mcessation and its role in national tobacco cessation and treatment system
TRANSCRIPT
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20161 |
mCessation and its role in national tobacco cessation
and treatment system
Dongbo FuTobacco Free Initiative
World Health Organization
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20162 |
Outline
What is mCessation?What are key components of a national
tobacco cessation and treatment system?How mCessation can be used to strengthen
national tobacco cessation and treatment system?
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20163 |
What is Mobile cessation
(mCessation)?
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20164 |
mCessation
Tobacco cessation interventions delivered by mobile phones– Mainly for tobacco users who want to
quit– Mainly via mobile text messaging
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20165 |
mCessation
Started as adjuncts to quit lines and Internet quit coaches
– New Zealand Quitline 'Txt2quit' programme– UK NHS Stop Smoking Service's 'Together'
programme – U.S. National Cancer Institute's smokefree TXT
programme
Standalone programme: – Costa Rica, Tunisia, India, the Philippines
Source: Whittaker R, et al. Mobile phone based interventions for smoking cessation, Cochrane Review 2012
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20166 |
Evidence
Smartphone applications
Mobile phone-based + Internet-based
Mobile phone-based
• There are no published studies on smartphone applications designed to help people stop smoking
• A combined internet-mobile phone programme is effective up to 12 months (RR 2.03, 95% CI 1.40 to 2.94)
• Combined evidence from 12 studies
• 6 month quit rate compared with control group (RR 1.67, 95% CI 1.46 to 1.90, over 11,000 participants)
Sources: 1. Cochrane review Whittaker 2016 2. Cochrane review Whittaker 2009
● Efficacy
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20167 |
Evidence
One analysis of txt2stop, a UK-based intervention, indicates that it was cost-effective
• Cost per quitter for telephone counselling: £895
• Cost per quitter: £278• Gain: 0.3 life years per
quitter; or 0.5 quality adjusted life years per quitter
Source: Guerriero 2012
● Cost-effectiveness
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20168 |
What are key components of a national tobacco
cessation and treatment system?
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20169 |
The WHO FCTC Article 14 guidelines recommend that
all Parties should aim to develop a comprehensive
tobacco cessation and treatment system
What support we should offer tobacco users to quit?
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201610 |
key components of a treatment system recommended by Article 14 guidelines
Population-level approaches– Mass communication– Brief advice– Quit lines
Intensive individual approaches– Specialized tobacco dependence treatment
MedicationsNovel approaches and media
– Cellphone text messaging
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201611 |
How mCessation can be used to
strengthen national tobacco cessation
and treatment system?
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201612 |
Evaluating the impact of tobacco cessation programmes
(Reach x Efficacy) x (Adoption x Implementation x Maintenance) = Impact
Source: Glasgow, RE, Vogt, TM, Boles, SM. Evaluating the public health impact of health promotion interventions: The RE-AIM framework. Am J Public Health 1999;89(9):1322–1327.
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201613 |
Source: WHO report on the global tobacco epidemic, 2015
24 countries provide comprehensive tobacco dependence treatment
97 countries providing tobacco cessation support in most or some PHC facilities, and fully or partially cost-covered
61 countries provide national toll-free tobacco quit line services
The reach of cessation programmes is low
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201614 |
mCessation has the potential to reach a large number of tobacco users
Mobile phones are a new channel for individualized information to be delivered inexpensively wherever the person is located:
– Worldwide: mobile cellular subscriptions will reach almost 7 billion (a penetration rate of 96%) by end of 2014.
– In developing countries: mobile-cellular penetration will reach 90% by end 2014; the number of mobile cellular subscriptions will account for 78% of the world’s total.
Source: The World in 2014: ICT Facts and Figures
ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201615 |
mCessation has the potential to reach a large number of tobacco users
The potential benefits of mobile phone-based smoking cessation interventions:
– The ease of use anywhere at anytime;– Cos-effective delivery and scalability to large populations
regardless of location– Reaching vulnerable populations who may be at risk of
smoking and who may have difficulty accessing traditional cessation services (such as adolescents and young tobacco users).
Sources: 1.Whittaker R, et al. Mobile phone based interventions for smoking cessation, Cochrane Review 2012; 2. Kong G, et al. Text messaging-based smoking cessation intervention: A narrative review 2014.
Thank you for your attention