Poco, Jovic Miguel B.

MD 1Y2-1

SMOKING CESSATION PROGRAM

Rationale:

The use of tobacco continues to be a major cause of health problems worldwide. There
is currently an estimated 1.3 billion smokers in the world, with 4.9 million people dying
because of tobacco use in a year. If this trend continues, the number of deaths will
increase to 10 million by the year 2020, 70% of which will be coming from countries like
the Philippines. (The Role of Health Professionals in Tobacco Control, WHO, 2005)

The World Health Organization released a document in 2003 entitled Policy

Recommendations for Smoking Cessation and Treatment of Tobacco Dependence. This
document very clearly stated that as current statistics indicate, it will not be possible to
reduce tobacco related deaths over the next 30-50 years unless adult smokers are
encouraged to quit. Also, because of the addictiveness of tobacco products, many
tobacco users will need support in quitting. Population survey reports showed that
approximately one third of smokers attempt to quit each year and that majority of these
attempts are undertaken without help. However, only a small percentage of cigarette
smokers (1-3%) achieve lasting abstinence, which is at least 12 months of abstinence
from smoking, using will power alone (Fiore et al 2000) as cited by the above policy
paper.

The policy paper also stated that support for smoking cessation or “treatment of tobacco
dependence” refers to a range of techniques including motivation, advise and guidance,
counseling, telephone and internet support, and appropriate pharmaceutical aids all of
which aim to encourage and help tobacco users to stop using tobacco and to avoid
subsequent relapse. Evidence has shown that cessation is the only intervention with the
potential to reduce tobacco-related mortality in the short and medium term and therefore
should be part of an overall comprehensive tobacco-control policy of any country.

The Philippine Global Adult Tobacco Survey conducted in 2009 (DOH, Philippines GATS
Country Report, March 16, 2010) revealed that 28.3% (17.3 million) of the population
aged 15 years old and over currently smoke tobacco, 47.7% (14.6 million) of whom are
men, while 9.0% (2.8 million) are women. Eighty percent of these current smokers are
daily smokers with men and women smoking an average of 11.3 and 7 sticks of cigarettes
per day respectively.

The survey also revealed that among ever daily smokers, 21.5% have quit
smoking. Among those who smoked in the last 12 months, 47.8% made a quit attempt,
12.3% stated they used counseling and or advise as their cessation method, but only
4.5% successfully quit. Among current cigarette smokers, 60.6% stated they are
interested in quitting, translating to around 10 million Filipinos needing help to quit
smoking as of the moment. The above scenario dictates the great need to build the
capacity of health workers to help smokers quit smoking, thus the need for the
Department of Health to set up a national infrastructure to help smokers quit smoking.

The national smoking infrastructure is mandated by the Tobacco Regulations Act which
orders the Department of Health to set up withdrawal clinics. As such DOH Administrative
Order No. 122 s. 2003 titled The Smoking Cessation Program to support the National
Tobacco Control and Healthy Lifestyle Program allowed the setting up of the National
Smoking Cessation Program.

Vision: Reduced prevalence of smoking and minimizing smoking-related health risks.

Mission: To establish a national smoking cessation program (NSCP).

Objectives:

The program aims to:

1. Promote and advocate smoking cessation in the Philippines; and

2. Provide smoking cessation services to current smokers interested in quitting the

habit.

Program Components:

The NSCP shall have the following components:

1.Training

The NSCP training committee shall define, review, and regularly recommend training
programs that are consistent with the good clinical practices approved by specialty
associations and the in line with the rules and regulations of the DOH.

All DOH health personnel, local government units (LGUs), selected schools, industrial
and other government health practitioners must be trained on the policies and guidelines
on smoking cessation.
2. Advocacy

A smoke-free environment (SFE) shall be maintained in DOH and participating non-DOH

facilities, offices, attached agencies, and retained hospitals. DOH officials, staff, and
employees, together with the officials of participating non-DOH offices, shall participate
in the observance and celebration of the World No Tobacco Day (WNTD) every 31 st of
May and the World No Tobacco Month every June.

3. Health Education

Through health education, smokers shall be assisted to quit their habit and their
immediate family members shall be empowered to assist and facilitate the smoking
cessation process.

4. Smoking Cessation Services

5. Research and Development

Research and development activities are to be conducted to better understand the

nature of nicotine dependence among Filipinos and to undertake new pharmacological
approaches.
Poco, Jovic Miguel B.
MD 1Y2-1

A. Based on your own appreciation of your chosen health program, write

description of its objectives and strategies.

The program aims to promote smoking cessation for smokers in the

country through helping those smokers who wants to quit smoking for this
could minimize the risk of having diseases because of smoking. The
program also focuses on creating a successful smoking cessation
program for future quitters.

The program would promote smoking cessation through making

DOH and participating non-DOH facilities, offices, attached agencies, and
retained hospitals to a smoke-free environment and they shall participate
in the celebration of the World No Tobacco Day every May 31 and the
World No Tobacco Month every June.

The objectives can also be achieved through health education

wherein the smoker’s family shall be educated about the cessation
process and the smoker shall be assisted throughout the whole process.

There is already a National Smoking Cessation Framework

detailing Smoking Cessation services at different levels of care and further
research is being done for the continuous development of the program
and its services.

B. Discuss the importance of the implementation of this program.

The implementation of this program is important because based on

what I have read, smoking is one of the leading causes of health problems
in the world. And even if smokers do want to quit, most of them failed in
quitting completely. This program is significant for both smokers and non-
smokers. This is important for smokers because this gives them a way for
them to quit smoking entirely and this program raises awareness for the
positive effects of smoking cessation. For those people who are non-
smokers, when there are less people smoking, there is also a lesser
chance of one inhaling 2nd hand smoke from tobacco. So having less
people smoking could help in the overall wellbeing of the country and its
people.
C. Who will be its target beneficiaries and who will be involved in its
implementation?

The national smoking infrastructure is mandated by the Tobacco

Regulations Act which orders the Department of Health to set up
withdrawal clinics. As such DOH Administrative Order No. 122 s. 2003
titled The Smoking Cessation Program to support the National Tobacco
Control and Healthy Lifestyle Program allowed the setting up of the
National Smoking Cessation Program. The target beneficiaries of this
program would be the people who are smoking and those smokers that
would want to quit smoking entirely. Institutions with Primary, Secondary
or Tertiary level of care can have smoking cessation services and services
increase from primary to tertiary level.

D. Using the internet and other relevant resources research on the possible
problems or loopholes on the implementation of this program.

Based on an article on the American College of Cardiology website,

there are many barriers to implementing smoking cessation in patients.
One of those barriers is the patient itself, if the person is simply not
motivated to stop smoking. Having programs for helping people to quit
smoking is useless especially for those people who do not want to quit at
the first place. It is also stated in the article that current era patients are
well aware of the harms of tobacco usage, but they still have little
motivation to quit.

E. Recommend possible solutions to these problems.

For this problem, I think the government should not stop. They
should not stop in raising awareness for the harms of tobacco usage.
They should not stop in finding ways on how to convince people to stop
and quit smoking. Because if they did not stop there will come a time
where people would control their usage of tobacco and where people
could just quit smoking without having too much of a challenge in doing so
successfully.