Smoking Prevention and Cessation in the Africa and Middle East Region: A Consensus Draft Guideline for Healthcare Providers – Executive Summary

Abstract

Despite the abundance of scientific evidence confirming the health consequences of smoking and other forms of tobacco use, the tobacco epidemic remains an important public health problem and by 2030 it is predicted that more than 80% of tobacco deaths will be in developing countries. In Africa and the Middle East, many local factors contribute to the initiation and maintenance of tobacco use. Although efforts to reduce the mortality and morbidity associated with smoking and tobacco dependence are underway, there is a need for guidance on how to utilize appropriate tobacco control policies and psychology- and pharmacology-based therapies to counter tobacco dependence as recommended by the Framework Convention on Tobacco Control (FCTC). A group of tobacco cessation experts from public health services and/or academic institutions in Africa and the Middle East participated in a series of four meetings held in Cairo, Cape Town, and Dubai between May 2008 and February 2011 to develop a draft guideline tailored to their region. This article provides the background to the development of this draft smoking cessation guideline and discusses how the recommendations can be implemented and progress monitored to promote both primary prevention and cessation of tobacco use within our countries. The draft guideline for Africa and the Middle East provides an important resource in combating the devastating effects of tobacco use in these regions which can be further localized through engagement with local stakeholders in the countries of the region.

Prevalence of and Attitudes towards Smoking among Spanish Health Professionals

“…Only 58% of them believe that tobacco use is a chronic disease, while 35% believe that it is a bad habit. These beliefs stand in stark contrast to the definition of tobacco use given by Spanish and international scientific institutions [1,14,15,16]. All of them agree that tobacco use is a chronic disease.…”

“…The ‘5 As' strategy is recognised as a type of intervention in tobacco use that is more effective and has a higher cost-benefit ratio [14,16]. This strategy calls upon health professionals to intervene in the tobacco use of all the patients they see through the following activities: ask whether the patient is a smoker or not, advise the patient that he or she should quit smoking, assess whether the patient wants or does not want to quit smoking, assist the patient in quitting smoking and arrange follow-up to manage his or her process of quitting tobacco use [14,16].…”

“…This strategy calls upon health professionals to intervene in the tobacco use of all the patients they see through the following activities: ask whether the patient is a smoker or not, advise the patient that he or she should quit smoking, assess whether the patient wants or does not want to quit smoking, assist the patient in quitting smoking and arrange follow-up to manage his or her process of quitting tobacco use [14,16]. Two fundamental components of this strategy are to ask all patients seen by different health professionals about their tobacco use and to always advise them to quit [14,16]. Therefore, it is surprising to find that 44% of the health professionals in our study do not regularly ask the patients they see about tobacco use and that only 21% of them advise their patients who are smokers to quit using tobacco even if they are not suffering from any tobacco-associated diseases.…”

Impact of Legislation on Passive Smoking in Spain

“…There are several studies that have proven that such measures are effective in reducing exposure within homes and in reducing active smoking [6,7,8]. Two national laws have been passed in Spain aimed at controlling smoking in public places.…”

Water Pipe Smoking and Its Association with Cigarette and Cannabis Use in Young Adults in Switzerland

“…Water pipe use is a form of social smoking in that the pipes are often shared among friends and family at home or in bars and cafes that provide water pipe to customers. Large numbers of young females are also taking up this habit, perhaps due to a relative permissiveness of adult family members towards water pipe use in contrast to cigarette smoking [4]. …”