In the decade since the adoption of the FCTC, we have seen significant progress in the area of tobacco control policies that have helped decrease smoking prevalence.
We have also seen increased demand in cessation support, in the form of a short intervention by a health care provider, counselling, or other treatment modality.
However, medical practitioners and tobacco cessation specialists express the concern: “It is so difficult for a smoker in my country to have access to quitting support once they make the move to quit.” This is typically followed by “so they often give up and keep on smoking because it is cheaper for them in the short term.”
A number of global health governance tools and global advocacy opportunities can help secure resources for tobacco treatment at the local level.
The medical community can help advocate at the national and global levels.
This advocacy can create a global mechanism that will help secure resources for treatment and reach the objectives set by the UN Summit on Non Communicable Diseases.
Following the UN Summit in Sept 2011, the World Health Assembly adopted a global target calling for a 25% reduction in preventable deaths from NCDs by 2025.
Given tobacco is a leading risk factor for NCDs, this target can be achieved only if we address the tobacco epidemic through a number of interventions such as a ban on tobacco product advertising, tax and price measures to reduce smoking prevalence, smoke free policies and ensuring that smokers have access to treatment.
We expect that in September, a target will be approved demanding a 30% reduction in global smoking prevalence by 2015.
We need to use these targets in all of our advocacy efforts as we hold our governments accountable to these commitments.
The upcoming 5th Conference of the Parties (COP5) of the FCTC (November 2012) in Seoul, Korea, provides a unique opportunity to address the lack of resources for tobacco control, including resources for the treatment of tobacco dependence.
The meeting will provide more than 170 governments a platform to discuss and explore solutions to address the lack of resources for implementation of tobacco control measures.
It is crucial that governments agree at COP5 to set up a process that reviews the barriers countries face and develop solutions to address them.
The FCA proposes that governments move forward with the development of a working group that will review the implementation of the treaty, review mechanisms of assistance for implementation of the treaty, and identify implementation challenges as well as provide assistance to overcome them.
Another problem we face is that Non Communicable Diseases (NCDs ) — which include Cardiovascular, Cancer and Chronic Lung Diseases, for which tobacco is the leading risk factor — are absent from the development agenda and global development goals such as the Millennium Development Goals (MDGs).
This has led to a lack of resources for treatment of tobacco addiction from the major development agencies such as USAID, CIDA, DFID and other major development donors.
The MDGs are up for review as they expire in 2015, and this process, along with the outcomes of the UN Summit on NCDs, provides a unique opportunity to address the lack of treatment resources.
Our strategy should be to move from a current over- dependence on philanthropic funding to development aid in countries that need it, followed by fiscal independence at the national level for tobacco control programs through taxation of tobacco products.
There are examples from other fields that could be applied to tobacco in the area of development and prevention of NCDs.
There is an interesting example from Sweden, where they are attempting to move from only addressing pathogenesis to addressing salutogenesis.
Sweden found it to be cost effective to implement interventions through the medical community that encourages sedentary individuals to change their behaviour and exercise.
When a patient visits a doctor, they are asked if they exercise, frequency, intensity etc…
If the patient says they do not exercise, then a referral is made to a motivational therapist, a personal trainer, etc…
Based on the success of these interventions, they developed a pilot program through the Swedish Development Agency, and funds were made available to start a similar project in Vietnam.
These types of programs could be developed for tobacco control by integrating cessation measures along with other tobacco control measures in the development agenda of donor agencies.
For this to happen, the medical community will need to advocate in both donor countries as well as low and middle countries.
The medical community can engage in these processes by staying attuned to the development of the FCTC COP campaigns.