Tobacco cessation services in India: recent developments and the need for expansion.
Tobacco cessation services in India: recent developments and the need for expansion.
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DOI：
10.4103/0019-509x.63873
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发表时间：
2010-07-01
影响因子：
1
通讯作者：
Saddichha, S
中科院分区：
文献类型：
--
作者：
Murthy, P;Saddichha, S
烟草使用是印度可预防的死亡和疾病的主要原因。不幸的是，印度很少有人戒烟。缺乏对危害的认识、根深蒂固的文化态度以及缺乏对戒烟的支持使社区中的烟草使用得以维持。尼古丁的显著成瘾特性使得戒烟困难且复发常见。卫生专业人员几乎没有接受过培训，因此很少有人对烟草使用者进行适当的评估和干预。来自发达国家的证据表明，由不同卫生专业人员提供的简短干预措施对戒烟有效。将药理学方法与行为咨询相结合比单一策略产生更好的结果。在印度，戒烟的早期经验是在初级社区癌症控制教育的背景下发生的。最近，设立了戒烟诊所，以制定干预模式，并培训提供服务的卫生专业人员。这些需要在初级、二级和三级保健水平上扩大，需要开发具有成本效益的社区戒烟模式。戒烟是国家烟草控制计划的重要活动之一。迫切需要通过培训卫生专业人员提供常规临床干预措施、增加药物治疗的供应和补贴、制定戒烟热线等广泛战略和团体干预等具有成本效益的战略，扩大戒烟范围。
Tobacco use is a major cause of preventable death and disease in India. Unfortunately, very few people in India quit tobacco use. Lack of awareness of harm, ingrained cultural attitudes, and lack of support for cessation maintains tobacco use in the community. The significant addictive property of nicotine makes quitting difficult and relapse common. Health professionals have received little training, and very few thus carry out proper assessments and interventions among tobacco users. Evidence from the developed countries suggests that brief interventions delivered by diverse health professionals are effective in tobacco cessation. Combining pharmacologic approaches with behavioral counseling produces better results than a single strategy. In India, early experiences with tobacco cessation occurred in the context of primary community education for cancer control. More recently, tobacco cessation clinics have been set up to develop models of intervention, and train health professionals in service delivery. These need to be expanded at the primary, secondary, and tertiary care levels, and cost-effective community tobacco cessation models need to be developed. Tobacco cessation forms one of the critical activities under the National Tobacco Control Program. Tobacco cessation needs to be urgently expanded by training health professionals in providing routine clinical interventions, increasing availability and subsidy on pharmacotherapy, developing wide-reaching strategies, such as quitlines and cost-effective strategies, such as group interventions.