C2814 - Progress made in implementing Article 14

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Party 2020 2018 2016 Region
Afghanistan advocacy in high level to make tobacco cessation centers added tobacco cessation center is new health package (integrated package of essential health services) regular meeting with BPHS and EPHS package revision team to add tobacco cessation centers in these packages Answer not provided Answer not provided WHO Eastern Mediterranean Region
Albania Report not provided Report not provided Report not provided WHO European Region
Algeria Dans ce cadre , il y a eu élaboration de la stratégie nationale daide au sevrage tabagique qui sera suivi par lacquisition et la distribution gratuite des substituts nicotiniques aux fumeurs pour les premiers consultations Aussi , il y a eu création de 53 unités daide au sevrage tabagique au niveau national pour la prise en charge de la dépendance à légard du tabac. Dans ce cadre , il y a eu lélaboration de la stratégie nationale daide au sevrage tabagique qui sera suivi par lacquisition et la distribution gratuite des substituts nicotiniques aux fumeurs pour les premiers consultations Aussi , il y a eu création de 50 unités daide au sevrage tabagique au niveau national pour la prise en charge de la dépendance à légard du tabac Dans ce cadre , il y a eu lélaboration de la stratégie nationale daide au sevrage tabagique qui sera suivi par lacquisition et la distribution gratuite des substituts nicotiniques aux fumeurs pour les premiers consultations Aussi , il y a eu création de 50 unités daide au sevrage tabagique au niveau national pour la prise en charge de la dépendance à légard du tabac WHO African Region
Andorra Report not provided Report not provided Report not provided WHO European Region
Angola Answer not provided Answer not provided Answer not provided WHO African Region
Antigua and Barbuda Cessation drugs only available over the counter as needed. There is no national cessation program Report not provided Answer not provided WHO Region of the Americas
Armenia not availble Report not provided Report not provided WHO European Region
Australia In addition to the population level measures noted elsewhere in this report and previous Periodic Reports, the Australian Government promotes cessation of tobacco use and treatment for tobacco dependence through support for Quitline services and subsidies for nicotine replacement products, bupropion and varenicline. These initiatives are part of a balanced package of measures which in the long term will contribute to efforts to reduce smoking rates in Australia. The Australian Government has provided funding to support Quitline services, which provides information and advice or counselling for people who want to quit smoking. The Quitline is the responsibility of the sub-national governments. Quitlines offer a free call-back service, expert help in planning a quit attempt and advice on the use of nicotine replacement products. Quitline services are available in English, other languages and has a team of Aboriginal and Torres Strait Islander counsellors. A ‘Quit book’ can be mailed to callers with information and advice or callers can speak to someone with information on the best ways to quit, coping with withdrawal symptoms, guidance on quit courses and details of local organisations which provide individual support and counselling. Other services available to quit include: • My QuitBuddy mobile application; • Campaign website; and • Quit for you, Quit for Two mobile application which focuses on pregnant women and their partners and highlights the support tool to assist pregnant women quit smoking. The Australian Government also provides financial support to help people quit smoking by the listing of nicotine replacement therapies and other approved pharmacotherapies on the Pharmaceutical Benefits Scheme (PBS), which provides access for all eligible Australians (including concession card holders). All these products are available at a reduced price for eligible patients through the PBS with a prescription from a General Practitioner or health professional. In addition to the extensive education, communication, training and public awareness measures detailed at section 3.2.6 above, and as previously stated in our last two Periodic Reports (2014 and 2016), the Australian Government promotes cessation of tobacco use and treatment for tobacco dependence through support for Quitline services and subsidies for nicotine replacement products. These initiatives are part of a balanced package of measures which in the long term will contribute to efforts to reduce smoking rates in Australia. The Australian Government has provided funding to support Quitline services, which provide information and advice or counselling for people who want to quit smoking. The Quitlines are the responsibility of the state and territory governments. Quitlines offer a free call-back service, expert help in planning a quit attempt and advice on the use of nicotine replacement products. Quitline services are available in English and other languages. It also has a team of Aboriginal and Torres Strait Islander counsellors. A ‘Quit book’ can be mailed to callers with information and advice or callers can speak to someone with information on the best ways to quit, coping with withdrawal symptoms, guidance on quit courses and details of local organisations which provide individual support and counselling. Other services available to quit include: • My QuitBuddy mobile application; • Quitnow website; and • Quit for you, Quit for Two mobile application which focuses on pregnant women and their partners and highlights the support tool to assist pregnant women quit smoking. The Australian Government also provides financial support to help people quit smoking by the listing of nicotine replacement therapies on the Pharmaceutical Benefits Scheme (PBS), which provides access for all eligible Australians (including concession card holders). All these products are available at a reduced price for eligible patients through the PBS with a prescription from a General Practitioner or health professional. The Government’s subsidies include Bupropion (available in two brands) Varenicline (Champix®) and nicotine replacement therapy (available in the form of patches), including a continuation course (12 weeks or 24 weeks) of Varenicline through the PBS to aid in smoking cessation In addition to the extensive education, communication, training and public awareness measures detailed at section see also C261 above, and as previously stated in our last (2014) Periodic Report, the Australian Government promotes cessation of tobacco use and treatment for tobacco dependence through support for Quitline services and subsidies for nicotine replacement products. These initiatives are part of a balanced package of measures which in the long term will contribute to efforts to reduce smoking rates in Australia. The Australian Government has provided funding to support Quitline services, which provide information and advice or counselling for people who want to quit smoking. The Quitlines are the responsibility of the state and territory governments. Quitlines offer a free call-back service, expert help in planning a quit attempt and advice on the use of nicotine replacement products. Quitline services are available in English and other languages. A ‘Quit book’ can be mailed to callers with information and advice or callers can speak to someone with information on the best ways to quit, coping with withdrawal symptoms, guidance on quit courses and details of local organisations which provide individual support and counselling. The Australian Government also provides financial support to help people quit smoking by the listing of nicotine replacement therapies on the Pharmaceutical Benefits Scheme (PBS), which provides access for lower-income Australians and people with a prescription from the GP, and extended listings for the smoking cessation support drugs bupropion (available in two brands) and varenicline (Champix®). All of these products are available at a reduced price for eligible patients through the PBS with a prescription from a general practitioner. WHO Western Pacific Region
Austria Creation of a quality assured tobacco cessation and tobacco counseling curriculum; training since 2012 ("Curriculum zur RaucherInnenentwöhnung und -beratung nach den Standards der österreichischen Sozialversicherung") Communication between the regions who provide smoking counseling and smoking cessation programs Networking between the regions and experts Continuation of the quit-line for smoking cessation ("Rauchfrei Telefon", www.rauchfrei.at) Creation and implementation of a mobile phone application for smoking cessation ("Rauchfrei App", www.rauchfreiapp.at) Internet-based offers for smoking cessation (www.endlich-aufatmen.at) Special offers for women and pregnant women (e.g. www.juliarauchfrei.at) Different settings are being targeted (hospitals, workplaces, schools, etc.) In Styria there is a wide range of programs for professionals in the Smoking cessation: Implemented is the program "Smokefree in 6 weeks" that is offered in all parts of the Country. The program tries to achieve a Change of behavior and includes medical Treatment. "Smokefree in 6 weeks" works with a group of 6 up to 12 People and is guided by psychologists and physicians who all have a special training for smoking cessation. For People who, out of different reasons, cant join a group (such as pregnant women, shift workers or persons with serious diseases such as cancer or COPD) there is also a program in tobacco cessation for individuals. Young People can join the Training "take Control - the less Smoking course for young People" which is also designed for groups. Creation of a quality assured tobacco cessation and tobacco counseling curriculum; training since 2012 ("Curriculum zur RaucherInnenentwöhnung und -beratung nach den Standards der österreichischen Sozialversicherung") Communication between the regions who provide smoking counseling and smoking cessation programs Networking between the regions and experts Continuation of the quit-line for smoking cessation ("Rauchfrei Telefon", www.rauchfrei.at) Creation and implementation of a mobile phone application for smoking cessation ("Rauchfrei App", www.rauchfreiapp.at) Internet-based offers for smoking cessation (www.endlich-aufatmen.at) Special offers for women and pregnant women (e.g. www.juliarauchfrei.at) National Addiction Prevention Strategy (put into place in February 2016) Different settings are being targeted (hospitals, workplaces, schools, etc.) Creation of a quality assured tobacco cessation and tobacco counseling curriculum; training since 2012 ("Curriculum zur RaucherInnenentwöhnung and -beratung nach den Standards der österreichischen Sozialversicherung") Communication between the regions who provide smoking counseling and smoking cessation programs Networking between the regions and experts Continuation of the quit-line for smoking cessation ("Rauchfrei Telefon", www.rauchfrei.at) Creation and implementation of a mobile phone application for smoking cessation ("Rauchfrei App", www.rauchfreiapp.at) Internet-based offers for smoking cessation (www.endlich-aufatmen.at) Special offers for women and pregnant women (e.g. www.juliarauchfrei.at) National campaign around the World No Tobacco Day to raise awareness of the benefits of a smoke-free life style by role models (www.vorbild.rauchfrei.at) National Addiction Prevention Strategy (put into place in February 2016) Different settings are being targeted (hospitals, workplaces, schools, etc.) WHO European Region
Azerbaijan On 01 December 2017 the new Law of Azerbaijan Republic "On restriction of tobacco use" was adopted. The article 15 of the Law widely refers of demand reduction measures concerning tobacco dependence and cessation. On 01 December 2017 the new Law of Azerbaijan Republic "On restriction of tobacco use" was adopted. The article 15 of the Law widely refers of demand reduction measures concerning tobacco dependence and cessation. The National Clinical Protocol on Smoking Cessation developed and approved, The National Clinical Protocol on Prevention of Cardio-Vascular Diseases developed and approved. WHO European Region
Bahamas Report not provided Report not provided Answer not provided WHO Region of the Americas
Bahrain (Kingdom of) IN ADDITION TO THE THREE SMOKING CESSATIN CLINICS IN PRIMARY HEALTH CARE, AN ARRANGMENT WAS MADE TO START PROVIDING SMOKING CESSATION SERVICES IN THE MAIN SECONDARY HEALTH CARE CENTER IN BAHARIN (SALMANIYA MEDICAL CENTER). NRT ARE BEING OFFERED TO PEOPLE BEING ADMITTE TO THE HOSPITAL ESPCIALLY YJOSE WITH LONG OR FREQUENT ADMISSINS. IN ADDITION, ANOTHER PLAN IS BEING FORMULATED FOR HEALTHCARE WORKERS TO HELP THE IN SMOKING CESSATION. ALL SMOKING CESSATION SERVICES ARE FOLLOWING THE NATIONAL SMOKING CESSATION GUIDLINES. IN ADDITION TO THE THREE SMOKING CESSATIN CLINICS IN PRIMARY HEALTH CARE, AN ARRANGMENT WAS MADE TO START PROVIDING SMOKING CESSATION SERVICES IN THE MAIN SECONDARY HEALTH CARE CENTER IN BAHARIN (SALMANIYA MEDICAL CENTER). NRT ARE BEING OFFERED TO PEOPLE BEING ADMITTE TO THE HOSPITAL ESPCIALLY YJOSE WITH LONG OR FREQUENT ADMISSINS. IN ADDITION, ANOTHER PLAN IS BEING FORMULATED FOR HEALTHCARE WORKERS TO HELP THE IN SMOKING CESSATION. A new smoking cessation clinic was opened in Bahrain in May 2014, making the total number of clinics 3. the clinic is run by a Family Physician and a health educator, both received training on smoking cessation techniques. WHO Eastern Mediterranean Region
Bangladesh Answer not provided Answer not provided Answer not provided WHO South-East Asia Region
Barbados Much of the effort remain NGO and private sector driven with some input from Government. These include the national Council on Substance Abuse and faith based organizations Much of the effort remain NGO and private sector driven with some input from Government. These include the national Council on Substance Abuse and faith based organizations Much of the effort remain NGO and private sector driven with some input from Government. These include the national Council on Substance Abuse, the National Council for Prevention of Alcohol and Drug Dependency and faith based organizations WHO Region of the Americas
Belarus За последние годы увеличилось количество лиц, получивших консультации по вопросам отказа от курения. За последние годы увеличилось количество лиц, получивших консультации по вопросам отказа от курения. За последние годы увеличилось количество лиц, получивших консультации по вопросам отказа от курения. WHO European Region
Belgium La question du tabagisme et des mesures prises à son égard sont présentes dans le plan de prévention et de promotion de la santé en Wallonie horizon 2018-2030. GERMAN SPEAKING COMMUNITY To help people cessate self-help groups, which are free of charge are established, as well as personal coaching. Additionally consultations with tobbacologists are for the major part reimbursed. La question du tabagisme et des mesures prises à son égard sont présentes dans le plan de prévention et de promotion de la santé en Wallonie horizon 2018-2030. Answer not provided WHO European Region
Belize This part of the Outreach Services provided by the Rehabilitation and Treatment Unit of the National Drug Abuse Control Council and the Psychiatric Unit of the Ministry of Health. Report not provided Answer not provided WHO Region of the Americas
Benin le sevrage tabagique nest pas encore inclus dans les soins de santé primaire au Bénin, le programme WHO-PEN est mis en oeuvre à léchelle expérimentale dans certaines formations sanitaires au niveu communautaire, cest plus de la sensibilisation que du traitement le sevrage tabagique nest pas encore inclus dans les soins de santé primaire au Bénin, le programme WHO-PEN est mis en oeuvre à léchelle expérimentale dans certaines formations sanitaires au niveu communautaire, cest plus de la sensibilisation que du traitement le sevrage tabagique nest pas encore inclus dans les soins de santé primaire au Bénin, le programme WHO-PEN est mis en oeuvre à léchelle expérimentale dans certaines formations sanitaires au niveu communautaire, cest plus de la sensibilisation que du traitement WHO African Region
Bhutan establishment of Toll-free Number at Health Help Centre under Ministry of Health for Tobacco cessation and Counselling. Integration of counseling of tobacco dependency with that of a drug addict counseling at Hospitals and Rehabilitation Center. establishment of Toll-free Number at Health Help Centre under Ministry of Health for Tobacco cessation and Counselling. Integration of counseling of tobacco dependency with that of a drug addict counseling at Hospitals and Rehabilitation Center. Answer not provided WHO South-East Asia Region
Bolivia (Plurinational State of) Answer not provided Answer not provided Report not provided WHO Region of the Americas
Bosnia and Herzegovina Republic of Srpska In 2018, Public Health Institute of the Republic of Srpska implemented the Project on smoking cessation among healthcare professionals employed in family medicine teams in six Community Health Centres in the Republic of Srpska. Answer not provided Answer not provided WHO European Region
Botswana Treatment and cessation of tobaccco dependence is offered free. The government pays for the services, unless provided at private facilities. Treatment and cessation of tobaccco dependence is offered free. The government pays for the services, unless provided at private facilities. Report not provided WHO African Region
Brazil Since 2017 specialists in smoking control and technicians from the Ministry of Health (among them, technicians of the National Cancer Institute) have been working on updating the Clinical Protocol of Nicotine Dependence Treatment. Since 2017 specialists in smoking control and technicians from the Ministry of Health (among them, technicians of the National Cancer Institute) have been working on updating the Clinical Protocol of Nicotine Dependence Treatment. From 2014 to 2015 the National Public Health System provided free tobacco cessation treatment for 463 565 smokers in about 2500 municipalities. WHO Region of the Americas
Brunei Darussalam Telephone quitline was terminated in 2014 since there were no uptake from the public. The team tried to be pro-active by calling the smokers that were fined (for smoking at prohibited areas), for consultation & referral, they refused to pick up the call. During anti-tobacco exhibition & roadshows, the team are actively recruiting smokers by delivering 5As onsite and referring them to the nearest smoking cessation clinic. Smoking cessation clinic is available in respiratory clinic and anti-tobacco health talk is also available for cardiac rehabilitation patients. Through the health talks, smokers will be recruited and referred to the nearest smoking cessation clinic. Smoking cessation clinic is National Dental Centre has ceased to operate since in 2016. Smoking cessation module is currently only available in Dental & Pharmacy course, as well as Masters in Public Health. 5As brief intervention smoking cessation training was conducted for all doctors and nurses in the Maternal & Child Health Services Division. Answer not provided Report not provided WHO Western Pacific Region
Bulgaria A campaign for early detection of lung diseases of active and passive smokers conducted. Screening organised and conducted. The aim of the campaign is to focus attention on interactions between tobacco use and pulmonary diseases. The Ministry of Health organizes and finances the campaign for free screening examinations of active and passive smokers as part of the NCD Prevention National Program 2014-2020. The campaign has been initiated by the National Association for the Prophylaxis of Pulmonary Diseases and carried out with the support of Sofia Municipality by providing it with a fluorographer to perform the screening. The reviews have been carried out by teams of specialists in pulmonary diseases on a specific schedule in the cities of Blagoevgrad, Sofia and 5 settlements in Vratsa region, under the motto "Stop Now for Better Health Tomorrow", and tailored to the WHO voluntary screening requirements. After 2002 there are free of charge 28-th smoking cessation clinics, incorporated in the structure of the 28 in Regional Health Inspections across the country (Sofia included). In Sofia are functioning additional 3 clinics under NGO’s & Medical associations; Based in mostly in this kind of medical units, Bulgarian smoking cessation clinics are out patient counseling and smoking cessation promotion offices; Their activity is based on provision of information and advice; Health professionals are mostly engaged in counseling than in therapeutic activities, having no rights to prescribe medications (According to the Law of Medical Establishments). For 10 years there are free of charge 28-th Consultative Quit Offices in Regional Health Inspections across the country. Provision of services in the Cabinet for consultation and smoking cessation - consulting and spirometric measurements of carbon monoxide in the lung and the residual amounts of carboxyhemoglobin in the blood of active and passive smokers , Determination of the degree of dependence through test of Fagerstryom; Demonstration of the harmful effects of smoking using a model - Sue doll; There is a National Quitline 0700 10 323. The Ministry of Health organizes tranings in methods for quit consultations for general practitioners/family doctors, medical specialists from educational institutions. In 2015 Ministry of Health bought additional equipment for Consultative Quit Offices in 28 Regional Health Inspections. Every year Ministry of Health and regional health inspections implement the following activities across the country: Ministry of Health and regional health inspections have been involved in the European Campaign „Exsmokers are unstoppable” through providing the opportunity to use internet platform iCoach for individual registration and personal support to tobacco dependence peorle. www.exsmokers.eu; http://www.mh.government.bg/bg/novini/aktualno/ministerstvo-nazdraveopazvaneto- otbelyazva-30-okt/ WHO European Region
Burkina Faso Un module de formation et des directives du sevragr tabagique ont été élaborés. Une unité de sevrage tabagique a été créé à lhôpital national de réference. Le nouveau plan stratégique de lutte antitabac 2016-2020 prévoit la création de deux centres de sevrage dans les deux grandes villes du pays ainsi que des formations continues sur le sevrage et la prise en charge de la dépendance tabagique. Le nouveau plan stratégique de lutte antitabac 2016-2020 prévoit la création de deux centres de sevrage dans les deux grandes villes du pays ainsi que des formations continues sur le sevrage et la prise en charge de la dépendance tabagique. WHO African Region
Burundi Dans le plan stratégique national de lutte contre le tabagisme 2016-2020 élaboré est prévu une opérationnalisation des services d’addictologie et Intégration de curricula de formation dans les écoles médicales Report not provided Dans le plan stratégique national de lutte contre le tabagisme 2016-2020 bientôt élaboré est prévu une opérationnalisation des services d’addictologie et Intégration de curricula de formation dans les écoles médicales WHO African Region
Cabo Verde Formation et sensibilisation de l´abandon de l´utilisation Formation et sensibilisation de labandon de lutilisation Formation et sensibilisation de labandon de lutilisation WHO African Region
Cambodia Answer not provided Answer not provided Report not provided WHO Western Pacific Region
Cameroon Il convient de relever la volonté des pouvoir publics à mettre en oeuvre ce volet important de réduction de la demande de tabac; Un arrêté portant création des unités spécialisés de soins et de prévention en addictologie dans les formations sanitaire a été signé en janvier 2015. le processus de mise en place de ces unités se poursuit. Il convient de relever la volonté des pouvoir publics à mettre en oeuvre ce volet important de réduction de la demande de tabac; Un arrêté portant création des unités spécialisés de soins et de prévention en addictologie dans les formations sanitaire a été signé en janvier 2015. le processus de mise en place de ces unités est en cours. Answer not provided WHO African Region
