Tobacco and cessation treatment

2010-01-27

A factual text on the harmful effects of tobacco and the need for cessation treatment.

Tobacco use is the single factor responsible for the greatest part of the burden
of disease in Sweden, and every year it causes a minimum of 6,600 premature
deaths, primarily with heart- and lungdisease and cancer. The main focus of this report is tobacco prevention in the county councils, especially tobacco cessation treatment. Tobacco cessation treatment is considered a key factor in tobacco prevention due to the fact that most premature deaths over the foreseeable future will be among people who are smokers already.

By quitting, these people can also become good role models for generations to come. But only 56–73 per cent of the primary care units offer tobacco cessation therapy, generally at a low level, and 16 out of 21 county councils estimate that their tobacco cessation service is currently undersized in 2009. At the same time, by ratifying the WHO Framework Convention on Tobacco Control, Sweden and a majority of countries around the world have assumed an obligation to actively offer tobacco cessation treatment to the population and to work to prevent young people from starting to use tobacco. A great deal of development still needs to be done, and we are far from reaching the tobacco prevention goals set by up the Swedish government for 2014.

This publication presents well-known methods for smoking cessation that are cost effective, easy to learn, easy to implement in healthcare and can provide a ten-fold improvement in their effects compared to the ways healthcare professionals are generally known to treat tobacco users today.

The scientific literature confirms that all methods for smoking cessation treatment are cost-effective. The same methods can also be applied to cessation treatment for smokeless tobacco (snuff). The overall goal is to reduce the total use of tobacco. High quality tobacco cessation treatment can be established in the county councils without very large investments. But the management structure, steering documents and reimbursement systems must be in line with and support the work with tobacco prevention. The costs for healthcare, sick leave and lost productivity due to smoking-related diseases, estimated at SEK 30 billion per year, could thereby be radically reduced.

Policy and decision-makers and managers in the county councils need to establish a plan for providing tobacco cessation services including:

• healthcare professionals routinely asking about tobacco use and noting the patient’s tobacco habits in their medical records
• healthcare professionals in all units routinely offering advice about tobacco cessation to ill as well as healthy patients
• all healthcare units employing cessation therapists with adequate education
  or enter an agreement with another healthcare unit to accept patients for cessation treatment
• making it easier for dental care to provide cessation treatment to their own patients
• actively working to make the tobacco cessation services known to the public
• trying to align the county councils’ systems for commissioning, providing
  and reimbursing different kinds of healthcare in order to facilitate and stimulate the development of tobacco cessation services.