On July 2, 2024, the World Health Organization (WHO) released its first-ever clinical treatment guideline for tobacco cessation in adults. This landmark document provides comprehensive recommendations to help the more than 750 million tobacco users worldwide who want to quit. The guidelines include behavioral support, digital cessation interventions, and pharmacological treatments.
The Scope of the Guideline
A Comprehensive Approach
The WHO guideline emphasizes a multifaceted approach to tobacco cessation. It is designed to assist all adults seeking to quit various tobacco products, including cigarettes, waterpipes, smokeless tobacco, cigars, roll-your-own tobacco, and heated tobacco products (HTPs). The recommendations are grounded in extensive research and aim to provide practical, accessible solutions for individuals and health systems alike.
The Global Burden of Tobacco Use
Over 60% of the world’s 1.25 billion tobacco users, or more than 750 million people, express a desire to quit. However, 70% of these individuals lack access to effective cessation services. This significant gap highlights the need for comprehensive, accessible cessation programs to address the global burden of tobacco-related diseases.
Key Recommendations
Behavioral Support
WHO recommends integrating behavioral support into health-care settings. This includes brief counseling sessions, lasting from 30 seconds to three minutes, routinely offered by health workers. For those interested, more intensive behavioral support is available through individual, group, or phone counseling. These interventions are crucial for providing immediate and ongoing support to individuals attempting to quit tobacco.
Digital Cessation Interventions
Digital tools are also recommended as part of the cessation strategy. These include text messaging, smartphone apps, and internet programs, which can serve as adjuncts or self-management tools. Digital interventions provide a flexible, scalable option for reaching a wide audience, especially in regions where traditional healthcare services may be limited.
Pharmacological Treatments
Combining pharmacotherapy with behavioral interventions significantly increases the success rates of quitting tobacco. WHO recommends the use of varenicline, Nicotine Replacement Therapy (NRT), bupropion, and cytisine as effective pharmacological treatments. These medications can help reduce withdrawal symptoms and cravings, making it easier for individuals to quit.
Challenges and Solutions
Resource Limitations in Health Systems
One of the major challenges to effective tobacco cessation is the resource limitations faced by health systems, particularly in low- and middle-income countries. The WHO guideline encourages countries to provide cessation treatments at no or reduced cost to improve accessibility. This recommendation aims to ensure that financial barriers do not prevent individuals from accessing the help they need.
The Struggle to Quit
Quitting tobacco is a significant challenge for many individuals. Dr. Rüdiger Krech, Director of Health Promotion at WHO, emphasizes the immense struggle people face when trying to quit smoking. He calls for a deep appreciation of the strength and suffering endured by individuals and their loved ones during this process. The guidelines are designed to provide the best possible support to those on this challenging journey.
Improving Access to Effective Therapies
Prequalification Procedure for Medicinal Products
In 2023, WHO initiated a prequalification procedure for medicinal products to treat disorders caused by tobacco use. This process aims to improve global access to recommended tobacco cessation medications. In April 2024, Kenvue’s nicotine gum and patch became the first WHO-prequalified NRT products. This milestone is expected to enhance the availability and affordability of effective cessation therapies worldwide.
Encouraging Adoption and Implementation
WHO encourages healthcare providers, policymakers, and stakeholders to adopt and implement the guideline to promote tobacco cessation. By doing so, they can improve the health of millions of people worldwide. The guideline serves as a critical tool for countries to support individuals in quitting tobacco and alleviating the global burden of tobacco-related diseases.
The Role of Healthcare Providers
Routine Counseling and Support
Healthcare providers play a crucial role in tobacco cessation efforts. By offering routine counseling and support, they can help individuals navigate the quitting process. Brief interventions during regular health-care visits can have a significant impact, providing the necessary encouragement and guidance for those attempting to quit.
Intensive Behavioral Support
For individuals requiring more support, healthcare providers can offer intensive behavioral interventions. These can include individual counseling sessions, group therapy, or phone counseling. Such interventions provide ongoing support and motivation, which are essential for maintaining long-term abstinence from tobacco.
The Importance of Digital Interventions
Accessibility and Flexibility
Digital interventions offer a flexible and accessible option for tobacco cessation. Tools such as text messaging, smartphone apps, and internet programs can reach a broad audience, providing support and resources at any time. These tools are particularly valuable in areas where traditional healthcare services may be less accessible.
Integration with Other Treatments
Digital interventions can enhance the effectiveness of behavioral and pharmacological treatments when used together. By integrating digital tools into a comprehensive cessation strategy, individuals can receive continuous support and monitoring, improving their chances of successfully quitting tobacco.
Conclusion
The WHO’s first-ever clinical treatment guideline for tobacco cessation represents a significant milestone in the global fight against tobacco use. By providing comprehensive recommendations for behavioral support, digital interventions, and pharmacological treatments, the guideline empowers countries to support individuals in quitting tobacco. This initiative aims to bridge the gap in cessation services and improve the health and well-being of millions of people worldwide. As healthcare providers, policymakers, and stakeholders adopt and implement these guidelines, they will contribute to reducing the global burden of tobacco-related diseases and promoting a healthier future for all.