Canada Demand reduction, in the Canadian context, is a responsibility shared through federal policy and provincial/territorial service delivery. A number of projects have been developed/supported in implementing Article 14. Since the last FCTC report in 2018, Canada’s Tobacco Strategy was renewed, bringing an added focus to sub groups of the Canadian population who face higher rates of tobacco use and health inequalities. The Public Health Agency of Canada has provided contribution funding for three projects which have been completed, two projects are still underway, and two additional projects focused on populations with high prevalence of tobacco use have been launched. In response to question C28, Canada experienced difficulty in reporting on variations between the sub-national authorities. The following narratives addresses the variations between jurisdictions. In response to C281, of those jurisdictions that responded, 75% are developing and disseminating appropriate, comprehensive and integrated guidelines based on scientific evidence and best practices. In response to C282, of those jurisdictions that responded, 100% of programs promote cessation of tobacco use, including media campaigns emphasizing the importance of quitting. In terms of programs specially tailored: 100% of jurisdictions had some for girls and young women. 42% had some for women. 50% had some for pregnant women. 100% had telephone quitlines. 92% had local events like World No Tobacco Day or National No Smoking Day. In response to C283 on the location of implementation of programs aimed at promoting cessation, of those jurisdictions that responded: 85% were in educational institutions. 100% were in health-care facilities. 77% were in workplaces. 46% were in sporting environments. In response to C284 on the inclusion of diagnosis and treatment of tobacco dependence and counselling services for cessation of tobacco use: 83% included services in tobacco control programs, plans and strategies. 75% included services in health programs, plans and strategies. 50% included services in education programs, plans and strategies. In response to C285, 92% of jurisdictions have programs for the diagnosis and treatment of tobacco dependence in the health-care system. In response to C286, of those jurisdictions that responded: 92% provided programs for the diagnosis and treatment of tobacco dependence in primary health care. 83% provided programs for the diagnosis and treatment of tobacco dependence in secondary health care. 54% provided programs for the diagnosis and treatment of tobacco dependence in specialized centers for cessation counseling. 50% responded as having programs in rehabilitation centers. In response to question C287 on reimbursements: 38% reported “full” and 46% reported “partial” coverage in primary health care. 38% reported “full” and 53% reported “partial” in secondary health care programs. In response to specialized health care, 18% reported having “full” coverage, while 36% reported having “partial” coverage and 46% reported not providing funding. In response to specialized centers, 33% reported having “full” coverage, 33% reported “partial” coverage, and 34% reported not providing funding. In response to rehabilitation centers, 9% had “full funding”, 36% “partial”, and 55% reported not providing funding. In response to question C288 on health professionals involved in programs offering treatment for tobacco dependence and counselling services: 100% reported “Yes” for physicians. 69% reported “Yes” for dentists. 92% reported “Yes” for family doctors. 44% reported “Yes” for practitioners of traditional medicine. 100% reported “Yes” for nurses. 25% reported “Yes” for midwives. 100% reported “Yes” for pharmacists. 85% reported “Yes” for community workers. 73% reported “Yes” for social workers. 43% reported “Yes” for others. In responding to C289 on training curriculum, there was varied response. Education is governed at the sub-national level. Of the sub-national jurisdictions that responded: 58% did not provide training in medical programs. 58% did not provide training in dental programs. 17% did not provide training in nursing programs. 42% did not provide training in pharmacy programs. In responding to question C2811 on providing access to treatment, 92% responded “Yes” with the primary source being a pharmacy. In responding to question C2813 on funding for NRT, the majority of jurisdictions indicated support for at least partial funding of pharmaceutical products legally available for the treatment of tobacco dependence. Specifically: 67% reported partial support for NRT while 25% provide full support. 75% reported partial support for bupropion while 15% provide full support. 77% reported partial support for varenicline while 15% provide full support. Of note, Ontario implemented a Provincial Smoking Cessation Campaign targeted to the 18-44 age group which ran from December 25, 2017 to February 28, 2018. Local Public Health Units and Smoke-Free Ontario partners also conduct local public education, smoking cessation campaigns and other initiatives. Also, each Canadian province/territory has an agreement with Health Canada for the delivery of the Pan-Canadian Quitline Initiative including the administration of the quitline and web counselling services. Ontario based calls and web services are delivered by the Canadian Cancer Society, Ontario Division, Smokers’ Helpline. Smokers’ Helpline provides quitline services to residents of Ontario who contact the Smokers Helpline, call the Pan-Canadian toll-free quitline number and/or access web counselling via the cessation web portal displayed on tobacco packaging. Since October 1, 2019, Ontarians have easy access to registered nurses and smoking cessation support through Telehealth Ontario, in combination with wraparound services and health information already offered, including professional medical advice, nutrition counselling and referrals to mental health and addictions support. It should be noted that Cytisine is available in Canada for the treatment of tobacco dependence without a prescription. It was approved by Health Canada in August 2017 as a natural health product. The cost of these products is not covered by public funding or reimbursement. Demand reduction, in the Canadian context, is a responsibility shared through federal policy and provincial/territorial service delivery. A number of projects have been developed/supported in implementing Article 14. In response to question C28, Canada experienced difficulty in reporting on variations between the sub-national authorities. Responses are provided to those questions that had consistent answers by all jurisdictions. The following narratives address the variations between jurisdictions. In response to C286, of those jurisdictions that responded: 42% provided programs for the diagnosis and treatment of tobacco dependence in specialized centers for cessation counseling 36% responding as having programs in rehabilitation centers 92% responding as having programs in treatment in primary health care 83% responding as having programs in secondary health care 33% responding as having programs with specialists In response to question C287 on reimbursements: 50% reported “full” and 42% reported “partial” coverage in primary health care. 50% reported “full” and 42% reported “partial” in secondary health care programs. In response to specialist health care, 30% reported having “full” coverage; 30% reported having “partial” coverage. In response to special centers for cessation, 36% reported having “full” coverage and 18% reported “partial” coverage. In response to rehabilitation centers, 10% had “full funding” while 30% “partial” coverage In response to question C288 on health professionals: 22% of those responding indicated “Yes” for practitioners of traditional medicine. 82% reported “Yes” for community workers. 40% reported “Yes” for social workers. 92% reported “Yes” for physicians. 92% reported “Yes” for family doctors. 67% reported “Yes” for dentists. 100% reported “Yes” for nurses. 92% reported “Yes” pharmacists. In responding to C289 on training curriculum, there was varied response. Education is governed at the sub-national level. Of the sub-national jurisdictions that responded: 50% did not provide training in medical programs 70% did not provide training in dental programs 36% did not provide training in nursing programs 40% did not provide training in pharmacy programs In responding to question C2810 on providing access to treatment, 100% responded “Yes” with the primary source being a pharmacy. In responding to question C2813 on funding for NRT, the majority of jurisdictions indicated support for partial funding. Specifically: 83% reported partial support for NRT, 100% reported partial support for bupropion. 100% reported partial support for varenicline Demand reduction, in the Canadian context, is a responsibility shared through federal policy and provincial/territorial service delivery. A number of projects have been developed/supported in implementing Article 14. In response to question C28 Canada experienced difficulty in reporting on variations between the sub-national authorities. Responses are provided to those questions that had consistent answers by all jurisdictions. The following narratives addresses the variations between jurisdictions. In response to C286, of those jurisdictions that responded: 46% provided programs for the diagnosis and treatment of tobacco dependence in specialized centers for cessation counseling. 31% responding as having programs in rehabilitation centers. In response to question C287 on reimbursements: 62% reported “full” and 23% reported “partial” coverage in primary health care. 54% reported “full” and 39% reported “partial” in secondary health care programs. In response to specialized health care, 23% reported having “full” coverage, while 15% reported having “partial” coverage. In response to specialized centers, 23% reported having “full” coverage, 15% reported “partial” coverage. In response to rehabilitation centers, 15% had “full funding”, 8% “partial”, while reported as not 77% providing funding. In response to question C288 on health professionals:  31% of those responding indicated “Yes” for practitioners of traditional medicine. 69% reported “Yes”for community workers. 31% reported “Yes” for social workers. In responding to C289 on training curriculum, there was varied response. Education is governed at the sub-national level. Of the sub-national jurisdictions that responded: 69% did not provide training in medical programs. 77% did not provide training in dental programs. 39% did not provide training in nursing programs. 54% did not provide training in pharmacy programs. In responding to question C2810 on providing access to treatment, 92% responded “Yes” with the primary source being a pharmacy. In responding to question C2813 on funding for NRT, the majority of jurisdictions indicated support for partial funding. Specifically: 54% reported support for NRT, 62% reported support for bupropion. 69% reported support for varenicline. WHO Region of the Americas
Central African Republic Report not provided Report not provided Report not provided WHO African Region
Chad se sont les campagnes de sensibilisation réalisées et laccompagnement qui est assuré par une structure confessionnelle la CEEDIRA . La prise en charge est assuré par les hôpitaux publics dans le cadre doffre de soins général se sont les campagnes de sensibilisation réalisées et laccompagnement qui est assuré par une structure confessionnelle la CEEDIRA . La prise en charge est assuré par les hôpitaux publics dans le cadre doffre de soins général Report not provided WHO African Region
Chile Durante este periodo se han establecidos dos cursos de capacitación en linea para profesionales de la salud, el primero en consejería breve anti tabaco y el segundo en estrategias de cesación del consumo, esto para comenzar a instalar las capacidades en los profesionales ya que se está trabajando en la actualidad para poder generar un programa de cesación en el país. Junto con lo anterior se incluyó en la nueva advertencia sanitaria un numero para recurir a consejería telefónico. En la actualidad hay intervenciones en el programa de salud bucal y respiratoria pero no tienen seguimiento. Se implementó durante el año 2018 y 2019 un piloto de cesación del consumo de tabaco en tres comunas de la región metropolitana alcanzando un total de 414 beneficiarios, lo que ha permitido evaluar el protocolo de intervención y poder formular una nueva implementación durante 2020 y 2021 con el objetivo de validar la intervención en la atención primaria. Durante este periodo se han establecidos dos cursos de capacitación en linea para profesionales de la salud, el primero en consejería breve anti tabaco y el segundo en estrategias de cesación del consumo, esto para comenzar a instalar las capacidades en los profesionales ya que se está trabajando en la actualidad para poder generar un programa de cesación en el país. Junto con lo anterior se incluyó en la nueva advertencia sanitaria un numero para recurir a consejería telefónico. En la actualidad solo hay intervenciones en el programa de salud bucal y respiratoria pero no tienen seguimiento. Durante este periodo se han establecidos dos cursos de capacitación en linea para profesionales de la salud, el primero en consejería breve anti tabaco y el segundo en estrategias de cesación del consumo, esto para comenzar a instalar las capacidades en los profesionales ya que se está trabajando en la actualidad para poder generar un programa de cesación en el País. Junto con lo anterior se incluyó en la nueva advertencia sanitaria un numero para recurir a consejería telefónica. En la actualidad solo hay intervenciones en el programa de salud bucal y respiratoria pero no tienen seguimiento. WHO Region of the Americas
China 1.国家卫生健康委通过基本公共卫生服务项目,继续在全国范围内推动各地建设戒烟门诊,推广全国戒烟热线,完善工作网络;开发戒烟门诊数据管理平台,规范数据提交形式,提高数据收集效率;在各级医疗机构中进行简短戒烟干预服务的技术指导与推广。中日友好医院加入世界卫生组织移动戒烟项目,开发移动戒烟APP。 2.举办戒烟能力培训。如2019年中国疾控中心举办2期全国戒烟干预技能提高培训班,培训超200人次;各省共举办省级培训40次,培训5232人次;市县级培训967次,共培训50384人次;戒烟门诊所在医院培训378次,共培训64391人次。中日友好医院举办实施世界卫生组织《烟草控制框架公约》 第14条准则“与烟草依赖和戒烟有关降低烟草需求的措施”国际研讨会-简短戒烟干预高级培训班、全国戒烟医师培训班。 国家卫生计生委通过基本公共卫生服务项目,继续在全国范围内推动各地卫生计生系统建设戒烟门诊,推广全国戒烟热线,完善工作网络;建立戒烟数据收集与管理平台,不断完善戒烟相关数据收集;在各级医疗机构中进行简短戒烟干预服务的技术指导与推广,开展卫生计生人员控烟能力培训;发展适用于我国的新型戒烟技术,如戒烟APP,并开展国际合作与相关研究。 2016年,世界卫生组织授予中日友好医院成为戒烟与呼吸疾病预防合作中心。2016年8月,国家卫生计生委委托中日友好医院牵头成立中国戒烟联盟并召开了中国戒烟联盟成立大会,充分发挥委属委管医院等医疗机构在戒烟治疗方面的作用,进一步强化无烟医院建设,帮助吸烟的医生首先戒烟。2017年5月,举办了全国戒烟能力培训暨中国戒烟联盟戒烟医者先行启动会,在全国范围内启动戒烟“医者先行”倡导活动。 政府支持在全国推广和建设戒烟门诊和及戒烟热线,引入简短戒烟干预服务技术,在中国各级医疗机构中开展培训,并进行技术推广,开发中文版的简短戒烟干预服务指南,更新戒烟门诊操作指南,开发戒烟热线操作指南。 WHO Western Pacific Region
Colombia Tanto en el Plan Decenal de Salud Pública, como en el Plan Decenal de Cáncer se establecieron metas para cesación de tabaco. En cumplimiento de estas metas, se desarrolló el Programa Nacional de Cesación (Ver Anexo 12). En este marco, se han desarrollado las siguientes acciones: 1. Talento humano. Entrenamiento consejería breve en los profesionales de la salud de atención primaria mediante talleres presenciales donde se capacitaron 160 profesionales de la salud entre médicos, psicólogos, odontólogos, enfermeras y trabajadora social. 2. Programa de educación. Desarrollo de un curso virtual incluido en un programa de educación continuada en consejería breve mediante el cual se entrenaron y certificaron a 1600 profesionales de la salud del país. 3. Implementación del programa de cesación de tabaco en seis prestadores de servicios de salud de cuatro ciudades del país (Bogotá, Valle, Antioquia, Cartagena) donde cinco se encuentran en proceso de implementación específicamente en la fase de planeación y una en la fase de ejecución del programa. Tanto en el Plan Decenal de Salud Pública, como en el Plan Decenal de Cáncer se establecieron metas para cesación de tabaco. En cumplimiento de estas metas, se desarrolló el Programa Nacional de Cesación (Ver Anexo 11). En este marco, se han desarrollado las siguientes acciones: • Profesionales de salud entrenados en consejería breve. Como parte de las estrategias para el control de tabaco en Colombia, el Ministerio de Salud y Protección Social, con el apoyo de la Organización Panamericana de la Salud (OPS), avanzó en las jornadas de capacitación para el personal de salud sobre el fortalecimiento del tratamiento de la dependencia del tabaco en la atención primaria en salud a partir de la realización de dos talleres presenciales. Al encuentro asistieron representantes de las Secretarias de Salud de Bogotá, Antioquia, Huila, Meta, Tolima y Nariño. También asistieron Empresas Administradoras de Planes de Beneficios de Salud (EAPB), Instituciones Prestadoras de Servicios (IPS), y universidades. Aproximadamente se capacitaron 96 profesionales de la salud entre médicos, psicólogos, fisioterapeutas, enfermeras y trabajadora social. • Financiamiento. Gestión para la inclusión de intervenciones en cesación del consumo de tabaco financiadas por el sistema general de seguridad social en salud. • Prestación de servicios. Desarrollo del documento programa, que da las orientaciones sobre la atención para las personas que desean dejar de fumar. • Sistema de información. Definición de indicadores nacionales para el seguimiento al programa de cesación desde los servicios de salud. • Medicamentos. Se realiza la gestión para que el país cuente con la disponibilidad de parches de nicotina (aún en proceso). • Iniciativas para la implementación del programa de cesación de tabaco en tres instituciones entre Bogotá e Ipiales (Nariño). Paralelamente, el Instituto Nacional de Cancerología ha desarrollado el curso de cesación tabáquica (“estrategias para la cesación tabáquica”) dirigido a médicos generales encargados de la consejería breve. También desarrolló un documento con las recomendaciones actualizadas para profesionales de la salud. Ver: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/IA/INCA/cesacion-tabaquica.pdf Tanto en el Plan Decenal de Salud Pública, como en el Plan Decenal de Cáncer se establecieron metas para cesación: – Plan Decenal de Salud Pública: dentro del componente de condiciones crónicas prevalentes, se estableció como meta “Incrementar programas y/o clínicas de cesación de tabaco en el 80% de los departamentos“. – Plan Decenal de Cáncer: en la Línea estratégica 1 (Control del riesgo-Prevención primaria, entre las acciones a nivel político y normativo, está el desarrollar guías de práctica clínica para la cesación tabáquica, y gestionar la inclusión de programas de cesación en el Plan Obligatorio de Salud (POS). Entre las acciones en los servicios de salud se encuentran : a) Implementar la guía de práctica clínica para la cesación tabáquica ; b) Introducir programas de cesación de tabaco basados en evidencia científica ; c) Entrenar al personal de salud para la implementación de la consejería breve como herramienta para la identificación de riesgos y cesación del consumo de tabaco y sus derivados ; d) Capacitar al personal de salud en la normatividad vigente relacionada con el control del consumo de tabaco y sus derivados; e) 1.1.5. Desarrollar e implementar las estrategias educativas para los profesionales de los servicios de salud, como complemento a la comunicación masiva y a las intervenciones comunitarias en los temas de control del consumo y exposición al humo de tabaco y sus derivados; f) Implementar clínicas de cesación con cobertura nacional. Se cuenta con la Guía de práctica clínica basada en la evidencia para la prevención, diagnóstico, tratamiento y seguimiento de la enfermedad pulmonar obstructiva crónica (EPOC) en población adulta, en el que se incluyen actividades relacionadas con la cesación de tabaco. Ver: http://gpc.minsalud.gov.co/guias/Documents/EPOC/GPC%20EPOC%20completa.pdf Por su parte, se ha diseñado y desarrollado un curso virtual en la Universidad de Antioquia, con el apoyo del Ministerio de Salud, sobre Estilos de Vida Saludable. En este curso se ha dispuesto un módulo sobre tabaquismo y control de tabaco. El curso está dirigido a profesionales de la salud, y tiene por objetivo fortalecer las capacidades del sistema de salud en cesación y prevención del consumo, particularmente de la población joven. Paralelamente, el Instituto Nacional de Cancerología ha desarrollado el curso de cesación tabáquica (“estrategias para la cesación tabáquica”) dirigido a médicos generales encargados de la consejería breve. (Disponible a mediados de Abril de 2016) Así mismo, en el marco de diversos convenios interadministrativos entre el Ministerio de Salud y el Instituto Nacional de Cancerología (INC), un grupo multidisciplinar integrado por la Subdirección de Investigaciones del Instituto Nacional de Cancerología, el Departamento de Medicina Preventiva y Social de la Pontificia Universidad Javeriana y clínicos representantes de algunas sociedades científicas e instituciones prestadoras de salud, avanzaron en la generación de recomendaciones basadas en la mejor evidencia disponible sobre las opciones terapéuticas en el ámbito clínico para apoyar la cesación del hábito de fumar en adultos. Ver: http://www.revistabiomedica.org/index.php/biomedica/article/view/651/2090 http://www.scielosp.org/pdf/rsap/v16n5/v16n5a12.pdf http://www.scielosp.org/pdf/spm/v55n2/v55n2a12.pdf En la actualidad se cuenta con un Convenio de Cooperación con la Representación en Colombia de la Organización Panamericana de la Salud (OPS/OMS), para elaborar los lineamientos técnicos para la cesación de tabaquismo, así como la propuesta para el diseño y validación de herramientas para la puesta en marcha del Programa Nacional de Clínicas de Cesación del tabaquismo. WHO Region of the Americas
Comoros Answer not provided Answer not provided Report not provided WHO African Region
Congo Beaucoup des personnes s intéressent au sevrage mais sont souvent butés par le manque des moyens. Lautre constat est que les points de vente des substituts nicotinique ont augmenté par rapport aux deux ans passes. Report not provided Beaucoup des personnes s intéressent au sevrage mais sont souvent butés par le manque des moyens. Lautre constat est que les points de vente des substituts nicotinique ont augmenté par rapport aux deux ans passes. WHO African Region
Cook Islands Smoking cessation program has been established in the Ministry of Health, and the service is currently free including the NRT products. However at the private pharmacy, you have to purchase products. Smoking cessation program has been established in the Ministry of Health, and the service is currently free including the NRT products. However at the private pharmacy, you have to purchase products. Smoking cessation program has been established in the Ministry of Health, and the service is currently free including the NRT products. However at the private pharmacy, you have to purchase products. WHO Western Pacific Region
Costa Rica Se ha incrementado el número de clínicas de cesación de fumado en la CCSS y el IAFA. La CCSS a partir de marzo del 2014 incluye 50-1575 | Vareniclina base 0.5 mg y 1 mg (como tartrato de vareniclina) cuyo uso es en pacientes en tratamiento para cese de fumado, en Clínicas de Cesación de Fumado debidamente constituidas y acreditadas bajo protocolo; además cuenta con 27 clínicas para cesación de fumado en sus centros médicos. El IAFA cuenta con el programa de espacios libres de humo de tabaco programa de promoción, educación, sensibilización y capacitación desarrollado en centros de trabajo públicos y privados desde el año 2000. Capacitación Clínicas de Cesación desde 1990, se capacita a profesionales de la Salud de los centros de trabajo, para el desarrollo de Clínicas de Cesación o grupos de apoyo Además de las clínicas de Cesación. A nivel privado existen algunas clínicas pero no se cuenta con los datos. La CCSS a partir de marzo del 2014 incluye 50-1575 | Vareniclina base 0.5 mg y 1 mg (como tartrato de vareniclina )cuyo uso es en pacientes en tratamiento para cese de fumado, en Clínicas de Cese de Fumado debidamente constituidas y acreditadas bajo protocolo, además cuenta con 27 clínicas para cesación de fumado en sus centros medico. El IAFA cuenta con Programa de espacios libres de humo de tabaco programa de promoción, educación, sensibilización y capacitación desarrollado en centros de trabajo públicos y privados desde el año 2000. Capacitación Clínicas de Cesación desde los años 90, se capacita a profesionales de la Salud de los centros de trabajo, para el desarrollo de Clínicas de Cesación o grupos de apoyo Además de las clínicas de Cesación. A nivel privado existen algunas clínicas pero no se cuenta con los datos. WHO Region of the Americas
Côte d'Ivoire Inscription des substituts nicotiniques dans la liste nationale des médicaments dits essentiels. La mise en place dune unité spécialisée dans le sevrage tabagique. Elaboration et validation dun protocole national de prise en charge des sujets dépendants du tabac. Elaboration et validation dun manuel national de référence de la formation à laide au sevrage tabagique. Formation de plus de 80 médecins à laide au sevrage tabagique. WHO African Region
Croatia Free phone line was implemented by Ministry of Health for smoking cessation information. Additionally, “Non-smoking schools” are implemented in all County Institutes of Public Health. Free phone line was implemented by Ministry of Health for smoking cessation information. Free phone line was implemented by Ministry of Health for smoking cessation information. WHO European Region
