Comprehensive Tobacco Control Measures - the Overview of the Strategies Recommended by Who

By Fronczak, Adam; Polanska, Kinga et al. | Central European Journal of Public Health, March 2012 | Go to article overview

Comprehensive Tobacco Control Measures - the Overview of the Strategies Recommended by Who


Fronczak, Adam, Polanska, Kinga, Usidame, Bukola, Kaleta, Dorota, Central European Journal of Public Health


SUMMARY

According to the World Health Organization, there are more than one billion smokers in the world, and tobacco is said to kill half of its users. The European Region of WHO, with only 15% of the world's population, faces nearly one third of the worldwide burden of tobacco related diseases. Millions of lives could be saved with effective and comprehensive tobacco control strategy. In response to this, the World Health Organization has offered a wide range of information and recommendations to governments, organizations, health-care professionals, and tobacco users and non-users worldwide.

This paper is focusing on various activities that governments, organizations or even individuals can undertake to help smokers to quit and decrease percentages of tobacco users and save millions of lives.

Key words: tobacco smoking, smoking cessation, treatment of tobacco dependence

INTRODUCTION

Although we know a lot about the health consequences of smoking and the ways to help smokers quit the habit and maintain smoking abstinence, tobacco is still the single most preventable cause of death in the world today. A long-term tobacco user has a 50% chance of dying prematurely from tobacco-caused disease (1 ). More than 9 lives are lost every single minute and 70% of them occur in the developing world (2). Each year, tobacco causes some 5 million premature deaths, with 1 million of these occurring in countries that can least afford the health-care burden. By the year 2030, tobacco will kill more than 1 0 million people annually, and claiming more lives than HIV, tuberculosis, maternal mortality, motor vehicle accidents, suicide, and homicide combined (3, 4). Halving global cigarette consumption per adult by the year 2020 would prevent about one third of the tobacco-related deaths in 2020 and would almost halve tobacco-related deaths in the second quarter of the century. Such changes could avoid between seven and ten million tobacco-related deaths by 2025 in the European Region. Increasing tobacco cessation in adults is critically important to improving public health in the short to medium term. This is because smokers die from tobacco-related disease in middle age (defined by epidemiologists as 35 to 69 years) as a result of the 25 to 30-year delay between smoking and the development of serious disease.

Tobacco products are highly addictive. Because tobacco products are carefully designed to undermine efforts to quit using them, quitting is not simply a matter of choice for the majority of tobacco users. Instead, it involves a struggle to overcome an addiction. Many factors combine with tobacco's addictive capacity to make quitting difficult including media depictions and cultural and societal acceptance of tobacco use. Quitting tobacco at any point in life provides both immediate benefits and substantial long-term benefits to health. Effective treatment for tobacco dependence can significantly improve overall public health within only a few years.

Systematic analyses of the smoking cessation interventions for different groups of smokers (such as young people, pregnant women, hospitalized patients, patients with COPD, or with CHD) and evaluation of effectiveness of different types of programmes (such as telephone, mass media interventions, group or individual counselling, workplace interventions, nicotine replacement therapy) are performed by Cochrane Collaboration Group (http:// www.cochrane.org). Such analyses indicate that even minimal assistance can increase cessation rate. Hundreds of controlled scientific studies have demonstrated that treatment can help tobacco users achieve permanent abstinence. People with tobacco dependence should be provided with effective and adequate treatment as in treating other chronic disorders. A minority of tobacco users (whether they smoke or use smokeless products) achieve permanent abstinence in an initial attempt to quit. Most tobacco users who want to quit go through multiple periods of relapse and remission (1).

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