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Published on : Mar 14, 2014
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Slide 1 - Martin Raw Universities of Nottingham, UK and Sao Paulo, Brazil SSA York, November 2013 A survey of tobacco cessation support in 121 countries
Slide 2 - Survey team and papers Martin Raw, Ann McNeill, Rachael Murray, Hemba Pine-Abata, Nancy Rigotti, Asaf Bitton Piné-Abata H, McNeill A, Raw M, Bitton A, Rigotti N, Murray R. A survey of tobacco dependence treatment guidelines in 121 countries. Addiction 2013, in press Piné-Abata H, McNeill A, Murray R, Bitton A, Rigotti N, Raw M. A survey of tobacco dependence treatment services in 121 countries. Addiction 2013, in press The papers will be free to view for everyone
Slide 3 - Survey funding This survey was funded by the Society for the Study of Addiction, to whom we are extremely grateful
Slide 4 - Interests statement I do not accept funding from the manufacturers of stop smoking medications My funding since 2008 is from: Society for the Study of Addiction, Roswell Park Transdisciplinary Tobacco Use Research Centre, SRNT, FCA, Global Bridges, Bloomberg Philanthropies
Slide 5 - Sample All Parties to the FCTC in December 2011 173 (174 less EU) Couldn’t find contacts in 10 so 163 We surveyed four UK countries separately so 166 survey emails sent out 121 replies (73%)
Slide 6 - Response rates by region and income level
Slide 7 - Basic infrastructure e n = 121
Slide 8 - Basic infrastructure by income level High=High income countries; UM=Upper middle income countries; LM=Lower middle income countries; Low=Low income countries
Slide 9 - Components of national treatment system n = 121
Slide 10 - Components of national treatment system by income level High=High income countries; UM=Upper middle income countries; LM=Lower middle income countries; Low=Low income countries
Slide 11 - Quitline characteristics n = 44
Slide 12 - Specialised treatment provision by income level High=High income countries; UM=Upper middle income countries; LM=Lower middle income countries; Low=Low income countries n = 121
Slide 13 - Availability of help by income level Can tobacco users easily get help to stop in the following settings?
Slide 14 - Availability of medications by income level High=High income countries; UM=Upper middle income countries; LM=Lower middle income countries; Low=Low income countries
Slide 15 - Affordability of medications by income level * % expressed as n/base
Slide 16 - Basic infrastructure e n = 121
Slide 17 - Countries that have treatment guidelines by region and income level
Slide 18 - Guidelines content n = 53
Slide 19 - Guidelines writing process n = 53
Slide 20 - Guidelines funding and conflicts of interest n = 53
Slide 21 - Guidelines dissemination strategy n = 53
Slide 22 - Conclusions Very good response rate – possibly largest most detailed treatment survey ever The basic infrastructure data suggest that for most countries treatment is low on their agenda Perhaps not surprisingly existence of treatment infrastructure is related to income level Key measure for getting tobacco use on healthcare system agenda – recording tobacco use in notes – VERY POOR INDEED
Slide 23 - Conclusions Relatively few countries have quitlines Their provision also is strongly related to income level Those that exist are run broadly in line with the evidence base Provision of specialist treatment facilities strongly related to income level As is the rated affordability of medications
Slide 24 - Can tobacco users easily get help to stop in the following settings? The reality is that in most of the world tobacco users cannot easily get help to stop Outside high income countries NO percentage reached 30% in any setting Even in high income countries percentage only exceeded 30% in general practice, pharmacies, hospitals, and from the internet
Slide 25 - Guidelines Broadly evidence based More than half based on those of other countries Majority follow good practice in their writing Except in declaration of conflicts-of-interest But only half had a dissemination strategy
Slide 26 - Guidelines Clear relationship between having guidelines and income level Most high income countries have guidelines but very few low income countries No African countries at all in our survey have guidelines
Slide 27 - What should ALL countries be doing now? Ensuring that tobacco use is recorded in all notes Addressing the issue of tobacco use in healthcare workers Integrating brief advice into all healthcare systems (or at least making a start on this) Encourage the licensing of affordable medications
Slide 28 - One sentence summary of our results?Offering support to tobacco users who wish to stop is not yet a priority for the majority of countries in the world
Slide 29 - Thank youmartin@martinraw.com
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