Cyprus The referrals to the smoking cessation program happens through a central free access telephone line. The accessibility to the program has improved in the last year through providing a contact number for the programs on cigarette packages.The clinical approach used by our programs consists of nicotine replacement therapy and behavioural approaches. The rate of success at the moment is stable at 47%. The referrals to the smoking cessation program happens through a central free access telephone line. The accessibility to the program has improved in the last year through providing a contact number for the programs on cigarette packages.The clinical approach used by our programs consists of nicotine replacement therapy and behavioural approaches. The rate of success at the moment is stable at 47%. The referrals to the smoking cessation program have remained stable since 2013. The accessibility to the program has improved in the last year through transferring the smoking cessation program under the supervision of the Mental Health Services. We have additionally created a four-digit telephone number which provides prompt access to the program which will soon go operational. Furthermore, in the last two years we have initiated a pilot smoking cessation program in the military which involved the training of professional soldiers in smoking cessation protocols. The clinical approach used by our programs consists of nicotine replacement therapy and behavioural approaches. The rate of success at the moment is 47%. WHO European Region
Czech Republic There is a legally binding obligation for health professionals to conduct a brief intervention consisting of the timely diagnosis of abuse among persons who use tobacco products which is incorporated in revised version in the above mentioned new Act No. 65 /2017 Coll. The brief intervention is mostly offered by physicians and increasingly also by nurses. There are specialised courses in place on prevention of harmful use of addictive substances and treatment of addictions is obligatory for all physicians of all branches as a part of specialization trainings (as mentioned already above). The Society for Treatment of Tobacco Dependence (www.SLZT.CZ) provides continuing education in treatment of tobacco dependence for physicians (CME credits of the Czech medical Chamber, one-day courses), nurses (CME credits of the Czech Association of Nurses, one-day course) and pharmacists (CME credits of the Pharmacist’s Chamber, 2-day course). It provides also education and regular update for nurses and physicians of Centres for Tobacco-Dependent, including regular conferences at least twice a year. There was a collaboration of nurses from the General University Hospital in Prague and the Society for Treatment of Tobacco Dependence with International Society of Nurses in Cancer Care (www.isncc.org) which was focused on educating nurses in brief interventions. Most of health professions undergo occasional trainings in treatment of tobacco dependence, but it is not systematic. Trainings include treatment of pregnant, psychiatric, adolescent and other disadvantaged smokers, as well. Tobacco Guidelines for treatment of tobacco dependence (from 2015) are used. (Available on-line: http://www.vnitrnilekarstvi.eu/vnitrni-lekarstvi-clanek/doporuceni-pro-lecbu-zavislosti-na-tabaku-52291). New guidelines for psychiatric care, including a chapter about tobacco dependence treatment for psychiatric patients were published in 2018 (available: https://postupy-pece.psychiatrie.cz/specialni-psychiatrie/f1-zavislost-latky/lzt-obecny-postup). Intensive treatment is offered in the frame of the Centres for Tobacco-Dependent, based in hospitals mostly at pneumology, cardiology, internal clinics - currently 43 Centres across the country (see http://www.slzt.cz/centra-lecby). They are under supervision of the Society for Treatment of Tobacco Dependence. Treatment is also provided by some physicians, pneumologists and other medical specialists. It is not systematic. Treatment can be provided also by addictologists (a official branch of health professionals in the Czech Republic who focus on prevention and treatment of addictive diseases). Addictologist services should supplement the existing network of Centres for Tobacco-Dependent in future and could focus on smokers with dual substance abuse and dependence. In terms of coverage of treatment by public funding, there are two treatment codes covered by the health insurance companies (60 minutes intervention, 30 minutes follow-up visit). From January 2017, these treatment codes for ambulant patients can be contracted by insurance companies also in some other types of health care facilities (not only in centres for Treatment of Tobacco Dependence). A legislation adopted in 2013 allows to cover a treatment provided by addictologists from health insurance system. These agreements also include the work with users of tobacco. The treatment service is free of charge apart from medication for patients. The pharmacotherapy is not reimbursed generally by health insurance companies - only some of them financially support pharmacotherapy for their clients treated in the specialized Centres for Tobacco-Dependent and addictologic centers or in certified pharmacies. Treatment of tobacco dependence is provided also in the Army of the Czech Republic (ACR). There is new Conception of primary prevention of risk behaviour at personnel of Ministry of Defence (2020 – 2027). Among tasks of conception are also preventive intervention as regards tobacco use. Czech Pharmacist´s Chamber continued to organise program “Smoking Cessation in Pharmacies” in 2018 and 2019. The Office of the Government of the Czech Republic, The Drug Policy Department: A phone number of “Quit line” was changed in 2016 (new number 844 35 00 00) and (from 2017) is quitline called “National”. The telephone number is provided by the Office of the Government of the Czech Republic (National Monitoring Centre for Drugs and Addictions), however operated by the NGO “Czech Coalition against Tobacco” with financial support of the Office of the Government of the Czech Republic and of Ministry of Health (as regards promotion of the number). It is available between 10 – 18 hours during working days. On national websites www.koureni-zabiji.cz is available (among others) map of help (with overview of services for treatment of tobacco dependence etc). National Public Health Institute: Between 2018 and 2019, the "Short Intervention in Practice" project was implemented at national level, including tobacco dependence and motivation to quit smoking. The project is a two-stage education, first of all health workers (especially nurses) who, after acquiring skills in the methodology, have short interventions with their patients. In the same way, students of health care schools are taking part in short interventions in their practice. Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague: Public health Centre for Tobacco Use Prevention and Research was established at the Department of Addictology of 1st Faculty of Medicine in 2018. It´s multidisciplinary expert team has started working in 2019. Concept of a smoke-free detoxification unit at the Department of Addictiology was prepared by Centre for Tobacco Use Prevention and Research. Smoking cessation support program at detoxification unit was launched at the end of the year 2019. RCT study of eHealh intervention for smoking cessation and recruitment of respondents has been ongoing in 2019/2020. Preliminary results will be presented in scientific journal in 2020. Smoking cessation support is offered to patients under the addiction treatment at outpatient services of Department of Addictiology. Application of accredited training in smoking cessation for nurses was prepared and was sent to the certification process to the General University Hospital. Several hospitals are active in Health Promoting Hospitals/Smokefree Hospitals Program As of 1 July 2017, a National network of non-smoking hospitals of the Czech Republic (official name in English: The National GNTH Network of the Czech Republic) was established at the Ministry of Health, which is now the main and official platform for the non-smoking hospital program in Czech Republic. In 2018 and 2019 implementation of the program continued. Up to March 2020 the National Network consists of 10 members. The main platform for discussions and information sharing of GNTH coordinators, responsible members of hospital management and authorized employees of the Ministry of Health is currently a newly established working group (Working Group for the Implementation of International Health Promotion Principles in Quality Management in Healthcare Services, Pracovní skupina pro rozvoj a implementaci mezinárodních principů na podporu zdraví do systémů řízení kvality ve zdravotnických zařízeních; or PSRIPZ in Czech), with its first meeting held in January 2020. Further related activites/Campaigns/projects: In January 2020 new expert group focusing on the preparation of the Lung Carcinoma Early Detection Program was established at Ministry of Health of the Czech Republic. There have not been any national specially designed programmes for specific social groups in the past two years. Campaigns/projects were rather generally focused. There were some local events, mainly related to World No Tobacco Day, organised by some municipalities, hospitals, NGOs every year (more information in C268) There is a legally binding obligation for health professionals to conduct a brief intervention consisting of the timely diagnosis of abuse among persons who use tobacco products which is incorporated in revised version in the above-mentioned new Act No. 65 /2017 Coll. The brief intervention is mostly offered by physicians and increasingly also by nurses. There are specialised courses in place on prevention of harmful use of addictive substances and treatment of addictions is obligatory for all physicians of all branches as a part of specialization trainings (as was aforementioned). The Society for Treatment of Tobacco Dependence (www.SLZT.CZ) provides continuing education in treatment of tobacco dependence for physicians (CME credits of the Czech medical Chamber, one-day courses), nurses (CME credits of the Czech Association of Nurses, one-day course) and pharmacists (CME credits of the Pharmacist’s Chamber, 2-day course). It provides also education and regular update for nurses and physicians of Centres for Tobacco-Dependent, including regular conferences at least twice a year. There is a collaboration of nurses from the General University Hospital in Prague and the Society for Treatment of Tobacco Dependence with International Society of Nurses in Cancer Care (www.isncc.org) which is focused on educating nurses in brief interventions. Most of health professions undergo occasional trainings in treatment of tobacco dependence, but it is not systematic. Trainings include treatment of pregnant, psychiatric, adolescent and other disadvantaged smokers, as well. Tobacco Guidelines for treatment of tobacco dependence (from 2015) are used. (Available on-line: http://www.vnitrnilekarstvi.eu/vnitrni-lekarstvi-clanek/doporuceni-pro-lecbu-zavislosti-na-tabaku-52291). New guidelines for psychiatric care, including a chapter about tobacco dependence treatment for psychiatric patients, are ready to be published in 2018. Intensive treatment is offered within the Centres for Tobacco-Dependent, based in hospitals mostly at pneumology, cardiology, internal clinics - currently 41 Centres across the country (see http://www.slzt.cz/centra-lecby). They are under supervision of the Society for Treatment of Tobacco Dependence. Treatment is also provided by some physicians, pneumologists and other medical specialists. It is not systematic. Treatment can be provided also by addictologists (a official branch of health professionals in the Czech Republic who focus on prevention and treatment of addictive diseases). Addictology services should supplement the existing network of Centres for Tobacco-Dependent in future and could focus on less motivated smokers, etc. In terms of coverage of treatment by public funding, there are two treatment codes covered by the health insurance companies (60 minutes intervention, 30 minutes follow-up visit). From January 2017, these treatment codes for ambulant patients can be contracted by insurance companies also in some other types of health care facilities (not only in Centres for Treatment of Tobacco Dependence). Legislation adopted in 2013 allows to cover treatment provided by addictologists by health insurance. These agreements also include work with users of tobacco. The treatment service is free of charge apart from the medication for patients. Generally, the pharmacotherapy is not reimbursed by health insurance companies - only some of them financially support pharmacotherapy for their clients treated in the specialized Centres for Tobacco-Dependent and addictologic centres or in certified pharmacies. Treatment of tobacco dependence is provided also in the Army of the Czech Republic (ACR), in particular on the basis of the Conception of primary prevention of risk behavior at personnel of the Ministry of Defence for the period of 2015 – 2019. It, inter alia, provides for preventive intervention as regards tobacco use. Czech Pharmacists Chamber continued to organise program “Smoking Cessation in Pharmacies” in 2016 a 2017. Phone number of the “Quit line” was changed in 2016 (the new number is 800 350 000) and from 2017, the quitline is called “National”. The telephone number is provided by the Office of the Government of the Czech Republic (National Monitoring Centre for Drugs and Addiction), but operated by the NGO “Czech Coalition against Tobacco”. It is available between 10 – 18 hours (more hours per day than in 2016) during working days. It is operated by the NGO “Czech Coalition against Tobacco” with financial support from the Office of the Government of the Czech Republic and of Ministry of Health (as regards promotion of the number). National Public Health Institute: In 2016 and 2017, projects "Short Interventions in Practice I" and "Short Intervention in Practice II" were implemented. The projects are implemented as a two-stage intervention with the education of health professionals / students at the first level who subsequently educate patients / clients of health care facilities. This is the "training of trainers" principle. Short intervention is aimed at reducing tobacco consumption as part of the portfolio of risk factors along with alcohol, nutrition and others. The regional NIPH workplace in Jihlava is run by the Counseling Center for Smoking Cessation for the Vysocina Region. Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague: Besides introducing tobacco cessation interventions into in-patient treatment programme, several studies were conducted in 2016 – 2017 on various populations. 1) Users of tobacco in GPs practice – evaluation of the impact of a “tobacco ban legislation” that was introduced in mid 2017. A pre-post assessment was conducted with ~140 patients. Results are to be published in specialty journals. 2) Use of tobacco in the therapeutic communities – the study aimed at the assessment of views of the tobacco problem by treatment staff, mapping of what interventions they use in a day-to-day practice, etc. Results are to be published in specialty journals. 3) A feasibility study of an eHealth intervention that is based on tobacco relapse management was conducted in 2016 and 2017 with very promising results. A wider implementation is expected in 2018-2019. Results will be published in a specialty journal. 4) An update of an early detection and intervention aimed at Children and Adolescents as Patients in General Practice was conducted – declaring the importance of tobacco problem. Several hospitals are active in the Health Promoting Hospitals/Smokefree Hospitals Program. As of 1 July 2017, a national network of non-smoking hospitals of the Czech Republic (official English translation: The National GNTH Network of the Czech Republic) was established at the Ministry of Health, which is now the main and official platform for the non-smoking hospital program in the Czech Republic. This program associates healthcare facilities with the intent of combating smoking as the most important cause of mortality and morbidity in the population. Worldwide, the Global Network for Tobacco-Free Healthcare Services, which today consists of 24 sub-networks from 16 countries, covers the initiative. The National GNTH Network of the Czech Republic has currently 5 members and Czech HPH (Health Promoting Hospitals) Network, which is focused on healthy lifestyle and also tobacco control in hospitals, consists of 11 members. Further campaigns/projects: There have not been any national specially designed programmes for specific social groups in the past two years. Campaigns/projects were rather generally focused. There were some local events, mainly related to the World No Tobacco Day, organised by several NGOs every year. There was also a campaign ”Last stub out” (Poslední típnutí) organised by the Ministry of Health aiming on new legislation in the area, smoking prevention and promotion of cessation (more details to be found in answer C268). On the national website www.koureni-zabiji.cz is available, inter alia, map of help (with an overview of services for treatment of tobacco dependence, etc). There is a legally binding obligation for health professionals to conduct a brief intervention consisting of the timely diagnosis of abuse among persons who use tobacco products which is incorporated in the above mentioned Act No. 379/2005 Coll. The brief intervention is mostly offered by physicians and increasingly also by nurses. There are specialised courses in place on prevention of harmful use of addictive substances and treatment of addictions is obligatory for all physicians of all branches as a part of specialization trainings (as mentioned already above). The Society for Treatment of Tobacco Dependence (www.SLZT.CZ) provides continuing education in treatment of tobacco dependence for physicians (CME credits of the Czech medical Chamber, one-day courses), nurses (CME credits of the Czech Association of Nurses, one-day course) and pharmacists (CME credits of the Pharmacist’s Chamber, 2-day course). It provides also education and regular update for nurses and physicians of Centres for Tobacco-Dependent, including regular conferences at least twice a year. There is a collaboration of nurses from the General University Hospital in Prague and the Society for Treatment of Tobacco Dependence with International Society of Nurses in Cancer Care (www.isncc.org) which is focused on educating nurses in brief interventions. Most of health professions undergo occasional trainings in treatment of tobacco dependence, but it is not systematic. Trainings include treatment of pregnant, psychiatric, adolescent and other disadvantaged smokers, as well. In 2015 New Tobacco dependence treatment guidelines Tobacco Guidelines for treatment of tobacco dependence were published in journal of Czech Society of Internal Medicine and Slovak Society of Internal Medicine “Vnitřní lékařství”. (Available on-line: http://www.vnitrnilekarstvi.eu/vnitrni-lekarstvi-clanek/doporuceni-pro-lecbu-zavislosti-na-tabaku-52291). Intensive treatment is offered in the frame of the Centres for Tobacco-Dependent, based in hospitals mostly at pneumology, cardiology, internal clinics - currently 41 Centres across the country (see http://www.slzt.cz/centra-lecby). They are under supervision of the Society for Treatment of Tobacco Dependence. In terms of coverage of treatment by public funding, there are two treatment codes covered by the health insurance companies (60 minutes intervention, 30 minutes follow-up visit). The treatment service is free of charge apart from medication for patients. The pharmacotherapy is not reimbursed generally by health insurance companies - only some of them financially support pharmacotherapy for their clients treated in the specialized Centres for Tobacco-Dependent . . Treatment is also provided by some physicians, pneumologists and other medical specialists. It is not systematic. Treatment can be provided also by addictologists (a new official branch of health professionals in the Czech Republic who focus on prevention and treatment of addictive diseases). A legislation adopted in 2013 allows to cover a treatment provided by addictologists from health insurance system. In 2015 contracts for the first 7 addictologist outpatient services were negotiated with VZP (Health Insurance Company). These agreements also include the work with users of tobacco. Addictologist services should supplement the existing network of Centres for Tobacco-Dependent in future and could focus on less motivated smokers etc. Treatment of tobacco dependence is provided also in the Army of the Czech Republic (ACR). In November 2014 Minister of Defence approved Conception of primary prevention of risk behaviour at personnel of Ministry of Defence for the period of 2015 – 2019. Among tasks of conception are also preventive intervention as regards tobacco use. Czech Pharmacist´s Chamber continued to organise program “Smoking Cessation in Pharmacies”in 2014-2015. A “Quit line” (number 844 600 500) is available for a reduced charge between 11 – 16 hours during working days. However, it is provided by the NGO “Czech Coalition against Tobacco” without any systematic support by the state. Consultants work on volunteer basis. Project of quit line was prepared also by the Department of Addictology of the First Faculty of Medicine Charles University in Prague General University Hospital in Prague. Campaigns/projects: There have not been any national specially designed programmes for specific social groups in the past two years. Campaigns/projects were rather generally focused. There were some local events, mainly related to World No Tobacco Day, organised by several NGOs every year. The Department of Addictology of the First Faculty of Medicine Charles University in Prague General University Hospital in Prague stabilised screening and intervention program for pregnant women – users of tobacco. Several hospitals are active in Health Promoting Hospitals/Smokefree Hospitals Program. WHO European Region
Democratic People's Republic of Korea Health facilities provide the free services like consultation, diagnosis and treatment at the state expense and, when individuals want, no-tobacco centres and pharmacies sell the nicotine-depending drugs at low price. Service providers at Tobacco Cessation Centres at different levels are trained on tobacco counselling and cessation and they are providing dependence care, counselling services and motivate smokers for cessation. They are also conducting research and produce stop tobacco pills using herbs. Health facilities provide the free services like consultation, diagnosis and treatment at the state expense and, when individuals want, no-tobacco centres and pharmacies sell the nicotine-depending drugs at low price. Report not provided WHO South-East Asia Region
Democratic Republic of the Congo Aucun progrès. LONG britanique Global Bridge avait, en novembre 2011, financé un atelier de renforcement de capacités en matière de traitement de la dépendance et du sevrage tabagique. Un projet de 2 ans a été élaboré avec budget à installer pour 2 ans à lHôpital Général de Référence de Kintambo où 2 Centres de Santé avait été retenus à titre expérimental. mais il ny a pas eu de suite à ce jour. Aucun progrès. LONG britanique Global Bridge avait, en novembre 2011, financé un atelier de renforcement de capacités en matière de traitement de la dépendance et du sevrage tabagique. Un projet de 2 ans a été élaboré avec budget à installer pour 2 ans à lHôpital Général de Référence de Kintambo où 2 Centres de Santé avait été retenus à tite expérimental. mais il ny a pas eu de suite à ce jour. Aucun progrès. LONG britanique Global Bridge avait, en novembre 2011, financé un atelier de renforcement de capacités en matière de traitement de la dépendance et du sevrage tabagique. Un projet de 2 ans a été élaboré avec budget à installer pour 2 ans à lHôpital Général de Référence de Kintambo où 2 Centres de Santé avait été retenus à tite expérimental. mais il ny a pas eu de suite à ce jour. WHO African Region
