The Need for Tobacco Dependence Treatment

Tobacco dependence treatment can substantially reduce the huge global death toll from tobacco in the near future.  The World Health Organization’s Framework Convention on Tobacco Control recognizes the right of dependent tobacco users to receive treatment.  Evidence clearly indicates that treatment of tobacco dependence is both effective and cost-effective.  Simple advice from a clinician increases quitting and more intense interventions including counseling and/or medication further increase the likelihood of success.  Given the devastating impact of tobacco and the reported desire by most tobacco users to quit, it is of particular concern that approximately 95% of the world’s population has little or no access to treatment.  High-income countries are far more likely to offer comprehensive cessation services than are middle- or low-income countries, but even in high-income countries the situation typically is far from ideal especially for traditionally underserved populations.  Needed is a sustainable, comprehensive, and affordable approach to delivery of tobacco dependence treatment services.   Trained lay interventionists can deliver effective counseling at minimal cost.  Telephone support and text messaging can be delivered inexpensively through cell phones.  Physicians and other highly regarded professionals can be enlisted as nontobacco role models. Inexpensive medications may be available including generic products and those manufactured locally.  In many countries, infrastructure can be put in place to support provision of services through existing healthcare systems.  Universal accessibility of effective treatments is both a public health imperative and an ethical and moral obligation.