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HomeHarm ReductionTobacco use declines globally, strategies for cessation – WHO tobacco report

Tobacco use declines globally, strategies for cessation – WHO tobacco report

The fourth World Health Organisation (WHO) global tobacco trends report, released on 15 November, shows that there are 1.30 billion tobacco users globally compared to 1.32 billion in 2015, with this number expected to drop to 1.27 billion by 2025, writes Chad Williams for the African News Agency. Also, MedicalBrief includes key excerpts from the report on smoking cessation strategies and their potential impacts.

According to the report, 60 countries are now on track to achieve the voluntary global target of a 30% reduction in tobacco use between 2010 and 2025: two years ago only 32 countries were on track.

The WHO says millions of lives have been saved by effective and comprehensive tobacco control policies under its Framework Convention on Tobacco Control (FCTC) and MPOWER – a great achievement in the fight against the tobacco epidemic.

“It is very encouraging to see fewer people using tobacco each year, and more countries on track to meet global targets,” WHO Director-General Dr Tedros Adhanom Ghebreyesus says,” continues the article published on Independent Online.

“We still have a long way to go, and tobacco companies will continue to use every trick in the book to defend the gigantic profits they make from peddling their deadly wares.

The report also urges countries to accelerate implementation of the measures outlined in the WHO FCTC in an effort to further reduce the number of people at risk of becoming ill and dying from a tobacco-related disease.

Among the key findings of the WHO global report on trends in prevalence of tobacco use 2000-2025 are:

  • In 2020, 22.3% of the global population used tobacco, 36.7% of all men and 7.8% of the world’s women.
  • Africa has the lowest average rate of tobacco use at 10% in 2020, down from 15% in 2010.

The report, writes the African News Agency, found that one in three countries are likely to achieve the 30% reduction target, and low-income countries are currently achieving the most progress against tobacco.

The data behind the estimates are from 1,728 national surveys run by countries between 1990 and 2020, which together asked 97% of the world’s population about their tobacco use.

Find the link to the full story below.

 

WHO report – The Global Investment Case for Tobacco Cessation

The WHO report, The Global Investment Case for Tobacco Cessation, is accessible via the link below. It was released after COP9, the Ninth Session of the Conference of the Parties to the WHO FCTC. Ahead of the event, there was controversy over WHO's failure to include e-cigarettes as a smoking cessation strategy, and over the organisation's refusal to allow a broad range of stakeholders to attend, including the media.

The following table is at the heart of the report, describing suggested interventions to support smoking cessation and their anticipated impacts, writes MedicalBrief.

These interventions form the basis of WHO’s calculations of investment levels and areas needed: an additional US$1.68 invested in all six cessation interventions, per capita per year from 2021 to 2030.

The models utilised in the study, the report says, examined the impact of investing in three evidence-based population-level tobacco cessation strategies and three pharmacologic interventions.

The models looked at several parameters such as per capita costs, number of successful quitters, lives saved, and the economic benefits and returns on investment after a 10-year investment period (2021-2030) and until the cohort of quitters reaches the age of 65 years.

Population-level interventions

Brief advice – Advice to stop using tobacco, usually taking only a few minutes, is given to all tobacco users during the course of a routine consultation and/or interaction with a physician or health care worker. Assumed coverage target: 50% of all tobacco users aged 15+. Impact (percentage of users that quit tobacco) – 2%.

National toll-free quitline – A national toll-free quit line is a telephone counselling service that can provide both proactive and reactive counselling. A reactive quit line provides an immediate response to a call initiated by the tobacco user, but only responds to incoming calls. A proactive quit line involves setting up a schedule of follow-up calls to tobacco users to provide ongoing support. Assumed coverage target: 5% of all tobacco users aged 15+. Impact – 5%.

mCessation – Tobacco cessation interventions are delivered via mobile phone text messaging. Mobile technologies provide the opportunity to expand access to a wider population, and text messaging can provide personalised tobacco cessation support in an efficient and cost-effective manner. Assumed coverage target: 3.5% of all tobacco users aged 15+. Impact – 4%

Pharmacological interventions

Nicotine replacement therapy (NRTs) – NRTs are available in several forms including gum, lozenges, patches, inhalers and nasal spray. These cessation tools reduce craving and withdrawal symptoms by providing a low, controlled dose of nicotine without the toxins found in cigarettes. The doses of NRT are gradually reduced over time to help the tobacco user ween off of nicotine by getting used to less and less stimulation. Assumed coverage target: an additional 5% on top of estimated current NRT use among tobacco users aged 15+ (varies per country). Impact – 6%

Bupropion – Non-nicotine pharmacotherapy. These pharmacotherapies reduce cravings and withdrawal symptoms and decrease the pleasurable effects of cigarettes and other tobacco products. Assumed coverage target: an additional 1.5% on top of estimated current NRT use among tobacco users aged 15+ (varies per country). Impact – 7%.

Varenicline – Non-nicotine pharmacotherapy. These pharmacotherapies reduce cravings and withdrawal symptoms and decrease the pleasurable effects of cigarettes and other tobacco products. Assumed coverage target: an additional 1.5% on top of estimated current NRT use among tobacco users aged 15+ (varies per country). Impact – 15%.

Estimated impacts

An additional US$1.68 invested in all six cessation interventions, per capita per year from 2021 to 2030.

  • By 2030: 152 million smokers will have been helped to quit tobacco use, and 2.7 million lives will have been saved.
  • Benefits will continue to accrue incrementally, beyond the investment period. By the time the cohort of quitters reaches 65 years old: 16 million lives will have been saved, and each dollar invested will have yielded US$7.50 in gains.
  • The three population-level cessation interventions cost little, though they deliver significant returns on investment within 10 years, and tremendous returns by the time quitters reach 65 years of age.

On average, countries need to invest only 21 cents per capita annually on the three population-level interventions. Each US$ 1 investment yields US$ 3.58 in gains by 2030, and each US$ 1 investment produces US$ 35.40 in returns by the time quitters reach 65 years.

In total, population-level interventions can lead to 88 million successful quitters and 1.4 million lives saved by 2030, and 9.3 million lives saved in total by the time quitters reach 65 years. Clearly, these three population-level interventions are highly cost-effective.

  • Pharmacologic cessation interventions – NRTs, bupropion and varenicline – cost more, but produce substantial returns demonstrated over the lifetime of quitters.

The cost of investing in pharmacologic interventions is US$1.49 per capita annually, and the 10-year return on investment is 40 cents for every dollar, but this increases to US$ 3.60 per dollar over the lifetime of the cohort of quitters. Pharmacologic interventions can produce up to 66 million more successful quitters and 1.3 million lives saved by 2030, and 6.8 million lives saved when quitters reach 65 years of age.

 

African News Agency report on Independent Online – Tobacco use declines globally – WHO tobacco report – Open access

 

WHO report – The Global Investment Case for Tobacco Cessation (Open access)

 

See also from the MedicalBrief archives

 

Tobacco harm reduction – ‘We’ll take to the streets” – Letlape

 

100 experts from 30 countries urge WHO to change tobacco harm reduction stance

 

Global tobacco control ‘hugely outdated’ – Dr Kgosi Letlape

 

To quit or to substitute – The new global tobacco war

 

 

 

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