Denmark Counselling sessions concerning smoking cessation are offered in the majority of municipalities at no costs for the smokers. Some municipalities cover some expenses to smoking cessation medications at their own costs. There are national co-founding for some groups. Counselling sessions concerning smoking cessation are offered in the majority of municipalities at no costs for the smokers. Some municipalities cover some expenses to smoking cessation medications at their own costs. General practitioners (GP´s) are more involved in giving brief advice to smokers than seen before. In 2013 the Government ensured funds for 2014-2017 (42 million DKK) to help heavy smokers to quite smoking which also include the covering of parts of the cost of pharmaceutical products to smokers, where relevant, together with counselling sessions concerning smoking cessation. A number of municipalities is running time limited programmes through these funds. In 2011, the Government and the majority of the political parties of the Parliament have earmarked new funds for 2012-2015 (16 million DKK) to prevention measures aimed at preventing youth smoking and to the launch of a national strategy to combat smoking among young people. Counselling sessions concerning smoking cessation are offered in the majority of municipalities at no costs for the smokers. Some municipalities cover some expenses to smoking cessation medications at their own costs. General practitioners (GP´s) are more involved in giving brief advice to smokers than seen before. In 2013 the Government ensured funds for 2014-2017 (42 million DKK) to help heavy smokers to quite smoking which also include the covering of parts of the cost of pharmaceutical products to smokers, where relevant, together with counselling sessions concerning smoking cessation. A number of municipalities is running time limited programmes through these funds. In 2011, the Government and the majority of the political parties of the Parliament have earmarked new funds for 2012-2015 (16 million DKK) to prevention measures aimed at preventing youth smoking and to the launch of a national strategy to combat smoking among young people. WHO European Region
Djibouti Answer not provided Answer not provided Answer not provided WHO Eastern Mediterranean Region
Dominica Report not provided Report not provided Answer not provided WHO Region of the Americas
Ecuador En enero de 2018, el Ministerio de Salud Pública, la Organización Panamericana de la Salud (OPS/OMS Ecuador) y la Sociedad Respiratoria Europea (SRE), realizaron un taller de entrenamiento a entrenadores en intervenciones en tabaco en Ecuador. Esto se realizó gracias a que la OMS y la SRE establecieron una nueva estrategia en el 2016 de colaboración conjunta a nivel global para apoyar a los países en sus esfuerzos por entrenar a profesionales de atención primaria en salud en temas relacionados a cesación del consumo de tabaco en pacientes con enfermedades respiratorias. Ecuador fue seleccionado como país prioritario para implementar este proyecto. El proyecto se desarrolló con el modelo de capacitación en cascada a entrenadores y técnicos en atención primaria de salud (TAPS) dentro de la estrategia Médico del Barrio para identificar a nivel local a personas que fuman y que tienen problemas respiratorios, a fin de incidir en ellas con un proceso de cesación del consumo de tabaco. El proyecto incluyó un taller de dos días con expertos de OPS/OMS y de la SRE capacitando a 40 médicos, y entrenamiento a alrededor de 100 TAPS sobre intervenciones cortas de cesación de consumo de tabaco. En enero de 2018, el Ministerio de Salud Pública, la Organización Panamericana de la Salud (OPS/OMS Ecuador) y la Sociedad Respiratoria Europea (SRE), realizaron un taller de entrenamiento a entrenadores en intervenciones en tabaco en Ecuador. Esto se realizó gracias a que la OMS y la SRE establecieron una nueva estrategia en el 2016 de colaboración conjunta a nivel global para apoyar a los países en sus esfuerzos por entrenar a profesionales de atención primaria en salud en temas relacionados a cesación del consumo de tabaco en pacientes con enfermedades respiratorias. Ecuador fue seleccionado como país prioritario para implementar este proyecto. El proyecto se desarrolló con el modelo de capacitación en cascada a entrenadores y técnicos en atención primaria de salud (TAPS) dentro de la estrategia Médico del Barrio para identificar a nivel local a personas que fuman y que tienen problemas respiratorios, a fin de incidir en ellas con un proceso de cesación del consumo de tabaco. El proyecto incluyó un taller de dos días con expertos de OPS/OMS y de la SRE capacitando a 40 médicos, y entrenamiento a alrededor de 100 TAPS sobre intervenciones cortas de cesación de consumo de tabaco. Se incluye al Tabaco en la Ley de Prevención integral del fenómeno socio económico de las drogas y de regulación y control de uso de sustancias catalogadas sujetas a fiscalización. WHO Region of the Americas
Egypt اصدار و نشر الدليل الارشادي المصري للمساعده علي علاج الاعتماديه علي التبغ اصدار و نشر الدليل الارشادي المصري للمساعده علي علاج الاعتماديه علي التبغ اصدار و نشر الدليل الارشادي المصري للمساعده علي علاج الاعتماديه علي التبغ WHO Eastern Mediterranean Region
El Salvador El Fondo Solidario para la Salud ha ampliado la cobertura de los Centros de Prevención y Tratamiento de las Adicciones (CPTA) de 4 a 5 establecimientos de salud. Estos ofrecen servicios de detección, tratamiento y rehabilitación a personas afectas por el consumo del tabaco. El Fondo Solidario para la Salud ha ampliado la cobertura de los Centros de Prevención y Tratamiento de las Adicciones (CPTA) de 4 a 5 establecimientos de salud. Estos ofrecen servicios de detección, tratamiento y rehabilitación a personas afectas por el consumo del tabaco. El Fondo Solidario para la Salud ha ampliado la cobertura de los Centros de Prevención y Tratamiento de las Adicciones (CPTA) de 4 a 5 establecimientos de salud. Estos ofrecen servicios de detección, tratamiento y rehabilitación a personas afectas por el consumo del tabaco. WHO Region of the Americas
Equatorial Guinea LA CAMPAÑA NACIONAL SIN TABACO LA CAMPAÑA NACIONAL SIN TABACO LA CAMPAÑA NACIONAL SIN TABACO WHO African Region
Estonia No progress from previous report. No changes from previous report. No changes from previous report. WHO European Region
Eswatini Report not provided Report not provided Answer not provided WHO African Region
Ethiopia Report not provided Report not provided Report not provided WHO African Region
European Union Measures concerning tobacco dependence and cessation are a primary responsibility of the EU Member States. While the EU provides the regulatory framework for the authorisation of medicinal products, the Member States decide about their accessibility e.g. the need for prescription, reimbursement status. However, the EU supports Member States in their implementation of Article 14 of the FCTC. The Council Recommendation on smoke-free environments 2009/C 296/02 of 30 November 2009 calls on Member States to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence as outlined in Article 14 of the FCTC. In the past, the EU Health Programme provided funding to projects related to cessation of tobacco use. Cessation was also one of the three themes of the EU media campaign "HELP - for a life without tobacco" targeted at young people. Cessation was also the theme of the media campaign - "Ex-smokers are unstoppable", see http://www.exsmokers.eu/ . The Commission also funded the TOB-G project that aims to develop guidelines that will contain strategies and recommendations designed to assist health professionals in delivering and supporting effective treatment of dependence on tobacco. In addition, information on cessation services are to be included in the graphic health warnings required on tobacco packages under Directive 2014/40/EU. Measures concerning tobacco dependence and cessation are a primary responsibility of the EU Member States. While the EU provides the regulatory framework for the authorisation of medicinal products, the Member States decide about their accessibility e.g. the need for prescription, reimbursement status. However, the EU supports Member States in their implementation of Article 14 of the FCTC. The Council Recommendation on smoke-free environments 2009/C 296/02 of 30 November 2009 calls on Member States to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence as outlined in Article 14 of the FCTC. The EU Health Programme provided funding to projects related to cessation of tobacco use. Cessation was also one of the three themes of the EU media campaign "HELP - for a life without tobacco" targeted at young people. Cessation is also the theme of the latest media campaign - "Ex-smokers are unstoppable", see http://www.exsmokers.eu/ . The Commission also funded the TOB-G project that aims to develop guidelines that will contain strategies and recommendations designed to assist health professionals in delivering and supporting effective treatment of dependence on tobacco. In addition, information on cessation services are to be included in the graphic health warnings required on tobacco packages under Directive 2014/40/EU. Measures concerning tobacco dependence and cessation are a primary responsibility of the EU Member States. While the EU provides the regulatory framework for the authorisation of medicinal products, the Member States decide about their accessibility e.g. the need for prescription, reimbursement status. However, the EU supports Member States in their implementation of Article 14 of the FCTC. The Council Recommendation on smoke-free environments 2009/C 296/02 of 30 November 2009 calls on Member States to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence as outlined in Article 14 of the FCTC. The EU Health Programme provides funding to projects related to cessation of tobacco use. Cessation was also one of the three themes of the EU media campaign "HELP - for a life without tobacco" targeted at young people. Cessation is also the theme of the latest media campaign - "Ex-smokers are unstoppable", see http://www.exsmokers.eu/ . The Commission also funds the TOB-G project that aims to develop guidelines that will contain strategies and recommendations designed to assist health professionals in delivering and supporting effective treatment of dependence on tobacco. In addition, information on cessation services are to be included in the graphic health warnings required on tobacco packages under Directive 2014/40/EU. WHO European Region
Fiji In 2020, the MOHMS will be developing national tobacco cessation guidelines and SOPs. Report not provided Report not provided WHO Western Pacific Region
Finland The Current Care Guidelines for “Tobacco and nicotine dependency, prevention and treatment” were updated in 2018. The guidelines are developed by the Finnish Medical Society Duodecim in association with various medical specialist associations.These guidelines are drawn up in support of health care professionals and for the benefit of patients. https://www.kaypahoito.fi/en/ccs00026 The task of the Council for Choices in Health Care in Finland (Palko) is to issue recommendations on services that should be included in the range of public health services. The Council is a permanent body appointed by the Government that works in conjunction with the Ministry of Social Affairs and Health.The Council started to prepare the recommendations for smoking cessation in 2018. The recommendations are expected to be ready in 2020. Finnish Lung Health Association (FILHA) has several projects for smoking cessation, targeting especially vulnerable groups (=> more details C2817). - Lobbying and discussion about smoking cessation in the strucure of Finnish health care reform - "Current care guidelines for nicotine dependence and smoking cessation" have been under updating process in 2017. Current Care is a Finnish unit producing evidence-based treatment guidelines for the Finnish Medical Society Duodecim. These guidelines are drawn up in support of health care professionals and for the benefit of patients. - A tobacco cessation phone line and an Internet portal called Stumppi (www.stumppi.fi) by the Organisation for Respiratory Health - Finnish Lung Health Association (Filha): cessation peer support groups among unemployed, cessation support in the Defence Forces of Finland, national-wide trainings of health professionals, more details below: FILHA PROJECTS: Influencing the development of the health care system regarding tobacco cessation support as part of the national health sector reform have been a priority for Finnish Lung Health Association (Filha) during 2016-2017. Filha has conducted nation-wide trainings of health professionals in tobacco dependence treatment best practices ever since the national Current Care guideline first was introduced in 2002. During 2017 special emphasis has been put on developing tobacco cessation for mental health and substance abuse patients in a government funded project including 11/21 hospital districts in Finland. The work is executed by training health professionals, improving e.g. medical record documentation and referral practices as well as including peer support elements in the cessation support provided by health professionals. An internet-based tobacco cessation course for health professionals dealing with mental health and substance abuse patients has also been developed by Filha during 2017. Filha started a project to develop cessation practices and tobacco dependence treatment for pregnant women in 2017. The work has started in maternal health care units in three municipalities in Finland and will result in a national recommendation and practical tool kit by the end of 2019. Filha has developed a peer support-based tobacco cessation counselling model including group and individual face-to-face as well as internet-based counseling. The model has during 2016-2017 been developed especially taking into consideration population groups that on average use a lot of tobacco products such as mental health patients, unemployed, certain immigrant groups and vocational school students. Filha continues to work in collaboration with the Defense Forces of Finland influencing attitudes and practices regarding tobacco control by increasing general knowledge about tobacco related issues as well as cessation support. During 2016-2017 a guideline for tobacco-free Defence Forces was produced and nation-wide implementation of the guideline conducted. Through these actions a decrease in tobacco consumption for military conscripts and personnel of the Defense Forces is expected. - Current care -cessation guidelines (2012) should be used by health care professionals. Current Care is a Finnish unit producing evidence-based treatment guidelines for the Finnish Medical Society Duodecim. These guidelines are drawn up in support of health care professionals and for the benefit of patients. - Finnish Lung Health Association (Filha): cessation peer support groups among unemployed, cessation support in the Defence Forces of Finland, national-wide trainings of health professionals - Annual Quit and Win competition for adults (by North Karelia Centre for Public Health) - A tobacco cessation phone line and an Internet portal called Stumppi (www.stumppi.fi) by the Organisation for Respiratory Health WHO European Region
France Depuis novembre 2016, le dispositif ad hoc de prise en charge à travers le forfait d’aide au sevrage permet de rembourser à hauteur de 150 euros par an pour tous les assurés les prescriptions de TSN. Entre 2016, 49 000 personnes de plus que en 2015 ont eu recours au forfait d’aide au sevrage, soit une augmentation de 29%. La varénicline bénéficie d’un remboursement de la sécurité sociale à hauteur de 75%, avec la possibilité de prise en charge du reste par la mutuelle du patient. Depuis novembre 2016, le dispositif ad hoc de prise en charge à travers le forfait d’aide au sevrage permet de rembourser à hauteur de 150 euros par an pour tous les assurés les prescriptions de TSN. Entre 2016, 49 000 personnes de plus que en 2015 ont eu recours au forfait d’aide au sevrage, soit une augmentation de 29%. La varénicline bénéficie d’un remboursement de la sécurité sociale à hauteur de 75%, avec la possibilité de prise en charge du reste par la mutuelle du patient. Triplemenrt du forfait sevrage pour les 20-30 ans, les personnes souffrant dun cancer et les bénéficiaires de la complémentaire couverture maladie universelle. WHO European Region
Gabon Answer not provided Answer not provided Answer not provided WHO African Region
Gambia The Tobacco clinical cessation guidelines was developed and launched recently in April 2016. This was followed by the training of policy makers and next is the step down training of health care providers. Twenty healthcare providers from five different facilities were trained on these guidelines in 2017. The Tobacco clinical cessation guidelines was developed and launched recently in April 2016. This was followed by the training of policy makers and next is the step down training of health care providers. The Tobacco clinical cessation guidelines was developed and launched recently in April 2016. This was followed by the training of policy makers and next is the step down training of health care providers. WHO African Region
Georgia The comprehensive tobacco dependency treatment clinical guideline and protocol are updated and presented to the Ministry of Health for review. Free quit line 116001 is operational and brief consultation by trained psychologist on quitting smoking is accessible for every citizen. Quit smoking mobile application has been developed and aired for both android and iOS users. The NRTs and other cessation medications are not provided by any reimbursement schemes, although now they can be imported in the country tax free. Still very limited physical and financial accessibility. The comprehensive tobacco dependency treatment clinical guideline and protocol are updated. NCDC is conducting regular training of the PHC doctors and nurses on delivering brief cessation interventions. smoking status is mandatory in medical records. The National Cessation Strategy has been developed and is in the process of approval The NRTs and other cessation medications are not provided by any reimbursement schemes and have very limited physical and financial accessibility. within the national health promotion program, we are conducting trainings of PHC doctors in providing brief counseling intervention on tobacco cessation nationwide. This effort is continuous and integration of this service in the healthcare system is envisaged in the tobacco cessation national strategy and guideline which are in the process of development. WHO European Region
Germany In May 2016 the national quitline and the BZgA online cessation program had to be printed on every cigarette pack in combination with the combined health warnings which led to a quadruplication of inbound calls and an increase of online registrations.Since then there are still high call numbers at the national quitline. In May 2015 the national quitline and the BZgA online cessation program had to be printed on every cigarette pack in combination with the combined health warnings which led to a quadruplication of inbound calls and an increase of online registrationsnted by a new module (online-mentors) In 2014 the national quitline became toll-free which led onincreasing number of inbound calls! The online services were supplemented by a new module (online-mentors) WHO European Region
Ghana Ghana produced a Tobacco Cessation Guidelines with WHO AFRO in August 2016. The Guidelines provides for the health workers, the structures and the medicines to be used for treating tobacco dependence and cessation. Ghana produced a Tobacco Cessation Guidelines with WHO AFRO in August 2016. The Guidelines provides for the health workers, the structures and the medicines to be used for treating tobacco dependence and cessation. Ghana has come out with Cessation Guidelines to be inaugurated with WHO AFRO in August 2016. The Guidelines provides for the health workers, the structures and the medicines to be used for treating tobacco dependence and cessation. WHO African Region
Greece No progress has been made in the past two years to implement Article 14. No progress has been made in the past two years to implement Article 14. Answer not provided WHO European Region
Grenada NA NA Answer not provided WHO Region of the Americas
Guatemala Ninguno. Ninguno. Ninguno. WHO Region of the Americas
Guinea Report not provided Report not provided Le sevrage tabagique, la réduction de la demande en rapport a la dépendance et le sevrage tabagique ainsi que le traitement de la dépendance ne sont pas pris en compte dans nos activités WHO African Region
Guinea-Bissau Answer not provided Answer not provided Answer not provided WHO African Region
Guyana The Tobacco Cessation programme is currently under review. The Tobacco Cessation programme is currently under review. The Tobacco Cessation programme is currently under review. WHO Region of the Americas
Honduras En Honduras para la aplicación del Artículo 14 del CMCT de la OMS sobre las medidas de reducción de la demanda relativa a la dependencia y al abandono del tabaco, se cuenta con el Centro de Atención Integral del IHADFA donde se brinda tratamiento ambulatorio a pacientes que consumen productos derivados de tabaco, incluyendo a sus familiares. En los últimos dos años desde el 2018 no se ha inaugurado ninguna clínica de cesacion privada para el tratamiento del consumo de tabaco esperamos que con el acceso a los medicamentos para tal efecto podamos ir capacitando a especialistas y médicos en general y otro personal para incentivarlos y los pacientes y sus familiares tengan más alternativas a los mismos. En Honduras para la aplicación del Artículo 14 del CMCT de la OMS sobre las medidas de reducción de la demanda relativa a la dependencia y al abandono del tabaco, se cuenta con el Centro de Atención Integral del IHADFA donde se brinda tratamiento ambulatorio a pacientes que consumen productos derivados de tabaco, incluyendo a sus familiares. En Honduras para la aplicación del Artículo 14 del CMCT de la OMS sobre las medidas de reducción de la demanda relativa a la dependencia y al abandono del tabaco, se cuenta con el Centro de Atención Integral del IHADFA donde se brinda tratamiento ambulatorio a pacientes que consumen productos derivados de tabaco, incluyendo a sus familiares. WHO Region of the Americas
Hungary The National Methodology Centre for Smoking Cessation Support continued its wide array of smoking cessation programs. The Centre is responsible for running the national quitline service, providing courses on tobacco dependence and cessation training, being present at public community events aiming at health promotion and collaborating nationally with specialists for comprehensive tobacco dependence treatment. In 2018-2020 213 healthcare workers attended brief advice training and 200 professionals learned behavioral counseling. The Center coordinated the development of a cessation support application for mobile phones. The National Methodological Centre for Smoking Cessation continued its wide array of smoking cessation programmes (TÁMOP). The Centre is responsible for running the national quitline service, providing courses on tobacco dependence and cessation training, being present at public community events aiming at health promotion and collaborating nationally with specialists for comprehensive tobacco dependence treatment. The National Tobacco Cessation Methodological Centre works at full scale. In the last two years several projects included smoking cessation programmes (TÁMOP 625) at primary health care setting, there is an increasing interest towards skill training of smoking cessation and several educational and training programme have been provided by the Methodological Centre. An active networking is in operation between different units dealing with smoking cessation. Special referral programmes have been developed for inpatients and group smoking cessation programmes are in operation at different institutions. WHO European Region
Iceland There is a interactive website in development at Primary healthcare in cooperation with Directorate of health were tobacco cessation and prevention will have a big role. There is full awareness of lack of cessation and likely to be addressed in official public policy that is now in process. There is also ongoing work with a new webpage on how to stop using tobacco along with support material There is full awareness of lack of cessation and likely to be addressed in official public policy that is now in process. There is also ongoing work with a new webpage on how to stop using tobacco along with support material WHO European Region
