A new study published in the journal Addiction suggests countries have no excuse for not helping their citizens quit smoking.
With tobacco still the leading cause of preventable death worldwide, killing some 5 million people annually, even the poorest countries can do their part.
The international team of researchers behind the study offer up six methods that are globally affordable and shown to work.
1. Healthcare advice
Simple one-on-one discussions between a doctor and patient can be enormously effective in getting people to see firsthand — on a personal, not statistical, level — how tobacco use can harm their health.
Even five-minute chats, which require only a small investment of time, were found to raise quitting rates by 2 percentage points.
2. Self-help materials
People who want to quit smoking can expect modest support if they use leaflets and books offering advice, support, and, in some cases, information regarding medication use.
Researchers saw an increase in cessation by 2 percentage points when people used printed materials instead of white-knuckling the quitting process.
3. Telephone helplines
Encouraging people to sign up for so-called proactive hotlines, in which a trained counselor initiates the call to tobacco users, can raise cessation rates by up to 3 percentage points, provided the support is offered on a regular, ongoing basis.
Meanwhile, hotlines that require callers to dial in themselves — known as “reactive” hotlines — haven’t conclusively been shown to help people quit, the researchers explain.
4. Automated text messaging
Even in low-income countries, text messages can serve as helpful reminders to smokers looking to quit.
Functioning similar to face-to-face healthcare advice, texts can deliver motivational messages and offer behavioral distractions when needed, the report explains. Quitting rates bumped up 4 percentage points over no intervention.
Cytisine is a cheap plant extract that binds with nicotine receptors to make smoking less satisfying. It also alleviates the withdrawal symptoms that make quitting so hard.
Cytisine has been in use under the Bulgarian brand Tabex for decades, but, regretfully, has yet to win over scientists in the Western world. According to the new model, cytisine could help people from all income levels quit smoking at a low cost. When used by people who smoke at least 15 cigarettes a day, cytisine has shown bumps to cessation rates of 6 percentage points.
A kind of antidepressant, nortriptyline requires consistent monitoring from a healthcare professional, the researchers write.
Typically combined with behavioral support, as the drug comes with some mild adverse side effects, a 12-14-week regimen can result in a gain of 10 percentage points in quitting rates compared to a placebo.
“One of the barriers to countries doing more to offer support has been concern about cost,” says Martin Raw, the co-author of the study and director of the International Center for Tobacco Cessation.
He and his colleagues used four countries of varying income levels to represent cost-effectiveness: Nepal for low-income countries, India for middle-low-income countries, China for upper-middle-income countries, and the United Kingdom for high-income countries.
“Affordable” treatments were those whose cost to save a year of life fell below the average economic output of people in that country, otherwise known as the per capita GDP. Treatments were deemed effective if they helped people quit smoking for 6-12 continuous months.
The beauty of these six solutions, says lead author of the study Robert West, is that countries can essentially mix and match them according to their resources.
“Our report shows that every country in the world could be doing something,” West explained. “The more a country does, the more of their citizens’ lives they will protect.”