Tobacco control and Healthcare professionals – growing future leaders
Prof Luke Clancy, Director GeneralTobaccoFree Research Institute Ireland, Dublin
6 June 2014, Riddel Hall, Belfast
What can HCPs do for TC?
Leadership
Advocacy
Research
Education
Networks
Collaboration
Leadership
Position
Institutional
Organisational
Leadership
Position
Power-to convene
Power-to encourage
Power-to resource
Leadership
Individual- sense of mission, passion
LeadershipPassion is not enough
Commitment
Compassion
Competence
Capacity
Confidence
Leadership
Individual• Imagination to Innovate
• Competence to perform
• Openness to Collaborate
• Understanding the need for Perseverance
Understanding Advocacy Roles
Governments/Institutions adopt policies in a climate of public readiness
Public health advocates need to shift public opinion in the right direction
Political action becomes compelling
Political inaction becomes a liability
Smokefree Success Factors
Sustained consistent simple health message
Sustained political leadership/commitment
Partnership – Health alliance, OTC, DOHC
Cross party political support
Trade union support
“I believe that in every decade, we are presented with one major choice - a choice where, if we call it right, we change the future for the better.”
Micheál Martin TD, Minister for Health and Children, 2003
Irish Independent, Sat 10 April 2004
Imitation is the sincerest form of flattery
Exemptions allowed. Does not give protection against the harmful effects of SHS
Total ban including bars and restaurants Closely in line with Article 8 moking rooms allowed but only under strict criteriaWorkers and public unprotected
NORTH SEA
ATLANTIC OCEAN
MEDTERRANEAN SEA
Denmark
Finland
Poland
France
Germany
Spain
Portugal
Greece
ItalyTurkey
Switzer/land
Autstria
Estonia
Latvia
Lithuania
Belarus
Ukraine
RomaniaHungary
Slovakia Moldova
Bulgaria
Russia
Ireland
Great Britain
Serbia
Albania
Norway
Luxembourg
Malta
Slovenia
Nether-lands
BelgiumCzechRepublic
Research Strategy
• Control Policy not underpinned by Research-2nd Class
• Policy not evidence based not convincing
and not credible
• R & D or wither
TFRI
OTC
ICSIFH
Ash
Promote interest in Tobacco Research
• Identify key people
• Identify key Institutions
• Create an inventory of current Tobacco related research in Irish Institutions
What Type of Research
Health Effects
Exposure Assessments
Prevention
Intervention
Resource Needs
• Human• Do we have the necessary scientists• Research Training• Recruitment and Retention
• Financial• Quantum• Accessibility• Continuity
Global Tobacco Control is
Underfunded
•Globally, tobacco tax revenues are 500 times higher than spending on tobacco control•In low- and middle-income countries, tax revenues are 5,000 times higher
TC Research in the Netherlands• Universities
– Fundamental research– Testing new programs
• Stivoro– Testing effects of their campaigns
• RIVM– Testing cost-efficacy
• Funding:– ZONMW, The Netherlands Organisation for Health, Research and
Development. – Dutch Cancer Society– Dutch Asthma Fund– Dutch Heart Foundation
Research Projects re Ban
• Exposure assessment
• Media campaign
• Pharmacoeconomics
• Influence on adult smoking rates
• Effect on children's smoking
Research Opportunities
• Healthcare• Economics• Marketing• Advertising • Communications• Legal• Tax
Research Collaboration
• Pat Goodman- DIT, Kevin St• Michele Agnew-DIT, St James• Marie McCaffrey-HSE,DIT• Gillian Paul-TCD• Shane Allwright-TCD• Jim McLaughlin-UCD NUI• Kevin Kelleher-UCD NUI• Colin Todd-UCD NUI
Future
• Economics-Macro, Pharmaco.,
• Marketing-ICT
• Exposure-Exempted areas, Special situations
• Health effects-Resp., CVS, Cancer
• Attitudes in children
• Cross- border
• International
Education
Provide
University Focus
Tobacco Related Studies
Formal training on smoking cessation approaches varied between regions, but remains
lowThose who have had formal training on smoking cessation approaches
30.2
53.9
41.9
41.7
19.2
38.5
West
Med
Scan
Cent/E
Balt
All
Ref: Table 3
Percent (%)
General Practioners and the Economics
of Smoking Cessation in Europe (PESCE)
Policy recommendations
3. Structural Factors
TimeGPs perceive that smoking cessation ‘takes too long’
(32%-74% in different studies)
Education and trainingLack of training associated with low cessation activity in some
studies (more training=more cessation activity in other studies)
ReimbursementStudies find mixed results on whether GPs perceive lack of
reimbursement as a barrier (7%-64% across several studies)
PESCE 2008
European Standards for Accreditation of Tobacco Cessation Services
and of Training in Tobacco Cessation
Luke Clancy
Brussels 3rd October 2012
Social inequalitiesEducation
Occupation
Income
Health care
Disease prevention
Health promotion services
Public policies influencing the quantity, quality
and distribution of these Factors
Living conditions
Health related behaviours
Reducing inequalities through linking up with other policies.
• Smoking related to social position.• Tobacco control aimed at smoking has limited
effect among disadvantaged communities.• Specific tobacco control measures are not
effective.• Effects are larger when combined with policies
aimed to improve quality of life.
Networks
Respiratory PhysicianMedical Director St James President IUATLD-Euro regionChairman Medical Board SJHChairman Clinicians in Management in IrelandChairman ASH IrelandPresident European Network Smoking PreventionChairman Tobacco Control Committee (European Respiratory Society)
Success of Tobacco Control
Framework Convention for Tobacco Control is not enough
Politics
Corruption, Greed, Indifference
Politics
• “the pursuit and exercise of power—in the interest of those who pursue and exercise it”
Plato dialogues
Advantages of using HCP in TC
• Moral authority• Information• Public support• A champion• Persistence• Consistency