Tobacco cessation has, for the very first time, figured in the State’s health action plan as policy makers acknowledge that the high prevalence of tobacco use could be contributing to the State’s increasing burden of non-communicable diseases (NCDs).
The Health Department has decided to incorporate tobacco cessation counselling and sensitisation as a major activity within the primary care health system as Kerala launches its NCD control programme across 14 districts.
“For the first time, we are taking up tobacco as a key issue to be tackled within the health system as tobacco is the single common factor contributing to the increasing incidence and morbidity of all major NCDs prevalent in the State. The department will take up the initiative by linking it with the NCD control programme,” A.S. Pradeepkumar, Additional Director of Health Services (Public Health), said.
Clinics and counselling
Tobacco cessation counselling services and clinics will be started immediately in 3,000 to 5,000 sub-centres in all 14 districts. These will be weekly clinics attached to the NCD clinics. The department intends to back up the clinical services with a host of awareness programmes on tobacco hazards and its link to NCDs.
In Kerala, the prevalence of current smoking among men above 15 years is estimated to be 36% compared with 33% in India as a whole (2009). Approximately 10 per cent of adult men in Kerala use smokeless tobacco.
The department has started a training programme for doctors and health workers on tobacco hazards and running tobacco cessation programmes. About 230 doctors and 480 health workers were given training last week.
The Health Department is aided in this exercise by the Achutha Menon Centre for Health Science Studies (AMCHSS), the public health wing of Sree Chitra Tirunal Institute for Medical Sciences and Technology, the Regional Cancer Centre and Kottayam-based Kerala Voluntary Health Services, whose doctors and researchers are the key trainers.
Even though smoking and use of other forms of tobacco have been recognised as a major public health issue, governments’ efforts at reducing tobacco use among the public have focussed mostly on the taxation side. Linking tobacco to the NCD control programme is thus a pro-active public health intervention by the Health Department.
“There are many who would like to stop the use of tobacco, if only we could give them some support. There are few tobacco cessation counselling or clinical services in the State,” Dr. Pradeep pointed out.
Tobacco cessation is not very easy and, according to studies, the quit rate at population level in India is only about two per cent.
“There are only about 20 tobacco cessation clinics run by the WHO in India. But the community therapy and trained health workers can play a crucial role in helping those addicted to tobacco quit the habit,” says K.R. Thankappan, Professor and Head of AMCHSS.
As yet another World No Tobacco Day arrives on May 31, the State Health Department is unrolling a massive tobacco cessation initiative covering all the 14 districts, writes C. Maya