India Under the National Tobacco Control Programme funds are provided to each district tobacco control cell to make a provision of free NRT to those willing to quit tobacco. IT enabled cessation services are also available (m Cessation).One can register by giving a missed call to the number 011-22901701 or through registering at the http://www.nhp.gov.in/quit-tobacco. The Ministry set up a national Tollfree QUITLINE at Vallabhbhai Patel Chest Institute, New Delhi. Toll free Tobacco Cessation Quitline [1800-112-356] established for providing telephonic counselling services. The quitline services has been expanded to Satellite Centres for providing counselling services in regional languages. mainstreaming of tobacco cessation services in 310 dental colleges under Dental Council of India (DCI) is also being streamlined to establish Tobacco Cessation Centres in their institutions. Under the National Tobacco Control Programme funds are provided to each district tobacco control cell to make a provision of free NRT to those willing to quit tobacco. IT enabled cessation services are also available (m Cessation).One can register by giving a missed call to the number 011-22901701 or through registering at the http://www.nhp.gov.in/quit-tobacco. The Ministry set up a national Tollfree QUITLINE at Vallabhbhai Patel Chest Institute, New Delhi. Toll free Tobacco Cessation Quitline [1800-112-356] established for providing telephonic counselling services. The quitline services has been expanded to Satellite Centres for providing counselling services in regional languages. mainstreaming of tobacco cessation services in 310 dental colleges under Dental Council of India (DCI) is also being streamlined to establish Tobacco Cessation Centres in their institutions. Under the National Tobacco Control Programme funds are provided to each district tobacco control cell to make a provision of free NRT to those willing to quit tobacco. IT enabled cessation services are also available (m Cessation).One can register by giving a missed call to the number 011-22901701 or through registering at the http://www.nhp.gov.in/quit-tobacco. The Ministry is also setting up a national Tollfree QUITLINE at Vallabhbhai Patel Chest Institute, New Delhi. WHO South-East Asia Region
Iran (Islamic Republic of) No progress. It has comprehensively integrated into PHC. Tobacco Cessation-consultation has been fully integrated into the PHC. and all relevant health care providers were trained fpr tobacco cessation consultation Tobacco Cessation-consultation has been fully integrated into the PHC. WHO Eastern Mediterranean Region
Iraq Due the deficiency of the financial support to provide the nicotine replacement therapy which is needed for quitting services, we try to a locate only one center in each province , while we already provide tobacco brief interventions in all primary health care centers (in coverage rate of 25% annually) Answer not provided Answer not provided WHO Eastern Mediterranean Region
Ireland As of the end of 2019, 39 staff across the health service had completed the online training module in Intensive Smoking Cessation Assistance, bringing the total number of staff trained in intensive cessation to 336. Additionally. 27 Staff trained in the Mental Health specialist module and 14 staff trained in the pregnancy and smoking module to end of December 2019. HSE staff continue to deliver and support the "We Can Quit" smoking cessation programme, which targets smokers from disadvantaged areas, in conjunction with the Irish Cancer Society. In 2014, the HSE identified Identify a lead person with clear lines of responsibility for the co-ordination of smoking cessation services within the health service to ensure a national approach. National standards for intensive cessation services have been published. The intensive cessation service on-line training was commissioned and was delivered to more than sixty staff during 2014. Two further face to face training courses in behavioural support were also delivered to sixty staff in 2014. An integrated ""one-stop"" model QUIT service was also developed in 2014. Specific training in relation to mental health and pregnancy was launched in 2014. Two specialty on-line modules on smoking in pregnancy and smoking and mental health were commissioned and launched in 2014. Training targets set for the number of staff to be trained in Brief Intervention Smoking Cessation HSE Annual Service Plan. The total number trained in 2014 was 1,303. In 2015, 30 Staff trained as intensive tobacco cessation specialists in November 2015 (14 of which were Mental Health staff). One stop model service mapping survey completed in preparation for the IT Patient Management System Tender. QUIT at 4 week quality KPI developed (45% quit at 4 weeks) for each service to be reported on in 2016. NCSCT issued a report on specialist training for 2015. 42 Staff trained in Mental Health specialist training module and 32 trained in the pregnancy and smoking module to end of December 2015. HSE staff continue to deliver and support the We Can Quit smoking cessation programme in conjunction with the Irish Cancer Society. the programme targets women in disadvantaged communities in a number of areas. The total number of front line staff trained in 2015 was 1,185 plus an additional 452 undergraduate health professional students. Overall target for 2016 is 1,350. The Health and Quality Information Authority have agreed to commence an Health Technology Assessment of smoking cessation methodologies in their 2015 workplan. Nicotine Replacement therapies are now available on general sale. 60 staff completed the online training module in 2016 bringing its total trained to 156. 15 Staff trained in Mental Health specialist module and 14 trained in the pregnancy and smoking module to end of December 2016. HSE staff continue to deliver and support the "We Can Quit" smoking cessation programme, which targets smokers from disadvantaged areas, in conjunction with the ICS. This programme extended into CHO 4 and 7 in 2016. National Maternity Strategy published which includes specific recommendations on how to support smoking cessation in pregnancy. In 2014, the HSE identified Identify a lead person with clear lines of responsibility for the co-ordination of smoking cessation services within the health service to ensure a national approach. National standards for intensive cessation services have been published. The intensive cessation service on-line training was commissioned and was delivered to more than sixty staff during 2014. Two further face to face training courses in behavioural support were also delivered to sixty staff in 2014. An integrated ""one-stop"" model QUIT service was also developed in 2014. Specific training in relation to mental health and pregnancy was launched in 2014. Two specialty on-line modules on smoking in pregnancy and smoking and mental health were commissioned and launched in 2014. Training targets set for the number of staff to be trained in Brief Intervention Smoking Cessation HSE Annual Service Plan. The total number trained in 2014 was 1,303. In 2015, 30 Staff trained as intensive tobacco cessation specialists in November 2015 (14 of which were Mental Health staff). One stop model service mapping survey completed in preparation for the IT Patient Management System Tender. QUIT at 4 week quality KPI developed (45% quit at 4 weeks) for each service to be reported on in 2016. NCSCT issued a report on specialist training for 2015. 42 Staff trained in Mental Health specialist training module and 32 trained in the pregnancy and smoking module to end of December 2015. HSE staff continue to deliver and support the We Can Quit smoking cessation programme in conjunction with the Irish Cancer Society. the programme targets women in disadvantaged communities in a number of areas. The total number of front line staff trained in 2015 was 1,185 plus an additional 452 undergraduate health professional students. Overall target for 2016 is 1,350. The Health and Quality Information Authority have agreed to commence an Health Technology Assessment of smoking cessation methodologies in their 2015 workplan. Nicotine Replacement therapies are now available on general sale. WHO European Region
Israel Since January 2019, according to Israels Health services basket, any smoker can attend, free of charge, a smoking cessation counseling group or a smoking cessation counselor or get support from his family doctor/GP in his HMO or join a program with the quitline in his HMO or with the national one, and along this support he can purchase pharmaceutical products for the treatment of tobacco dependence in 85% discount. If the smoker choose not to get help and advise for smoking cessation, he/she can still purchase the pharmaceutical products for the treatment of tobacco dependence, but without the discount. Almost 30,000 smokers (2.5% of all the smokers in Israel) got help for smoking cessation in their HMO. Report not provided Report not provided WHO European Region
Italy on 2020 Italian society of tobaccology translate and disseminate the guidelines for smoking cessation produced by the ENSP (European Network for Smoking and Tobacco ) Answer not provided Answer not provided WHO European Region
Jamaica Further capacity building was done with Ministry officials and the National Council on Drug Abuse. Nicotine replacement therapy (Bupropion SR Tablets 150 mg and the Nicotine Patch 7 – 21 mg/24 h) is included in the Ministry of Health List of Vital Essential and Necessary Drugs and Medical Sundries. Further capacity building was done with Ministry officials and the National Council on Drug Abuse. Nicotine replacement therapy (Bupropion SR Tablets 150 mg and the Nicotine Patch 7 – 21 mg/24 h) is included in the Ministry of Health List of Vital Essential and Necessary Drugs and Medical Sundries. A National Guideline for Nicotine Use Disorder was developed in 2007. Training was conducted in the guidelines. A directory of tobacco cessation services available island wide was developed. Teams also were trained throughout the island to support scaling up of services. Nicotine replacement therapy (Bupropion SR Tablets 150 mg and the Nicotine Patch 7 – 21 mg/24 h) is included in the Ministry of Health List of Vital Essential and Necessary Drugs and Medical Sundries. WHO Region of the Americas
Japan Answer not provided Answer not provided Answer not provided WHO Western Pacific Region
Jordan تم افتتاح خمس عيادات لعلاج الراغبين بالاقلاع عن الادمان على التبغ وهى موزعة في الوسط عدد(2) عيادة والجنوب واحدة والشمال واحدة تم افتتاحها في الزرقاء وسيتم التوسع هذا العام بافتتاح عدد (2) من العيادات والتوسع مستقبلا لتصل الى عيادة في كل محافظة ويتم تخصيص مبالغ لشراء الادوية من حساب موازنة وزارة الصحة وتصرف مجانا وتم ادراج الادوية في قائمة الادوية الرشيدة الوطنية ليتم تمويل شرائها باستمرار دون انقطاع وتم اعتماد الادوية التالية لاصقات ، علكة ، فارنكلين ، وحبوب المضغ LOZENGE وتم تحديد رقم للمساعدة في الاقلاع عن التدخين ولكن غير عمامل لغاية تاريخة يجري تدريب الكادر عام 2020 تم افتتاح اربع عيادات لعلاج الراغبين بالاقلاع عن الادمان على التبغ وهى موزعة في الوسط عدد(2) عيادة والجنوب واحدة والشمال واحدة ويجري الان الاعداد لافتتاح عدد اخر من العيادات والتوسع مستقبلا لتصل الى عيادة في كل محافظة ويتم تخصيص مبالغ لشراء الادوية من حساب موازنة وزارة الصحة وتصرف مجانا Answer not provided WHO Eastern Mediterranean Region
Kazakhstan Answer not provided Answer not provided Report not provided WHO European Region
Kenya Answer not provided Answer not provided Answer not provided WHO African Region
Kiribati Improved Improved Improved WHO Western Pacific Region
Kuwait Training Health workers (Doctors and nurses on the treatment of nicotin addiction. Trying to include other drugs to the clinics Training Health workers (Doctors and nurses on the treatment of nicotin addiction. Trying to include other drugs to the clinics Training Health workers (Doctors and nurses on the treatment of nicotin addiction. Trying to include other drugs to the clinics WHO Eastern Mediterranean Region
Kyrgyzstan Report not provided Report not provided Answer not provided WHO European Region
Lao People's Democratic Republic Answer not provided Answer not provided Answer not provided WHO Western Pacific Region
Latvia Answer not provided Pharmaceutical products are issued by a doctor and they are available in a pharmacies. Different anti-smoking campaigns (with different activities for children and parents) were launched in 2014 by the Latvian Center For Disease Prevention and Control (www.spkc.gov.lv ). Campaigns were continued in 2015 as well. During campaigns mobile app for those wanting to quit smoking was developed ("80 brīvdienas" https://play.google.com/store/apps/details?id=lv.spkc.brivs) ; different contests for children organized, movement "Green bracelet" (self-made green bracelets to show that you are free from tobacco) developed, discussions in schools organized with participation of doctors, psychologists and publicly well know persons (popular in childrens population), website about dangers of tobacco second-hand smoking was developed (http://pasivasmekesana.lv/). Starting from 2015, quit line (not toll-free) is under the responsibility of the Latvian Centre for Disease Prevention and Control. WHO European Region
Lebanon Answer not provided Answer not provided Answer not provided WHO Eastern Mediterranean Region
Lesotho Answer not provided Report not provided Report not provided WHO African Region
Liberia Answer not provided Answer not provided Answer not provided WHO African Region
Libya تم تدريب اطباء على العمل بعيادات الاقلاع عن التدخين بالتعاون مع منظمة الصحة العالمية كما تم افتتاح عدد من عيادات الاقلاع من خلال الرعاية الصحية الاولية مع العلم بان الدولة في حالة طواري وحرب اهليه مند عام 2018 وانقسام سياسي ووجود اكثر من حكومة واحده في الدوله تم تدريب اطباء على العمل بعيادات الاقلاع عن التدخين بالتعاون مع منظمة الصحة العالمية كما تم افتتاح عدد من عيادات الاقلاع من خلال الرعاية الصحية الاولية تم تدريب اطباء على العمل بعيادات الاقلاع عن التدخين بالتعاون مع منظمة الصحة العالمية كما تم افتتاح عدد من عيادات الاقلاع من خلال الرعاية الصحية الاولية WHO Eastern Mediterranean Region
Lithuania Pilot telephone quit-line project was implemented in 2019 (project was funded from the National Public Health Promotion Fund, which consists of 0,5% of actual excise taxes of tobacco, alcohol and gambling, collected to state budget). Since 2015 there has been established an Internet website www.nerukysiu.lt, amanaged by Drug, Alcohol and Tobacco Control Department, where everyone who wants to quit smoking can find information for quitting smoking ((incl. tests, videos, practical advices, success stories, consultations, FAQs etc)), contacts of institutions which offer support (Primary health care centers, Mental health centres, Addiction diseases centers, municipal Public health bureaus). Public health bureaus in municipalities implement support programmes for people trying to guit smoking. According to recent plans, it is foreseen to fund in 2018 the national smoking cessation telephone quitline from the State Health Promotion Fund. Since 2015 there has been established an Internet website www.nerukysiu.lt ( translation would be www.Iw‘ontsmoke.lt), administrated by Drug, Alcohol and Tobacco Control Department, where everyone who wants to quit smoking can find some information about quitting smoking, institutions which offer help. Help is offered by Primary health care centers, Mental health centres, Addiction diseases centers, Public health bureaus. Public health bureaus implement support programmes for people trying to guit smoking. WHO European Region
Luxembourg - mise en place dune ligne dappel téléphonique. - révision du programme de sevrage tabagique actuel et proposition dun nouveau programme optimisé: négociation en cours avec notre caisse nationale de santé pour une amélioration du taux de remboursement et simplification administrative du programme. - mise en place dune ligne dappel - révision du programme de sevrage tabagique actuel et proposition dun programme optimisé non approuvé à cette date - mise en place dune ligne dappel - révision du programme d esevrage tabagique actuel et proposition dun programm revisité non approuvé à cette date WHO European Region
Madagascar Answer not provided Answer not provided Answer not provided WHO African Region
Malaysia Quit Smoking Services in Malaysia or mQuit has been strenghtening since 2015 and involves public private partnership where currently about 88 private healthcare facilities has been accredited to conduct mQuit services according to the latest Clinical Practice Guidelines 2016. The number of smokers who registered to Malaysia Quit Smoking Services (mQuit) both in government and private facilities increased since 2018. From the registered patients we focused to all patients with the Quit date. The Quit smoking rate among those who have quit date was above 40 percent for each year. However more effort needed in order to increase the number of registered patient to patient with Quit Date. No. of registered patient to quit smoking clinics: 2018 = 20,032; 2019 = 22,601. No of patient who are successfully quit smoking after 6 months: 2018 = 4,486; 2019 = 4,471. Quit Smoking Services in Malaysia or mQuit has been strenghtening since 2015 and involves public private partnership where currently about 88 private healthcare facilities has been accredited to conduct mQuit services according to the latest Clinical Practice Guidelines 2016. In November 2015, rebranding of Quit Smoking, from Quitline to MQuit Services. This is incline with strengthening Article 14. It is public private partnership that is a collabration between government facilities and private settings to provide a hollistic and comprehensive smoking cessation programme. WHO Western Pacific Region
Maldives Cessation Services, including, training, quit line and provision of medication is being piloted. Cessation Services, including, training, quit line and provision of medication is being piloted. Cessation Services, including, training, quit line and provision of medication is being piloted. WHO South-East Asia Region
Mali Answer not provided Answer not provided Answer not provided WHO African Region
Malta Continuous participation in various types of media discussing the hazards attributed to smoking as well as promoting our cessation services to the public. Smoking cessation programmes at the workplace for public and private organisations Smoking cessation one-to-one services in the community Smoking cessation Quit line Continuous participation in various types of media discussing the hazards attributed to smoking as well as promoting our cessation services to the public. Smoking cessation programmes at the workplace for public and private organisations Smoking cessation one-to-one services in the community Smoking cessation Quit line • TV Adverts • Participating in the media to discuss the hazards attributed to smoking and promoting our services to the public to help persons who want to quit smoking. • Smoking Cessation programmes at the workplace for public and private organisations • Drafting of a legislation stopping smoking in the presence of under aged persons in cars. • Inclusion of tobacco cessation quit line on unit packs and packaging of tobacco products WHO European Region
Marshall Islands Answer not provided Answer not provided Answer not provided WHO Western Pacific Region
Mauritania - - - WHO African Region
Mauritius The success rate was estimated at 20% following an evaluation of the smoking cessation clinics by a WHO Consultant in 2017. The services of our tobacco cessation clinics around the island have been enhanced and more smokers are being assisted with an increased sensitization programme. The success rate was estimated at 20% following an evaluation of the smoking cessation clinics by a WHO Consultant in 2017. The success rate was estimated at 20% following an evaluation of the smoking cessation clinics by a WHO Consultant. WHO African Region
Mexico Como parte de las acciones para la cesación del consumo de tabaco y del cumplimiento del Art. 14 del CMCT, en 2016, se presentaron los resultados del cuestionario diagnóstico de los Servicios de Cesación en México. El levantamiento de la información se llevó a cabo mediante un trabajo interinstitucional, con la participación de representantes de las principales instancias del Sistema Nacional de Salud Pública y organizaciones especializadas en tabaco de la sociedad civil (IMSS, ISSSTE, INCan, INER, HGM, CIJ, PEMEX, IPN, UNAM, SEDENA, FIC MÉXICO, ALIENTO, la clínica GRACIAS, NO FUMO, Aída Isibasi de Hodgers y CONADIC). El cuestionario fue validado por la OMS, y fue enviado a cada una de las instituciones para ser contestado. Los principales resultados señalaron que nuestro país cuenta con amplia infraestructura de servicios de salud para apoyar el abandono al consumo de tabaco, sin embargo, se vio necesario fortalecer el primer nivel de atención en salud a fin de coadyuvar en la referencia de los usuarios que consumen tabaco y requieren de un tratamiento o intervención. Derivado de los resultados obtenidos en dicho diagnóstico, se identificó la necesidad de fortalecer el primer nivel de atención en salud. Para cubrir dicho objetivo, se desarrolló el estándar de competencias en proporcionar consejo breve para la cesación del consumo de alcohol y tabaco, el cual fue publicado el pasado 14 de julio de 2017 en el Diario Oficial de la Federación (DOF) (puede consultarse en: http://www.conocer.gob.mx/contenido/publicaciones_dof/2017/EC0897.pdf) El estándar de competencias se trabajó de manera colegiada con expertos en consejo breve, atención de consumo de alcohol y tabaco de las principales instituciones públicas de salud y educación en el país y tiene como objetivo capacitar y evaluar al personal del primer nivel de atención en salud. A través de este estándar, se pretende que los médicos, psicólogos, enfermeras, odontólogos, educadores para la salud, entre otros, puedan otorgar un consejo breve a través de identificar en el consumo de alcohol y tabaco con un breve instrumento, posteriormente aconsejar a las personas que consuman alcohol y/o tabaco sobre las consecuencias del consumo, de las alternativas y ventajas de la cesación y de considerarlo conveniente proporcionar orientación y alternativas de atención al usuario de los servicios de salud que consume alcohol y/o tabaco. En 2019, se implementó y evaluó el proyecto piloto de consejería breve con base en el EC0897 en una Jurisdicción Sanitaria del Estado de México, teniendo un impacto de 6,512 consejos breves en población general que asistió a consulta en el primer nivel de atención en salud. Este año se propone que el EC0897 forme parte de los criterios de acreditación de las unidades médicas de salud. Como parte de las acciones para la cesación del consumo de tabaco y del cumplimiento del Art. 14 del CMCT, en 2016, se presentaron los resultados del cuestionario diagnóstico de los Servicios de Cesación en México. El levantamiento de la información se llevó a cabo mediante un trabajo interinstitucional, con la participación de representantes de las principales instancias del Sistema Nacional de Salud Pública y organizaciones especializadas en tabaco de la sociedad civil (IMSS, ISSSTE, INCan, INER, HGM, CIJ, PEMEX, IPN, UNAM, SEDENA, FIC MÉXICO, ALIENTO, la clínica GRACIAS, NO FUMO, Aída Isibasi de Hodgers y CONADIC). El cuestionario fue validado por la OMS, y fue enviado a cada una de las instituciones para ser contestado. Los principales resultados señalaron que nuestro país cuenta con amplia infraestructura de servicios de salud para apoyar el abandono al consumo de tabaco, sin embargo, se vio necesario fortalecer el primer nivel de atención en salud a fin de coadyuvar en la referencia de los usuarios que consumen tabaco y requieren de un tratamiento o intervención. Derivado de los resultados obtenidos en dicho diagnóstico, se identificó la necesidad de fortalecer el primer nivel de atención en salud. Para cubrir dicho objetivo, se desarrolló el estándar de competencias en proporcionar consejo breve para la cesación del consumo de alcohol y tabaco, el cual fue publicado el pasado 14 de julio de 2017 en el Diario Oficial de la Federación (DOF) (puede consultarse en: http://www.conocer.gob.mx/contenido/publicaciones_dof/2017/EC0897.pdf) El estándar de competencias se trabajó de manera colegiada con expertos en consejo breve de diversas instituciones (ISSSTE, INER, FP-UNAM, INPRF, HGM, FM-UNAM, CONOCER e IMSS), el cual tiene como objetivo capacitar y evaluar al personal del primer nivel de atención en salud. A través de este estándar, se pretende que los médicos, psicólogos, enfermeras, odontólogos, educadores para la salud, entre otros, puedan otorgar un consejo breve a través de identificar en el consumo de alcohol y tabaco con un breve instrumento, posteriormente aconsejar a las personas que consuman alcohol y/o tabaco sobre las consecuencias del consumo, de las alternativas y ventajas de la cesación y de considerarlo conveniente proporcionar orientación y alternativas de atención al usuario de los servicios de salud que consume alcohol y/o tabaco. Con el objetivo de promover la homologación de los servicios de cesación del consumo de tabaco del Sistema Nacional de Salud y dar cumplimiento a lo dispuesto en la Norma Oficial Mexicana NOM-028-SSA2-2009, para la prevención, tratamiento y control de las adicciones se desarrollaron los Lineamientos para el Funcionamiento de los Servicios para la Cesación del Consumo de Tabaco, mismos que pretenden garantizar servicios de calidad para los usuarios que consumen tabaco. Los lineamientos fueron desarrollados por CONADIC, en coordinación con expertos en tratamiento para la cesación del consumo de tabaco, de los Centros de Integración Juvenil, A.C. (CIJ), del Instituto Mexicano del Seguro Social (IMSS), del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), de la Universidad Nacional Autónoma de México, Facultad de Medicina (UNAM-FM), del Hospital General de México “Dr. Eduardo Liceaga” (HGM), del Instituto Nacional de Enfermedades Respiratorias (INER), del Instituto Nacional de Cancerología (INCan), así como con representantes de la Sociedad Civil, de la Fundación Interamericana del Corazón, A. C., México (FIC-M) y de Alianza Nacional para el Control del Tabaco, A. C. Los lineamientos muestran las modalidades de atención que están validadas así como los requerimientos para brindar consejo breve, los requerimientos para brindar tratamiento profesional y de los requisitos para las clínicas de cesación del consumo de tabaco, así como de los criterios para la confidencialidad, seguimiento y egreso y especificaciones de los métodos alternativos. Answer not provided WHO Region of the Americas
