findings / messages2.   All regions in world represented4.   Largest sample ever for civil society monitoring     (cur...
Key findings / messages1.   Under half of the countries in our sample run mass     media campaigns promoting cessation3.  ...
Key findings / messages1.   Recording of tobacco use in notes still not mandatory3.   Smoking health professionals still a...
Key findings / messages•   57% of countries have national guidelines•   Only half have a dissemination strategy•   Few hav...
In one sentence    Cessation support / treatmentis not yet a priority in most countries
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Overview of Tobacco Treatment Provisions at a National Level -- Martin Raw

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Presentation by Martin Raw, UK Centre for Tobacco Control Studies and National Institute of Alcohol and Drug Policies, Brazil, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.

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Overview of Tobacco Treatment Provisions at a National Level -- Martin Raw

  1. 1. Overview of treatment provision at national level Martin Raw UK Centre for Tobacco Control Studies & National Institute of Alcohol and Drug Policies, Brazil Global Bridges workshop, WCTOH, Singapore March 2012
  2. 2. Survey of Article 14 implementation This presentation is based on the preliminary results of a survey conducted with colleagues from Nottingham andHarvard Universities, funded by the Society for the Study ofAddiction and the FCA, to whom we are extremely grateful. We are:Asaf Bitton, Ann McNeill, Rachael Murray, Hemba Piné-Abata, Martin Raw, Nancy Rigotti Our posters reporting this work are presented at thisconference, and the survey will be published in a peer reviewscientific journal, and will also serve officially as FCA Article 14 monitoring in a report presented at COP5
  3. 3. Interests statementI do not accept funding from the manufacturers of stop smoking medications My funding since 2008 is from:Bloomberg Philanthropies, FCA, Global Bridges, Roswell Park Transdisciplinary Tobacco Use Research Centre, Society for the Study of Addiction, SRNT
  4. 4. SampleAll Parties to the FCTC for which we have contacts so far Parties 174 Countries* 176 No contacts yet 22 Total sample so far 154 Responses 69 (45%)* Parties minus EU and UK plus England, N Ireland, Scotland, Wales
  5. 5. Sample by region and income level Americas 41% Europe 56% Africa 29% Eastern Mediterranean32% South East Asia 20% Western Pacific 37% High income 33% Upper middle 33% Lower middle 23% Low 10%
  6. 6. Some key policy elements
  7. 7. Do you have specialised treatment services?
  8. 8. Quitlines (n=30)
  9. 9. Can tobacco users get help in the following settings? (%)
  10. 10. How medications are licensed (%)
  11. 11. Three key policiesMandatory recording of tobacco use in 27%medical notesPromote brief advice in existing services like 59%tuberculosis, HIV/AIDS, etcOffer help to healthcare workers to stop 48%
  12. 12. Reducing tobacco use in health professionalsTable 3.1: Selected studies of GP smoking prevalenceCountry Method and sample details Published % who smokeBulgaria3 National survey (n=1194) in 8 of 28 regions 2005 44Denmark6 Postal questionnaire with 313 GPs 1993 33 National questionnaire of 1,284 physicians including 370Greece10 GPs 2007 39Italy11 Regional phone interview 2003 28Netherlands12 Postal survey with GPs and other physicians. 1990/93 38Romania14 Survey, details not given, n=1136, p=0.05 2000 43Slovakia4 European postal survey of GPs 2005 49Sweden4 European postal survey of GPs 2005 4
  13. 13. Guidelines (n=39)Have national guidelines 57%For whole healthcare system 77%Dissemination strategy 51%Published in peer review journal 26%Government/public support 69%Clear description of writing process 69%COI statements for all authors 41%Pharma industry support 18%
  14. 14. Are the guidelines for all healthcare professionals?
  15. 15. Some key guideline characteristics
  16. 16. Year of guideline publication
  17. 17. Do guidelines recommend
  18. 18. Percent of guidelines that recommend these medications
  19. 19. More key guideline characteristicsStress that HCPs should not use tobacco 69%Formally endorsed by national professional 77%Associations (ten or more 18%)Peer reviewed 74%Formally supported by government 64%Professional associations involved in writing 74%or reviewingInclude cost effectiveness data 41%Reference other countries’ guidelines 69%Based on another countries 46%
  20. 20. Other countries’ guidelines referenced
  21. 21. Based on other countries’ guidelines
  22. 22. Key findings / messages2. All regions in world represented4. Largest sample ever for civil society monitoring (currently 88 countries or 50%)6. These findings will under-estimate provision (because low income regions under-represented in our reponses so far)
  23. 23. Key findings / messages1. Under half of the countries in our sample run mass media campaigns promoting cessation3. Only 44% have quitlines5. Only 25% have treatment systems with national coverage7. Another 25% have virtually no treatment provision at all
  24. 24. Key findings / messages1. Recording of tobacco use in notes still not mandatory3. Smoking health professionals still an issue5. Few tobacco users can easily get help in any settings
  25. 25. Key findings / messages• 57% of countries have national guidelines• Only half have a dissemination strategy• Few have COI statements• A surge in publishing guidelines in 2009/2010
  26. 26. In one sentence Cessation support / treatmentis not yet a priority in most countries

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