Micronesia (Federated States of) Planning of a comprehensive Cessation Package for the users is still underway. Planning of a comprehensive Cessation Package for the users is still underway. Planning of a comprehensive Cessation Package for the users is still underway. WHO Western Pacific Region
Mongolia No data available No data available Report not provided WHO Western Pacific Region
Montenegro It has already been stated that from 2009 at the primary health care level, prevention centers can be found in all of health units, and these centers implement the smoking cessation program among the young people. The program is implemented by selected doctors (doctors often chosen for children). The program is available to children and young people, and implementers are additionally trained in the implementation of this program and are able to provide counselling. The program includes psychologists and a nurse who works in the counselling center. This program is in compliance with the policy of the Ministry of Health and funded by the Health Fund. In prevention of complications of tobacco use it is very important to work in smoking cessation. Students of medicine and dentistry in the framework of public health study are educated about negative effects of tobacco smoke on human health. It has already been stated that from 2009 at the primary health care level, prevention centers can be found in all of health units, and these centers implement the smoking cessation program among the young people. The program is implemented by selected doctors (doctors often chosen for children). The program is available to children and young people, and implementers are additionally trained in the implementation of this program and are able to provide counselling. The program includes psychologists and a nurse who works in the counselling center. This program is in compliance with the policy of the Ministry of Health and funded by the Health Fund. In prevention of complications of tobacco use it is very important to work in smoking cessation. Students of medicine and dentistry in the framework of public health study are educated about negative effects of tobacco smoke on human health. It has already been stated that from 2009 at the primary health care level, prevention centers can be found in all of health units, and these centers implement the smoking cessation program among the young people. The program is implemented by selected doctors (doctors often chosen for children). The program is available to children and young people, and implementers are additionally trained in the implementation of this program and are able to provide counselling. The program includes psychologists and a nurse who works in the counselling center. This program is in compliance with the policy of the Ministry of Health and funded by the Health Fund. In prevention of complications of tobacco use it is very important to work in smoking cessation. Students of medicine and dentistry in the framework of public health study are educated about negative effects of tobacco smoke on human health. WHO European Region
Myanmar Since May 2017, the Ministry of Health and Sports initiated the implementation of WHO package of essential NCDs (PEN) interventions. The manual and guidelines were developed for Basic health staffs (BHS) and brief advice on tobacco cessation is one of the interventions in it.The BHS in 232 townships were trained till 2019. But, the medicines required for Nicotine Replacement Therapy (NRT) are still less accessible and affordable in Myanmar. Since May 2017, the Ministry of Health and Sports initiated the implementation of WHO package of essential NCDs (PEN) interventions. The manual and guidelines were developed for Basic health staffs (BHS) and brief advice on tobacco cessation is one of the interventions in it.The BHS in 90 townships were trained in 2017. But, the medicinesrequired for Nicotine Replacement Therapy (NRT) are still less accessible and affordable in Myanmar. In Myanmar, the community-based tobacco cessation activities were started as pilot townships in 2004. The National training workshop on cessation of tobacco products held in 2010, and the physicians and medical officers from State/Regional hospitals and State/Regional training teams were trained for tobacco cessation and counselling. They were encouraged to implement the community-based and institutional based cessation activities at primary, secondary and tertiary levels. But, the pharmacies required for Nicotine Replacement Therapy (NRT) are still less available and accessible in Myanmar. Although some hospitals reported about their tobacco cessation activities, there was not much progress during last 2 years. WHO South-East Asia Region
Namibia Efforts on demand reduction will be reflected in Sections 7, 13 and 15 of the regulations with relevant increase on tobacco/sin taxes. Report not provided Report not provided WHO African Region
Nauru Answer not provided Report not provided Answer not provided WHO Western Pacific Region
Nepal Answer not provided Answer not provided Report not provided WHO South-East Asia Region
Netherlands Since jan 1 2020 pharmaceurical products and prescription drugs are for free when used in combination with quit smoking support. The bill is always set off against the obligatory deductible excess (and eventually voluntary deductible excess). Answer not provided WHO European Region
New Zealand New Zealand publishes smoking cessation guidelines which set out the ‘ABC’ approach for all health care professionals - Ask, Brief advice, Cessation support. One of the Government’s six priority health targets is ‘better help for smokers to quit’. The current target is •90% of Primary Health Organisations (PHOs) enrolled patients who smoke have been offered help to quit smoking by a health care practitioner in the last 15 months. •95% of hospital patients who smoke and are seen by a health practitioner in a public hospital are offered brief advice and support to quit smoking. •90% of pregnant women who identify as smokers upon registration with a DHB-employed midwife or Lead Maternity Carer are offered brief advice and support to quit smoking New Zealand has also developed a guidance document that will help stop smoking services to better engage with young Māori women smokers. New Zealand publishes smoking cessation guidelines which set out the ‘ABC’ approach for all health care professionals - Ask, Brief advice, Cessation support. One of the Government’s six priority health targets is ‘better help for smokers to quit’. The current target is •90% of Primary Health Organisations (PHOs) enrolled patients who smoke have been offered help to quit smoking by a health care practitioner in the last 15 months. •95% of hospital patients who smoke and are seen by a health practitioner in a public hospital are offered brief advice and support to quit smoking. •90% of pregnant women who identify as smokers upon registration with a DHB-employed midwife or Lead Maternity Carer are offered brief advice and support to quit smoking The smoking cessation services funded by the government were realigned in 2016 to better support the Governments goal of an essentially smokefree New Zealand by 2025. New Zealand publishes smoking cessation guidelines which set out the ‘ABC’ approach for all health care professionals - Ask, Brief advice, Cessation support. One of the Government’s six priority health targets is ‘better help for smokers to quit’. The current target is •90% of PHO enrolled patients who smoke have been offered help to quit smoking by a health care practitioner in the last 15 months. •95% of hospital patients who smoke and are seen by a health practitioner in a public hospital are offered brief advice and support to quit smoking. •90% of pregnant women who identify as smokers upon registration with a DHB-employed midwife or Lead Maternity Carer are offered brief advice and support to quit smoking The smoking cessation services funded by the government are currently in the process of being realigned to better support the Governments goal of an essentially smokefree New Zealand by 2025 WHO Western Pacific Region
Nicaragua Answer not provided Answer not provided Answer not provided WHO Region of the Americas
Niger Answer not provided Report not provided Answer not provided WHO African Region
Nigeria Answer not provided Answer not provided Answer not provided WHO African Region
Niue The Niue health department conducts the first point of contact assessment of patients smoking status and brief smoking advice including appropriate referral for cessation and support. Report not provided Report not provided WHO Western Pacific Region
Norway A mobile app "Slutta" (launched in 2013) has been downloaded over 800 000 times in a country with a population of 5.4 million. The app is continuously updated and renewed and was launched as open-code in 2019. In 2020 we are starting a pilot project, smoking cessation for heavy smokers. The project includes cooperation between healthy life centers, hospitals, GPs, etc. and with partial subsidisation of pharmaceutical products. A scientific guideline in smoking cessation for general practitioners and others was finalised in 2016. On the other hand, the Quitline was shut down in January 2017. A mobile app "Slutta" (launched in 2013) has been downloaded nearly 600 000 times in a country with a population of about 5 million. The app is continuously updated and renewed. Further developed ‘healthy life centres’ locally, in all geographic regions, to support change of behaviours that have significance for health. The goal is to establish such centres in all municipalities. Cessation counsellors have been educated for the purpose of individual or group counselling in tobacco cessation. So far 250 of 428 municipalities are covered. A new scientific guideline in smoking cessation for general practitioners is in the phase of finalisation (by end of 2016). WHO European Region
Oman يتم تنظيم دورات للمدربين حول الاقلاع من ان لاخر يتم تنظيم دورات للمدربين حول الاقلاع من ان لاخر يتم تنظيم دورات للمدربين حول الاقلاع من ان لاخر WHO Eastern Mediterranean Region
Pakistan In line with Article 14 of FCTC to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence, Pakistan established cessation clinics at national and sub-national level with government funds. Two clinics have been established in Pakistan Institute of Medical Sciences and National Institution for Rehabilitation Medicine (two tertiary level hospitals). One clinic has been established in District Headquarters Hospital (secondary level) in Gujranwala. In line with Article 14 of FCTC to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence, Pakistan established cessation clinics at national and sub-national level with government funds. Two clinics have been established in Pakistan Institute of Medical Sciences and National Institution for Rehabilitation Medicine (two tertiary level hospitals). One clinic has been established in District Headquarters Hospital (secondary level) in Gujranwala. In line with Article 14 of FCTC to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence, Pakistan established cessation clinics at national and sub-national level with government funds. Two clinics have been established in Pakistan Institute of Medical Sciences and National Institution for Rehabilitation Medicine (two tertiary level hospitals). One clinic has been established in District Headquarters Hospital (secondary level) in Gujranwala. WHO Eastern Mediterranean Region
Palau Using Article 14 guidelines, Palau began a step-wise approach to cessation in 2019. A national situation analysis (NSA) has been completed through input from diverse stakeholders. Additionally, a national strategy has been drafted. We have determined our next steps as follows: 1. Develop and adopt an official national cessation policy 2. Help healthcare workers stop. 3. Ensure that the new treatment guidelines are in harmony with the recommendations of this report and the National Tobacco Cessation Strategy 4. Nominate an official focal point for cessation, someone within the Ministry or nominated by the Ministry. 5. Allocate a budget for cessation. 6. Appoint and fund a champion to lead the development of a comprehensive cessation programme, probably for a limited time. 7. Ensure that tobacco use is recorded in all medical records. 8. Train healthcare and other relevant workers (HCWs) to give brief advice 9. Integrate brief advice into the healthcare system. 10. Ensure that all patients are given brief advice. 11. Make NRT universally available and affordable. 12. Establish a specialist treatment facility with trained staff. 13. After HCWs prioritise cessation support for pregnant tobacco users. 14. Procure the training expertise that will be needed to achieve these objectives. 15. Establish a system to monitor the provision of cessation support. The Tobacco Control Working Group (TCWG) of the Coordinating Mechanism (CM) has recently completed a national cessation situation analysis found at treatobacco.net based on Article 14 guidelines. The analysis will be reviewed by an expert who will provide a brief summary of what seem to be key issues and possible next steps for Palau’s consideration. The Tobacco Control Working Group (TCWG) of the Coordinating Mechanism (CM) has recently completed a national cessation situation analysis found at treatobacco.net based on Article 14 guidelines. The analysis will be reviewed by an expert who will provide a brief summary of what seem to be key issues and possible next steps for Palau’s consideration. WHO Western Pacific Region
Panama En la actualidad contamos con 56 clínicas de cesación de tabaquismo en todo el país (detalles en www.panamalibredetabaco.com) ubicadas en las instalaciones públicas del MINSA o de la Caja de Seguro Social y la atención es gratuita. Las mismas se han integrado como parte del Programa de Salud Mental y funcionan en instalaciones ambulatorias como: Centros de Salud, MINSA CAPSi y Policlínicas, tanto del MINSA como de la Caja de Seguro Social. También están operando en Hospitales Públicos de II y III nivel de atención. Se ofertan, además de las clínicas de cesación de tabaquismo, consejo antitabaco y se vigila el cumplimiento de la Ley 13 de 2008 y de las disposiciones que la reglamentan, entre las cuales se incluyen las relativas a cesación de tabaco. Durante la epidemia COVID-19 a través del sistema de llamadas 169 y del Sistema de Respuesta Operativa de Salud Automática (ROSA) se da consejería antitabaco. De igual forma, los pacientes que manifiestan ansiedad debido a la necesidad de consumir productos de tabaco están siendo medicados con ansióliticos. Para minimizar el uso de productos de tabaco y relacionando la severidad del daño del COVID-19 han elaborado mensajes como los siguientes: 1- Queremos verte después de la cuarentena. Cuida tus pulmones. Es el mejor momento para dejar de fumar. 2- Fumar no relaja, te estresa y afecta tu sistema inmunológico dejándote expuesto al COVID-19 (logo de no fumar) 3- El primer anillo de seguridad ante el COVID-19 es tú sistema inmunológico. Por tú salud y la de los tuyos Dile NO al cigarrillo 4- El tratamiento se complica en un fumador con COVID-19. No mas cigarrillos 5- Fumar + COVID-19 = Muerte. En un fumador con COVID-19 el tratamiento se complica (logo de no fumar). Estos mensajes pueden se visto en www.panamalibredetabaco.com Se reitera que previo al inicio de operaciones de cada una de las clínicas se da un proceso de capacitación dirigido al personal de salud que se desempeñará en las mismas. La atención es ofrecida por un equipo multidisciplinario conformado por psiquiatras, psicólogos clínicos o generales, enfermeras de salud mental y médicos generales capacitados. Las clínicas se organizan para atender grupos hasta de 20 fumadores, con un promedio de 10 fumadores por grupo y una efectividad que fluctúa entre 60 y 90% y una tasa de abandono entre 20 y 25%. Previo al inicio de operaciones de cada una de las clínicas se da un proceso de capacitación dirigido al personal de salud que se desempeñará en las mismas. La atención es ofrecida por un equipo multidisciplinario conformado por psiquiatras, psicólogos clínicos o generales, enfermeras de salud mental y médicos generales capacitados. Las clínicas se organizan para atender grupos hasta de 20 fumadores, con un promedio de 10 fumadores por grupo y una efectividad que fluctúa entre 60 y 90% y una tasa de abandono entre 20 y 25%. Como estrategia del Programa de Salud Mental y de la implementación del Sistema de Expediente Electrónico, se continua enfatizando para que el diagnóstico de tabaquismo se haga en todas las instalaciones de la red pública y privada de servicios de salud, al igual que avanzar en el perfeccionamiento del registro de tabaquismo en el Sistema Electrónico de Información en Salud (Expediente electrónico - SEIS) mediante la promoción de la usabilidad del registro de consumo de tabaco de manera obligatoria para poder cerrar un expediente clínico. También se enfatiza en la importancia del registro de la administración del Consejo Breve y la referencia a las clínicas de cesación. Se efectúan acciones de capacitación para promover el uso del modulo específico para las clínicas de cesación de tabaquismo donde se debe registra el nivel de consumo, el nivel de dependencia, las intervenciones realizadas, la evolución de cada uno de los pacientes de las clínicas y en los casos requeridos las deserciones. Se continua financiando con los fondos recibidos por el MINSA producto del ISC la adquisición de equipo para las clínicas de cesación y la compra de medicamentos para dejar de fumar, Vareniclina 1 mg comprimido y Bupropión 150 mg comprimido de liberación prolongada que son los medicamentos que utiliza el programa en Panamá. Desde el año 2015, no se aplica terapia de reemplazo de nicotina en el programa de cesación del MINSA y CSS. Este producto tampoco esta disponible en las farmacias privadas. A pesar que hay divulgación de las clínicas de cesación de tabaquismo en las actividades de promoción de la salud realizadas en torno al tema de tabaco o las patologías asociadas a su consumo o exposición a su humo, es necesario mayor divulgación, mayor participación en la captación de casos, mayor registro del consejo anti tabaco y la activación del sistema de referencias a lo interno de cada una de las instalaciones en torno a la red para aumentar la demanda de atención en las mismas, tema que actualmente esta siendo gestionado. Detalles sobre cesación de tabaco en Panamá en: https://panamalibredetabaco.com/web/sisviscta/atencion-y-rehabilitacion1 El diagnóstico de tabaquismo se hace en todas las instalaciones de la red pública y privada de servicios de salud. En el Sistema Electrónico de Información en Salud (Expediente electrónico - SEIS) se ha habilitado el registro del consumo de tabaco de manera obligatoria para poder cerrar un expediente clínico. Este sistema permite el registro de la administración de l Consejo Breve y la referencia a las clínicas de cesación. Adicionalmente, se desarrollo un modulo específico para las clínicas de cesación de tabaquismo en el cual se registra el nivel de consumo, el nivel de dependencia, las intervenciones realizadas y la evolución de cada uno de los pacientes de las clínicas. De igual forma, se lleva el registro de las deserciones. En la actualidad contamos con 45 clínicas de cesación de tabaquismo en todo el país (se adjunta detalles en documento correspondiente) ubicadas en las instalaciones públicas del MINSA o de la Caja de Seguro Social y la atención es gratuita. Las mismas se han integrado como parte del Programa de Salud Mental y funcionan en instalaciones ambulatorias como: Centros de Salud, MINSA CAPSi y Policlínicas, tanto del MINSA como de la Caja de Seguro Social. También están operando en Hospitales Públicos de II y III nivel de atención (se adjunta listado de instalaciones que cuentan con las precitadas clínicas. Se ofertan, además de las clínicas de cesación de tabaquismo, consejo antitabaco y se vigila el cumplimiento de la Ley 13 de 2008 y de las disposiciones que la reglamentan, entre las cuales se incluyen las relativas a cesación de tabaco. Previo al inicio de operaciones de cada una de las clínicas se da un proceso de capacitación dirigido al personal de salud que se desempeñará en las mismas. La atención es ofrecida por un equipo multidisciplinario conformado por psiquiatras, psicólogos clínicos o generales, enfermeras de salud mental y médicos generales capacitados. Las clínicas se organizan para atender grupos hasta de 20 fumadores, con un promedio de 10 fumadores por grupo y una efectividad que fluctúa entre 60 y 90% y una tasa de abandono entre 20 y 25%. Con los fondos recibidos por el MINSA producto del ISC se ha efectuado mejoras a la infraestructura de 3 clínicas de cesación que incluyen equipamiento por un monto cercano a 1 millón de dólares y se realizan las adquisiciones en medicamentos para dejar de fumar. El programa utiliza Vareniclina 1 mg comprimido y Bupropión 150 mg comprimido de liberación prolongada. Desde el año 2015, se ha intentado adquirir terapia de reemplazo de nicotina y todas las licitaciones han quedado desiertas y tampoco esta disponible en las farmacias privadas. Los agentes comunitarios participan en forma indirecta ya que apoyan la captación, referencia y atención integral de los usuarios de las clínicas de cesación de tabaquismo. Como parte del Programa de Salud Ocupacional que se lleva a cabo en los lugares de trabajo se promueve el abandono del consumo de tabaco en los lugares de trabajo, en el caso de los entornos deportivos la Ley 13 de 2008, en su artículo 5 prohibe el consumo de productos de tabaco en espacios abiertos o cerrados dedicados al deporte. A pesar que hay divulgación de las clínicas de cesación de tabaquismo en medios de comunicación y en todas las actividades de promoción de la salud realizadas en torno al tema de tabaco o las patologías asociadas a su consumo o exposición a su humo, es necesario mayor divulgación, mayor participación en la captación de casos, mayor registro del consejo anti tabaco y la activación del sistema de referencias a lo interno de cada una de las instalaciones en torno a la red para aumentar la demanda de atención en las mismas, tema que actualmente esta siendo gestionado. Como una alternativa adicional se ha elaborado el documento técnico-conceptual sobre cesación virtual que esperamos prontamente poder implementar en el país. En el 2016 Panamá fue sede de un evento de Cooperación Sur- Sur con la finalidad de compartir la experiencia panameña en la implementación del artículo 14. Posteriormente, Panamá sirvió de oferente en dos talleres de cooperación para la implementación del artículo 14 del CMCT sobre las medidas de reducción de la demanda relativas a la dependencia y el abandono del tabaco, uno en Uruguay para países del Cono Sur y otro en Ginebra, para los países de Africa. En el 2017 el Programa de Salud Mental del MINSA en conjunto con el Campus Virtual de Salud Pública de OPS nodo de Panamá lanzó el primer curso virtual de Prevención, Diagnóstico y Tratamiento de Tabaquismo en Atención Primaria dirigido a profesionales de la salud de la Caja de Seguro Social y del MINSA. Este curso con la participación de 118 estudiantes inscritos de los cuales 41 aprobaron. El mismo se organizó con 10 tutores nacionales y la colaboración de una profesora de Uruguay. https://cursospaises.campusvirtualsp.org/course/view.php?id=308 El diagnóstico de tabaquismo se hace en todas las instalaciones de la red pública y privada de servicios de salud. En la actualidad contamos con 35 clínicas de cesación de tabaquismo en todo el país (se adjunta detalles en documento correspondiente) ubicadas en las instalaciones públicas del MINSA o de la Caja de Seguro Social y la atención es gratuitas. Las mismas se han integrado como parte del Programa de Salud Mental y funcionan en instalaciones ambulatorias como: Centros de Salud, MINSA CAPSi y Policlínicas, tanto del MINSA como de la Caja de Seguro Social. También están operando en Hospitales Públicos de II y III nivel de atención (se adjunta listado de instalaciones que cuentan con las precitadas clínicas. Se ofertan, además de las clínicas de cesación de tabaquismo, consejo antitabaco y se vigila el cumplimiento de la Ley 13 de 2008 y de las disposiciones que la reglamentan, entre las cuales se incluyen las relativas a cesación de tabaco. Previo al inicio de operaciones de cada una de las clínicas se da un proceso de capacitación dirigido al personal de salud que se desempeñará en las mismas. La atención es ofrecida por un equipo multidisciplinario conformado por psiquiatras, psicólogos clínicos o generales, enfermeras de salud mental y médicos generales capacitados. Las clínicas se organizan para atender grupos hasta de 20 fumadores, con un promedio de 10 fumadores por grupo y una efectividad que fluctúa entre 60 y 90% y una tasa de abandono entre 20 y 25%. Con los fondos recibidos por el MINSA producto del ISC se ha adquirido equipamiento para dichas clínicas por cerca de 300 mil dólares. La inversión en medicamentos para dejar de fumar en el periodo 2010 a 2014 fue de 1.4 millones de dólares y se han adquirido los siguientes medicamentos: Vareniclina 1 mg comprimido Bupropión 150 mg comprimido de liberación prolongada Nicotina 15 mg, parche transdérmico Nicotina 10 mg, parche transdérmico Nicotina 5 mg, parche transdérmico Actualmente, se esta en un proceso de mejora Los agentes comunitarios participan en forma indirecta ya que apoyan la captación, referencia y atención integral de los usuarios de las clínicas de cesación de tabaquismo. Como parte del Programa de Salud Ocupacional que se lleva a cabo en los lugares de trabajo se promueve el abandono del consumo de tabaco en los lugares de trabajo, en el caso de los entornos deportivos la Ley 13 de 2008, en su artículo 5 prohibe el consumo de productos de tabaco en espacios abiertos o cerrados dedicados al deporte. A pesar que hay divulgación de las clínicas de cesación de tabaquismo en medios de comunicación y en todas las actividades de promoción de la salud realizadas en torno al tema de tabaco o las patologías asociadas a su consumo o exposición a su humo, es necesario mayor divulgación, mayor participación en la captación de casos, mayor registro del consejo anti tabaco y la activación del sistema de referencias a lo interno de cada una de las instalaciones en torno a la red para aumentar la demanda de atención en las mismas, tema que actualmente esta siendo gestionado. En el mes de julio de 2016 Panamá será la sede de un evento de Cooperación Sur- Sur con la finalidad de compartir la experiencia panameña en las clínicas de cesación. WHO Region of the Americas
Papua New Guinea Articles 13 and 14 are yet to be fully implemented. Discussions are on the way to look at cessation programs. This is considered a priority. Due to lack of resources, the department is trying to get in touch with NGO churches especially to provide cessation services in the country. Resources are needed to implement this. Will be communicating with Secretariat and regional office to conduct training and establishing this services. It is evident from the GYTS 2016 as young people need professional assistance is quitting tobacco use. Articles 13 and 14 are yet to be fully implemented. Discussions are on the way to look at cessation programs. This is considered a priority. Due to lack of resources, the department is trying to get in touch with NGO churches especially to provide cessation services in the country. Resources are needed to implement this. Will be communicating with Secretariat and regional office to conduct training and establishing this services. It is evident from the GYTS 2016 as young people need professional assistance is quitting tobacco use. Articles 13 and 14 are yet to be fully implemented. Discussions are on the way to look at cessation programs. This is considered a priority. Due to lack of resources, the department is trying to get in touch with NGO churches especially to provide cessation services in the country. WHO Western Pacific Region
Paraguay El Bupropion es la droga utilizada en el proceso de rehabilitación del paciente fumador Habilitación de nuevos consultorios de cesación en el interior del país con personal capacitado Actualizaciones permanentes al personal encargado del tratamiento de cesación El Bupropion es la droga utilizada en el proceso de rehabilitación del paciente fumador. No es de fácil acceso a los pacientes ya que solo es adquirido por la cartera sanitaria. No todas las farmacias cuentan con la citada droga. El Bupropion es la droga utilizada en el proceso de rehabilitación del paciente fumador. No es de fácil acceso a los pacientes ya que solo es adquirido por la cartera sanitaria. No todas las farmacias cuentan con la citada droga. WHO Region of the Americas
Peru No se han detallado programas en centros de salud específicamente No se han detallado programas en centros de salud específicamente Answer not provided WHO Region of the Americas
Philippines Consultations and activities with concerned stakeholders are ongoing in order to finalize the draft guidelines on the implementation of standardized and unified tobacco cessation services at different levels of care, as well as the Brief Tobacco Intervention (BTI) guidebook for healthcare providers. Further, with the passing of the Universal Health Care Act, the government shall expand its existing benefit packages and establish financing mechanisms for the provision of basic primary care services including BTI. DOH is lobbying to Philhealth to include pharmacologic treatment for tobacco dependence in its benefit packages. On June 2017, the Department of Health in cooperation with the World Health Organization launched phone and mobile-centered support services Quitline to assist smokers quit tobacco use. Quitline is a hotline—164364— that smokers can call via landline. The hotline is currently toll-free for Metro Manila. For the mobile-based cessation, smokers can simply text STOPSMOKE to (29290)164364 and text messaging will begin support and guidance. Answer not provided WHO Western Pacific Region
Poland The trainings on tobacco dependence diagnosis and treatment has been implemented at nation-wide level within the National Health Program. National Health Fund partially covers the cost of tobacco dependence and cessation treatment (costs of individual treatment done by psychologist, psychotherapist or trained physician; costs of group therapies conducted by psychologist or psychotherapist). In the last years, the National Health Fund partially covers the cost of tobacco dependence and cessation treatment (costs of individual treatment done by psychologist, psychotherapist or trained physician; costs of group therapies conducted by psychologist or psychotherapist). However, the level of this funding is low, which seems to be one of the major obstacles in wider implementation of cessation programs. WHO European Region
Portugal The National Programme for Smoking Prevention and Tobacco Control is putting lots of effort in the promotion of smoking cessation: Initiative with health professional undergraduate schools in order to improve the teaching of smoking cessation brief interventions. Training seminars on smoking cessation for health professionals. Computerization of the clinical records regarding smoking cessation brief interventions and intensive care. In the past years the number of consultations to support smoking cessation in the NHS has increased, as well as the number of consultation units. In 2017, and for the first time, the reimbursement of anti-tobacco drugs subject to medical prescription was implemented. The National Programme for Smoking Prevention and Tobacco Control is puting lots of effort in the promotion of smoking cessation: Initiative with health professional undergraduated schools in order to improve the treaching of smoking cessation brief interventios. Training seminars on smoking cessation for health porofessionals. Computerazion of the clinical records regarding smoking cessation brief interventions and intensive care. In the past years the number of consultations to support smoking cessation in the NHS has increased, as well as the number of consultation units. In 2017, and for the first time, the reimbursement of anti-tobacco drugs subject to medical prescription was implem The National Programme for Smoking Prevention and Tobacco Control is pating lots of effort in the promotion of smoking cessation: Initiative with health professional undergraduated schools in order to improve the treaching of smoking cessation brief interventios. Training seminars on smoking cessation for health porofessionals. Computerazion of the clinical records regarding smoking cessation brief interventions and intensive care. WHO European Region
Qatar More than 80 health care providers have been trained in Tobacco dependence treatment and 40 nurses at educational facilities we well to support tobacco cessation . the NRTs are found in public health care facilities through reimburement system and in private pharmacies as well. referal ssytem has been established to support referral to health care facilities that provide quitting services Answer not provided Answer not provided WHO Eastern Mediterranean Region
Republic of Korea *Reinforcing national smoking cessation support services and systems. - Operating of the smoking cessation education campaign at the workplace (linking 4 agencies in 2018, and 7 agencies in 2019) - Designation of specialized smoking cessation centers (17 centers in total) at local level - Addition of information sharing function of nicotine additives purchasing by the public health center to smoking cessation services comprehensive information system - Distribution of Triple Crown Life Coaching Program(CROWN) booklet to encourage adolescents smoker to quit from 2019 *Reinforcing and expanding national smoking cessation support services. - Reinforcing and expanding of National Smoking Cessation Clinic (Budget: KRW 33 billion in 2016, KRW 38.5 billion in 2017, KRW 38.4 billion in 2018) - Implementation of smoking cessation services at the hospitals/clinics/dentists (approx. 12,000 places as of 2017) registered for smoking cessation service - Designation of specialized smoking cessation centres (18 centres in total) at local level - Expanding the smoking cessation program for military men and riot policemen (Limited access until 2014; since 2015, all military and riot policemen benefit the program.) Please refer to section C2811 for details. *Reinforcing and expanding national smoking cessation support services. - Reinforcing and expanding of National Smoking Cessation Clinic (Budget: 2014 KRW 12 billion, 2015 KRW 26.2 billion, 2016 KRW 33 billion) - Implementation of smoking cessation services at the hospitals/clinics (approx. 130 places) registered for smoking cessation service - Designation of specialized smoking cessation centres (18 centres in total) at local level - Expanding the smoking cessation program for military men and riot policemen (Limited access until 2014; since 2015, all military and riot policemen benefit the program.) Please refer to section C2811 for details. WHO Western Pacific Region
Republic of Moldova Adopted National Guidance on tobacco cessation - treatment and counseling, also Decree # of 03.03.2016 on establishing of tobacco cessation service and a national free quit-line Adopted National Guidance on tobacco cessation - treatment and counseling, also Decree # of 03.03.2016 on establishing of tobacco cessation service and a national free quit-line Adopted National Guidance on tobacco cessation - treatment and counseling, also Decree # of 03.03.2016 on establishing of tobacco cessation service and a national free quit-line WHO European Region
Romania Report not provided Report not provided Report not provided WHO European Region
Russian Federation Утверждены Клинические рекомендации "Синдром зависимости от табака, синдром отмены табака у взрослых" МКБ 10: F17.2, F17.3 Одним из направлений профилактической работы, направленной на формирование мотивации граждан к здоровому образу жизни, включая отказ от табака является работа Центров общественного здоровья. В 2019 году рекомендованы индивидуальные планы по здоровому образу жизни (паспорта здоровья) 4,7 млн человек. На телефонную линию консультативной помощи по вопросам ЗОЖ, включая консультации по отказу от табака, за 2019 год поступило 650 499 звонков. Report not provided Министерством здравоохранения Российской Федерации в рамках проведения Года борьбы с сердечно-сосудистыми заболеваниями (далее – ССЗ) были разработаны социально-информационные материалы, стимулирующие граждан к профилактике ССЗ, занявшие призовое место во Всероссийском конкурсе социальной рекламы среди органов государственной власти «Импульс». Для привлечения внимания населения к проблемам, связанным с ССЗ, в регионах Российской Федерации проведены следующие мероприятия: организована трансляция более 4,7 тыс. тематических видеороликов, вышло более 1 тыс. телевизионных и более 1,5 тыс. радиопередач с ведущими специалистами в области ССЗ, было подготовлено около 4 тыс. публикаций в региональных средствах массовой информации, проведено более 4,2 тыс. массовых акций и более 60 тыс. информационно-образовательных мероприятий, распространено более 1,2 млн памяток и буклетов о факторах риска развития ССЗ. Совместно с аэропортами Внуково, Шереметьево и Домодедово были размещены информационные плакаты на территории аэровокзалов, в бортовых журналах авиакомпании «Ютейр». В Московском метрополитене была проведена кампания по информированию посредством голосовых сообщений, а операторами сотовой связи «МТС» и «Билайн» посредством SMS-сообщений. В ноябре 2015 г. Министерство здравоохранения Российской Федерации презентовало социальный коммуникационный проект «Фабрика здоровья». Проект направлен на работу с факторами риска, и адресован активным людям трудоспособного возраста, которые рискуют столкнуться с первыми последствиями нездорового образа жизни. Суммарный охват аудитории интернет-проекта «Фабрика здоровья» более 10 млн человек. Функционирует мультимедийный Интернет-портал о здоровом образе жизни www.takzdorovo.ru, среднемесячная посещаемость сайта в 2014 году составила в среднем 250 000 пользователей. На нем размещено большое количество материалов по теме сокращения по борьбе против табака, в том числе статьи, новости, авторские колонки и опросы. Работает единая телефонная справочная служба программы «Здоровая Россия» 8 800-200-0-200, где предоставляются бесплатные консультации по отказу от табака, о работе центров здоровья и др. Среднемесячное количество обращений на горячую линию составило около 7 000 вызовов. WHO European Region
Rwanda Answer not provided Answer not provided Report not provided WHO African Region
Saint Kitts and Nevis Report not provided Report not provided Answer not provided WHO Region of the Americas
Saint Lucia The Ministry of Health and Wellness has prioritized the introduction of tobacco cessation programmes through its primary health care system. The Ministry of Health and Wellness has prioritized the introduction of tobacco cessation programmes through its primary health care. Answer not provided WHO Region of the Americas
Saint Vincent and the Grenadines Report not provided Report not provided Report not provided WHO Region of the Americas
Samoa National Cessation Training Manual was already drafted waiting for final copy than training for health professional non health professional will start this year.. This is now a priority and a focus for 2018 especially through the FCTC 2030 Project. This is now a priority and a focus for 2016-2017. WHO Western Pacific Region
San Marino Answer not provided Answer not provided Answer not provided WHO European Region
Sao Tome and Principe sin datos sin datos Report not provided WHO African Region
Saudi Arabia C287b كما جاء بالرد على - هناك عيادات خاصه ببرنامج مكافحة التدخين تقدم خدمات الاقلاع بشقيها المشوري والدوائي بالمجان ويتم التووسع حاليا في تقديم خدمات الاقلاع عن التدخين عن طريق مراكز الرعايه الصحيه الاوليه في جميع انحاء المملكه - هناك عيادات خاصه ببرنامج مكافحة التدخين تقدم خدمات الاقلاع بشقيها المشوري والدوائي بالمجان ويتم التووسع حاليا في تقديم خدمات الاقلاع عن التدخين عن طري ق مراكز الرعايه الصحيه الاوليه في جميع انحاء المملكه WHO Eastern Mediterranean Region
Senegal Les mesures visant à réduire la demande en rapport avec la dépendance et le sevrage ont été prises la mise en place dun numéro vert (800 00 50 50) mis sur les nouveaux paquets de tabac pour conseils, prévention et sevrage tabagique. . Les mesures visant à réduire la demande en rapport avec la dépendance et le sevrage ont été prises la mise en place dun numéro vert mis sur les nouveaux paquets de tabac pour conseils, prévention et sevrage tabagique. . Answer not provided WHO African Region
Serbia There is no progress since the previous report in 2018. Not much progress occurred since 2016, mostly due to the very limited funds for preventive activities in tobacco control. However, seminars have been organized in 2016 and 2017 by the Institute of Public Health of Serbia with approximately 320 participants. Seminars are intended to the health professionals of the different institute of public health in Serbia. The main topics of seminars are the actual principles in smoking prevention and cessation. Not much progress occurred since 2014, mostly due to the very limited funds for preventive activities in tobacco control. However, regular seminars have been organized by the Institute of Public Health of Serbia as follows: 2 in 2014, 5 in 2015 and 1 in 2016, total of 8 seminars, with approximately 70 participants per seminar. Seminars are organized for the health professionals for the different institute of public health in Serbia. The main topics of seminars are the actual principles in smoking prevention and cessation. WHO European Region
Seychelles Answer not provided Answer not provided Answer not provided WHO African Region
Sierra Leone Sierra Leone has not developed or implemented comprehensive guidelines on tobacco dependence and cessation, but this requirement is included in the National Tobacco Control Strategy 2012–2016. Sierra Leone has not developed or implemented comprehensive guidelines on tobacco dependence and cessation, but this requirement is included in the National Tobacco Control Strategy 2012–2016. Answer not provided WHO African Region
Singapore Schools are encouraged to implement a comprehensive tobacco control programme, focusing on both preventing initiation and supporting cessation for youth smokers. These cessation programmes for youth are underpinned by a strengths-based approach that seeks to harness positive aspects of the youth to bring about behaviour change. This approach is based on the understanding that youth will be more ready to address their problems when they feel empowered and more confident about their own abilities. HPB’s cessation programme helps youth channel their attention away from smoking and other risky behaviours by engaging in healthy activities aligned with their strengths. It also equips youth with the knowledge and skills to kick the habit and learn coping strategies to better deal with stress, anger, frustration or boredom. Student Health Advisors (SHAs) also provide tailored smoking cessation counselling to youth smokers in schools. Counselling sessions are conducted on an individual and/or group basis, depending on the youth’s specific needs and preferences. Since 2016, HPB has also intensified and expanded smoking control programmes for young uniformed services personnel. In the units that HPB is currently working with, a holistic health seminar, which covers a comprehensive range of health topics including physical activity, stress, smoking and alcohol use, is conducted for all new recruits upon enlistment. This is followed up by an intensive group counselling programme for selected recruits (after a screening procedure to identify those motivated to quit) who undergo weekly coaching and interactive counselling designed to help them quit or reduce. HPB is working with the Singapore Armed Forces to expand these programmes to more units Since the last update, HPB has implemented a targeted holistic tobacco control programme in schools with a high reported number of underage smokers. Schools are encouraged to implement a comprehensive tobacco control programme, focusing on both preventing initiation and supporting cessation for youth smokers. These cessation programmes for youth are underpinned by a strengths-based approach that seeks to harness positive aspects of the youth to bring about behaviour change. This approach is based on the understanding that youth will be more ready to address their problems when they feel empowered and more confident about their own abilities. HPB’s cessation programme helps youth channel their attention away from smoking and other risky behaviours by engaging in healthy activities aligned with their strengths. It also equips youth with the knowledge and skills to kick the habit and learn coping strategies to better deal with stress, anger, frustration or boredom. Student Health Advisors (SHAs) also provide tailored smoking cessation counselling to youth smokers in schools. Counselling sessions are conducted on an individual and/or group basis, depending on the youth’s specific needs and preferences. Since 2016, HPB has also intensified and expanded smoking control programmes for uniformed services personnel. In the units that HPB is currently working with, a holistic health seminar, which covers a comprehensive range of health topics including smoking and alcohol use, is conducted for all recruits upon enlistment. This is followed up by an intensive group cessation programme where selected recruits (after a screening procedure to identify motivated quitters) undergo weekly customized activities designed to help them quit or reduce. HPB is working with the Singapore Armed Forces to expand these programmes to more units to achieve service-wide coverage eventually. Since the last update, HPB has implemented a targeted holistic tobacco control programme in schools with a high reported number of underage smokers. Schools are encouraged to implement a comprehensive tobacco control programme, focusing on both preventing initiation and supporting cessation for youth smokers. These cessation programmes for youth are underpinned by a strengths-based approach that seeks to harness positive aspects of the youth to bring about behaviour change. This approach is based on the understanding that youth will be more ready to address their problems when they feel empowered and more confident about their own abilities. HPB’s cessation programme helps youth channel their attention away from smoking and other risky behaviours by engaging in healthy activities aligned with their strengths. It also equips youth with the knowledge and skills to kick the habit and learn coping strategies to better deal with stress, anger, frustration or boredom. Student Health Advisors (SHAs) also provide tailored smoking cessation counselling to youth smokers in schools. Counselling sessions are conducted on an individual and/or group basis, depending on the youth’s specific needs and preferences. Since 2014, HPB has also intensified and expanded smoking control programmes for uniformed services personnel. In the units that HPB is currently working with, a holistic health seminar, which covers a comprehensive range of health topics including smoking and alcohol use, is conducted for all recruits upon enlistment. This is followed up by an intensive group cessation programme where selected recruits (after a screening procedure to identify motivated quitters) undergo weekly customized activities designed to help them quit or reduce. HPB is working with the Singapore Armed Forces to expand these programmes to more units to achieve service-wide coverage eventually. WHO Western Pacific Region
Slovakia Answer not provided Answer not provided Answer not provided WHO European Region
Slovenia Report not provided In 2017 the Schedule/working hours of telephone quitline was expanded. It is now available not only during workdays afternoon but also in the morning, during weekend and during public holidays. Answer not provided WHO European Region
Solomon Islands There has not been much development except for training on dependence counselling for health officers, teachers as well as church workers. NRTs are available in certain private pharmacies but still to be procured by government pharmacies. NO government subsidies in place as well for cessation medicines. Tobacco cessation services to be part of the WHO PEN program that the country is rolling out There has not been much development except for training on dependence counselling for health officers, teachers as well as church workers. NRTs are available in certain private pharmacies but still to be procured by government pharmacies. NO government subsidies in place as well for cessation medicines. Tobacco cessation services to be part of the WHO PEN program that the country is rolling out Report not provided WHO Western Pacific Region
South Africa NRT is made available in the private sector and non governmental organisations provide counselling and support services for cessation. NRT is made available in the private sector and non governmental organisations provide counselling and support services for cessation. NRT is made available in the private sector and non governmental organisations provide counselling and support services for cessation. WHO African Region
Spain La ESTRATEGIA DE PROMOCIÓN DE LA SALUD Y PREVENCIÓN EN EL SISTEMA NACIONAL DE SALUD (SNS), en el marco del abordaje de la cronicidad en el SNS, recoge una serie de intervenciones para actuar sobre los principales determinantes y factores de riesgo de las enfermedades crónicas, como son el consumo de tabaco y de alcohol, el tipo de alimentación y la actividad física; introduciendo también el bienestar emocional. 1. Capacitación de la población: Web de Estilos de Vida Saludable, disponible desde noviembre de 2015. La sección de Prevención del Tabaquismo recoge también información y enlaces de interés sobre ayuda para dejar de fumar (http://www.estilosdevidasaludable.msssi.gob.es/tabaco/ayuda/home.htm). También se han elaborado materiales dirigidos a población sobre consejos de salud en estilos de vida, incluido uno sobre consumo de tabaco que se facilitará en Atención Primaria. 2. Capacitación de los profesionales sanitarios: Uno de los pilares fundamentales de la implementación de la Estrategia es el Consejo Integral sobre estilo de vida saludable en Atención Primaria vinculado a recursos comunitarios, se ha elaborado un documento donde se incluye una intervención sobre consumo de tabaco para población adulta en Atención Primaria (página 55). http://www.msssi.gob.es/profesionales/saludPublica/prevPromocion/Estrategia/Consejo_integral_EstilosVida.htm. Además, se ha desarrollado un proceso formativo on-line dirigido a todos los profesionales de Atención Primaria en metodología del cambio y Educación para la salud relacionada con un estilo de vida saludable, está acreditado y pretende ser un complemento de los programas formativos, que ya desarrollan las comunidades autónomas. Durante 2019 se ha elaborado un curso on-line sobre el “Abordaje del tabaquismo en Atención Primaria” dirigido a la capacitación de los profesionales en intervención en tabaquismo. A los largo de 2020 se van a celebrar dos ediciones del mismo. 3. Implementación Local de la Estrategia: adhesión de los municipios mediante aprobación por el pleno del ayuntamiento, mesas de coordinación intersectorial y mapeo de recursos comunitarios, incluidos aquellos relacionados con tabaquismo (http://localizasalud.msssi.es/maparecursos/main/Menu.action). Por otro lado, las distintas Comunidades Autónomas disponen de programas para promover el abandono del consumo de tabaco http://www.msssi.gob.es/ciudadanos/proteccionSalud/tabaco/ayudaCCAA.htm). En general, los planes regionales se dirigen a los distintos grupos de edad y colectivos, se realizan desde diversos entornos y abordan las diferencias de género y nivel socioeconómico. Con cierta variabilidad regional en los programas, incluyen atención a grupos especialmente vulnerables como embarazadas, grupos en situación de desigualdad, enfermedad mental, también a personal modélico (sanitarios, docentes). Se utilizan también los recursos web y redes sociales dirigidos a la población e iniciativas como “Hospitales sin Humo”. Asimismo, disponen de formación dirigida a los profesionales sanitarios. También algunas organizaciones no gubernamentales realizan actividades para promover el abandono del consumo de tabaco. La ESTRATEGIA DE PROMOCIÓN DE LA SALUD Y PREVENCIÓN EN EL SISTEMA NACIONAL DE SALUD (SNS), en el marco del abordaje de la cronicidad en el SNS, recoge una serie de intervenciones para actuar sobre los principales determinantes y factores de riesgo de las enfermedades crónicas, como son el consumo de tabaco y de alcohol, el tipo de alimentación y la actividad física; introduciendo también el bienestar emocional. 1. Capacitación de la población: Web de Estilos de Vida Saludable, disponible desde noviembre de 2015. La sección de Prevención del Tabaquismo recoge también información y enlaces de interés sobre ayuda para dejar de fumar (http://www.estilosdevidasaludable.msssi.gob.es/tabaco/ayuda/home.htm). También se han elaborado materiales dirigidos a población sobre consejos de salud en estilos de vida, incluido uno sobre consumo de tabaco que se facilitará en Atención Primaria. 2. Capacitación de los profesionales sanitarios: Uno de los pilares fundamentales de la implementación de la Estrategia es el Consejo Integral sobre estilo de vida saludable en Atención Primaria vinculado a recursos comunitarios, se ha elaborado un documento donde se incluye una intervención sobre consumo de tabaco para población adulta en Atención Primaria (página 55). http://www.msssi.gob.es/profesionales/saludPublica/prevPromocion/Estrategia/Consejo_integral_EstilosVida.htm. Además, se ha desarrollado un proceso formativo on-line dirigido a todos los profesionales de Atención Primaria en metodología del cambio y Educación para la salud relacionada con un estilo de vida saludable, está acreditado y pretende ser un complemento de los programas formativos, que ya desarrollan las comunidades autónomas. 3. Implementación Local de la Estrategia: adhesión de los municipios mediante aprobación por el pleno del ayuntamiento, mesas de coordinación intersectorial y mapeo de recursos comunitarios, incluidos aquellos relacionados con tabaquismo (http://localizasalud.msssi.es/maparecursos/main/Menu.action). Por otro lado, las distintas Comunidades Autónomas disponen de programas para promover el abandono del consumo de tabaco http://www.msssi.gob.es/ciudadanos/proteccionSalud/tabaco/ayudaCCAA.htm). En general, los planes regionales se dirigen a los distintos grupos de edad y colectivos, se realizan desde diversos entornos y abordan las diferencias de género y nivel socioeconómico. Con cierta variabilidad regional en los programas, incluyen atención a grupos especialmente vulnerables como embarazadas, grupos en situación de desigualdad, enfermedad mental, también a personal modélico (sanitarios, docentes). Se utilizan también los recursos web y redes sociales dirigidos a la población e iniciativas como “Hospitales sin Humo”. Asimismo, disponen de formación dirigida a los profesionales sanitarios. Salvo algunas experiencias concretas, los tratamientos de deshabituación no se financian. También algunas organizaciones no gubernamentales realizan actividades para promover el abandono del consumo de tabaco. La ESTRATEGIA DE PROMOCIÓN DE LA SALUD Y PREVENCIÓN EN EL SISTEMA NACIONAL DE SALUD (SNS), en el marco del abordaje de la cronicidad en el SNS, recoge una serie de intervenciones para actuar sobre los principales determinantes y factores de riesgo de las enfermedades crónicas, como son el consumo de tabaco y de alcohol, el tipo de alimentación y la actividad física; introduciendo también el bienestar emocional. 1. Capacitación de la población: Web de Estilos de Vida Saludable, disponible desde noviembre de 2015. La sección de Prevención del Tabaquismo recoge también información y enlaces de interés sobre ayuda para dejar de fumar (http://www.estilosdevidasaludable.msssi.gob.es/tabaco/ayuda/home.htm). También se han elaborado materiales dirigidos a población sobre consejos de salud en estilos de vida, incluido uno sobre consumo de tabaco que se facilitará en Atención Primaria. 2. Capacitación de los profesionales sanitarios: Uno de los pilares fundamentales de la implementación de la Estrategia es el Consejo Integral sobre estilo de vida saludable en Atención Primaria vinculado a recursos comunitarios, se ha elaborado un documento donde se incluye una intervención sobre consumo de tabaco para población adulta en Atención Primaria (página 55). http://www.msssi.gob.es/profesionales/saludPublica/prevPromocion/Estrategia/Consejo_integral_EstilosVida.htm. Además, se ha desarrollado un proceso formativo on-line dirigido a todos los profesionales de Atención Primaria en metodología del cambio y Educación para la salud relacionada con un estilo de vida saludable, está acreditado y pretende ser un complemento de los programas formativos, que ya desarrollan las comunidades autónomas. 3. Implementación Local de la Estrategia: adhesión de los municipios mediante aprobación por el pleno del ayuntamiento, mesas de coordinación intersectorial y mapeo de recursos comunitarios, incluidos aquellos relacionados con tabaquismo (http://localizasalud.msssi.es/maparecursos/main/Menu.action). Por otro lado, las distintas Comunidades Autónomas disponen de programas para promover el abandono del consumo de tabaco http://www.msssi.gob.es/ciudadanos/proteccionSalud/tabaco/ayudaCCAA.htm). En general, los planes regionales se dirigen a los distintos grupos de edad y colectivos, se realizan desde diversos entornos y abordan las diferencias de género y nivel socioeconómico. Con cierta variabilidad regional en los programas, incluyen atención a grupos especialmente vulnerables como embarazadas, grupos en situación de desigualdad, enfermedad mental, también a personal modélico (sanitarios, docentes). Se utilizan también los recursos web y redes sociales dirigidos a la población e iniciativas como “Hospitales sin Humo”. Asimismo, disponen de formación dirigida a los profesionales sanitarios. Salvo algunas experiencias concretas, los tratamientos de deshabituación no se financian. También algunas organizaciones no gubernamentales realizan actividades para promover el abandono del consumo de tabaco. WHO European Region
Sri Lanka The training programs are conducted by NATA, recently launched Tobacco mCessation package The training programs are conducted by NATA, recently launched Tobacco mCessation package Answer not provided WHO South-East Asia Region
Sudan تم انشاه 13 مركز اقلاع عن التدخين في العاصمة الخرطوم تم وضع مقترح لادراج خدمات الاقلاع في خدمات الرعاية الصحية الاولية Answer not provided Report not provided WHO Eastern Mediterranean Region
Suriname Answer not provided The Bureau Alcohol and Drugs continues with programs ineducational institutions, health care facilities and workplaces to promote tobacco cessation. The Detox clinic at the Psychiatric Center is providing supportive cessation services to tobacco dependence. However, the current economic crisis is affecting the implementation of the programs as well as access to NRT. The Bureau Alcohol and Drugs continues with programs ineducational institutions, health care facilities and workplaces to promote tobacco cessation. The Detox clinic at the Psychiatric Center is providing supportive cessation services re tobacco dependence. However, the current economic crisis will affect the implementation of the programs as well as access to NRT. WHO Region of the Americas
Sweden Answer not provided Answer not provided Answer not provided WHO European Region
Syrian Arab Republic Answer not provided Answer not provided Answer not provided WHO Eastern Mediterranean Region
Tajikistan Report not provided Report not provided Report not provided WHO European Region
Thailand 1.Training of Tobacco Control Leadership program for health professional and establish a leadership training center to promote treatment of tobacco addicts. There are Smart Quit Clinics (Fah Sai Clinic), and tobacco cessation clinics in MOPH health facility service for tobacco dependence cessation. 2. Develop integrated tobacco cessation system, drafting and testing the system for tobacco cessation using 1S3C in 3 pilot areas. 3. Support and promote quitline 1600 by coordination with related authorities for exempting call charge from both fixed line and mobile call. 4. Successfully implement tobacco cessation service & smoke-free policy in the prison & correctional institutions nationwide. 5. Successfully made “varenicline” available free-of-charge for smokers under social security funds nationwide. Training of Tobacco Control Leadership program for health professional and establish a leadership training center to promote treatment of tobacco addicts. There are 272 “Fah Sai (clear sky) clinic”, and 555 tobacco cessation clinics in MOPH health facility service for tobacco dependence cessation. Develop integrated tobacco cessation system, drafting and testing guideline for tobacco cessation using 1S3C in 3 pilot area. Support and promote quitline 1600 by coordination with related authorities for exempting call charge from both fixed line and mobile call. Making proposal to include NRT into national health security system and national essential drug list. Training of Tobacco Control Leadership program for health professional and establish a leadership training center to promote treatment of tobacco addicts. There are 272 “Fah Sai (clear sky) clinic”, and 555 tobacco cessation clinics in MOPH health facility service for tobacco dependence cessation. Develop integrated tobacco cessation system, drafting and testing guideline for tobacco cessation using 1S3C in 3 pilot area. Support and promote quitline 1600 by coordination with related authorities for exempting call charge from both fixed line and mobile call. Making proposal to include NRT into national health security system and national essential drug list. WHO South-East Asia Region
The former Yugoslav Republic of Macedonia Answer not provided Answer not provided Answer not provided WHO European Region
Timor-Leste Answer not provided Answer not provided Report not provided WHO South-East Asia Region
Togo Answer not provided Answer not provided Answer not provided WHO African Region
Tonga Ongoing provision of quitline services and supports to those who wanted to quit through quitline calls or through referral from other health facilities or community services. Ongoing provision of quitline services and supports to those who wanted to quit through quitline calls or through referral from other health facilities or community services. Tonga established its cessation programs for the very first time including a quitline services with a toll free number, and provision of one-to-one and group counseling programs. This will be launched together with the mass media campaign in May 31, 2016. WHO Western Pacific Region
Trinidad and Tobago Please note, bupropion does exist on the local formulary and is legally available but at this time, it is not available for treating tobacco dependence. At present discussions are underway for a renewal in the supply of bupropion through the National formulary specifically for tobacco dependence. Answer not provided Answer not provided WHO Region of the Americas
Tunisia Answer not provided Stabilisation du nombre de fumeurs désirant arrêter depuis 2011 (situation post révolution stressante) Stabilisation du nombre de fumeurs désirant arrêter depuis 2011 (situation post révolution stressante) WHO Eastern Mediterranean Region
Turkey A quit line for public is available for 24 hrs per day countrywide. Moreover, physicians at the primary health care level have been trained on smoking cessation to give brief counselling to smokers. In 2018-2019 921 physicians have been trained by online training followed by formal and practical one to work in cessation clinics. The number of Cessation Clinics increased to 537. A quit line for public is available for 24 hrs per day countrywide. Moreover, physicians at the primary health care level have been trained on smoking cessation to give brief counselling to smokers. Physicians and health workers have also been trained by online training followed by formal and practical one. The number of Cessation Clinics increased to 415 A quit line for public is available for 24 hrs per day countrywide. Moreover, physicians at the primary health care level have been trained on smoking cessation to give brief counselling to smokers. Physicians and health workers have also been trained by online training followed by formal and practical one. The number of Cessation Clinics increased to 415 WHO European Region
Turkmenistan В стране открыто 9 центров «Доверие» по консультированию отказа от курения. Также на базах психоневрологических диспансеров есть палаты для лечения табачной зависимости. В стране открыто 14 центров «Доверие» по консультированию отказа от курения. Также на базах психоневрологических диспансеров есть палаты для лечения табачной зависимости. В 2015 году был открыт специализированный реабилитационный центр для лечения различных зависимостей, включая табачную зависимость WHO European Region
Tuvalu Answer not provided Report not provided Report not provided WHO Western Pacific Region
Uganda Report not provided Report not provided Answer not provided WHO African Region
Ukraine Cessation quitline was established in 2017, but its capacity is very limited (just two part-time counsellors) Cessation quitline was established in 2017, but its capacity is very limited (just two part-time counsellors) No progress WHO European Region
United Arab Emirates يتم صرف الأدوية مجاناً لمواطني دولة الإمارات أما غير المواطنين يدفعون قيمة العلاج Answer not provided Answer not provided WHO Eastern Mediterranean Region
United Kingdom of Great Britain and Northern Ireland Nicotine replacement therapy such as patches and gum continue to be available free of charge from GPs and local stop smoking services. All non-licenced e-cigarettes, sold as consumer products, are subject to strengthened regulatory controls under the Tobacco and Related Products Regulations 2016 and continue to be available to buy from retailers for smokers who wish to use them to help them quit smoking. NRT is widely available, and sales tax continues to be the lowest amount permissible to encourage use. The Government has undertaken to work in collaboration with the public health community to consider what more can be done to help tobacco users who cannot quit, or who are unwilling to, to substitute alternative safer sources of nicotine, such as NRT, for tobacco. In support of this, the National Institute for Health and Clinical Excellence has produced public health guidance on the use of harm reduction approaches to smoking cessation. NRT such as patches and gum are available free of charge from GPs and local stop smoking services. The Medicines and Healthcare Products Regulatory Agency (MHRA licenced its first e-cigarette in November (2016). The manufacturers have yet to bring this product to market. All non-licenced e-cigarettes, sold as consumer products are subject to strengthened regulatory controls under the European EU Tobacco Products Directive and continue to be available to buy from retailers for smokers who wish to use them to help them quit smoking. Following a review by the Medicines and Healthcare Products Regulatory Agency (MHRA) in 2005, NRT can now be used by adolescents aged 12 and over, pregnant women and people with cardiovascular disease. Full details of the report can be found on the MHRA website : www.mhra.gov.uk/home/groups/pla/documents/websiteresources/con2023239.pdf NRT is widely available, and sales tax has been reduced to the lowest amount permissible to encourage use. The Government has undertaken to work in collaboration with the public health community to consider what more can be done to help tobacco users who cannot quit, or who are unwilling to, to substitute alternative safer sources of nicotine, such as NRT, for tobacco. In support of this, the National Institute for Health and Clinical Excellence has produced public health guidance on the use of harm reduction approaches to smoking cessation. NRT such as patches and gum are also available free of charge from GPs and local stop smoking services. The Medicines and Healthcare Products Regulatory Agency (MHRA licenced its first e-cigarette in November (2016). It is anticipated that it will be on the market next year and available for local stop smoking services and GPs to prescribe. All non-licenced e-cigarettes, sold as consumer products will be subject to strengthened regulatory controls under the European EU Tobacco Products Directive from May 2016 and will continue to be available to buy from retailers for smokers who wish to use them to help them quit smoking. Following a review by the Medicines and Healthcare Products Regulatory Agency (MHRA) in 2005, NRT can now be used by adolescents aged 12 and over, pregnant women and people with cardiovascular disease. Full details of the report can be found on the MHRA website : www.mhra.gov.uk/home/groups/pla/documents/websiteresources/con2023239.pdf NRT is widely available, and sales tax has been reduced to the lowest amount permissible to encourage use. The Government has undertaken to work in collaboration with the public health community to consider what more can be done to help tobacco users who cannot quit, or who are unwilling to, to substitute alternative safer sources of nicotine, such as NRT, for tobacco. In support of this, the National Institute for Health and Clinical Excellence has produced public health guidance on the use of harm reduction approaches to smoking cessation. The National Institute for Health Research is currently funding a randomised controlled trial to examine the efficacy of e-cigarettes compared with nicotine replacement therapy, when used within the UK stop smoking service. The report of the trial is expected to be published in 2018. WHO European Region
United Republic of Tanzania We have trained 20 ToTs on cessation programs, but there is very limited access to cessation services provided in specialized clinics. We have trained 20 ToTs on cessation programs, but there is very limited access to cessation services provided in specialized clinics. We have trained 20 ToTs on cessation programs, but there is very limited access to cessation services provided in specialized clinics. WHO African Region
Uruguay Answer not provided Answer not provided Answer not provided WHO Region of the Americas
Uzbekistan Report not provided Report not provided В Узбекистане следующие никотин заместительные препараты зарегистрированы Главным управлением по контролю качества лекарственных средств и медицинской технике Министерства: - никвитин (Niquitin) Nicotine, - нико-нет (Nico-Net) Nicotine, - никоретте (Nicorette) Nicotine, - табекс (Tabex) Cytisine, - чампикс (Champix) Varenicline. Эти препараты свободно реализуются в аптечной сети. WHO European Region
Vanuatu Available at own cost from private pharmacies only. Starting to train health care workers in primary health care on brief tobacco cessation intervention. Report not provided Available at own cost from private pharmacies only. Starting to train health care workers in primary health care on brief tobacco cessation intervention. WHO Western Pacific Region
Venezuela La República Bolivariana de Venezuela, a traves del Ministerio del Poder Popular para la Salud continua fortaleciendo la accion de cesación tabáquica, la cual se ha venido implementando desde los años 80, mediante la capacitación permanente a personal de salud en técnicas para ayudar a los pacientes a dejar de fumar. Actualmente se encuentran funcionando las unidades de cesación tabaquica a nivel nacional, dedicadas a la atencion de estos pacientes. y contamos con la Norma Oficial del Programa Antitabáquico con el objetivo de garantizar una atención integral para fumadores (as) y de obligatorio cumplimiento en todo el sistema público nacional de salud. Adicionalmente, contamos con el Sistema Nacional de Tratamiento en Adicciones y su infraestructura está insertada en todo el Sistema Público Nacional de Salud. Report not provided Report not provided WHO Region of the Americas
Viet Nam Established the tobacco counseling and voluntary cessation center in 9 hospitals and one hotline service 1800- 6606 Established the tobacco counseling and voluntary cessation center in 6 hospitals and one hotline service 1800- 6606 Established the tobacco counseling and voluntary cessation center in 6 hospitals and one hotline service 1800- 6606 WHO Western Pacific Region
Yemen Answer not provided Answer not provided Answer not provided WHO Eastern Mediterranean Region
Zambia Answer not provided Answer not provided Answer not provided WHO African Region
Zimbabwe Counseling is the most common intervention in this area Counseling is the most common intervention in this area Answer not provided WHO African Region
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Survey answers in 2020

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