The government announces that Poles wishing to break the tobacco habit will not, as before, be left alone with this problem. There are plans to launch a programme to help people quit nicotine. The programme's authors estimate that around half a million Poles per year could benefit from it.
The assumptions of the programme were presented for public consultation in a draft amendment to the regulation on guaranteed benefits of health programmes. "In order to successively reduce the percentage of smokers, it is necessary to undertake multifaceted measures, so one of the most important health interventions in this direction is the treatment of nicotine dependence syndrome. It should be emphasised that the current legislation regulating some of the issues of anti-smoking counselling limits its effectiveness," the document reads.
Its authors highlight that smoking is one of the main causes of premature deaths among thousands of Poles. According to Global Burden of Disease (GBD) estimates, smoking and tobacco consumption contributed to 83,000 deaths in Poland in 2019 (including 56,000 among men and 27,000 among women). Smoking and tobacco consumption leads to the loss of more than 2 million healthy life years (DALYs) each year in Poland. "Compared to the European Union, the value of the age-standardised rate of loss of life years in health due to tobacco per 100,000 population was 40 per cent higher in 2019 (European Union - 2,369, Poland - 3,315). A 41 per cent higher value of the age-standardised rate of deaths per 100,000 population due to tobacco is also observed, which in 2019 was 117 in Poland and 83 in the European Union." - reads the justification of the government regulation.
As Dr Filip Szymański, president of the Polish Society of Civilisation Diseases, points out, our health care system "does not treat nicotinism (per se) as a disease that can or even should be treated. This is a pity, because despite everything, we do have instruments that, although not entirely effective, are at least worth trying". The first method available to doctors is behavioural-cognitive therapy (i.e. individual and/or group psychotherapy). The second method is nicotine-replacement preparations. The third is pharmacological treatment: cytisine and bupropion. The PTChC calculates that when we do not even try to support smokers medically to quit, as many as 80 per cent of those trying to quit return to smoking.
The Ministry of Health has decided to change this. In its justification, it cites the British experience - "There are 170 tobacco dependence syndrome treatment centres in the UK, covering the whole country. The programme is delivered in outpatient clinics and pharmacies. Intensive individual and group support is offered to patients. Counselling is mainly provided by a specially trained counsellor (psychologist, nurse, therapist, social worker, etc.). Free medication is offered to patients on the lowest income, the others receive medication for which they pay a lump sum of £8.60 per fortnight (by comparison, a packet of cigarettes costs £8.80 on average)."
A similar model is to apply in Poland. According to the draft regulation, people who want to quit smoking will be able to:
- repeatedly (in the event of unsuccessful attempts) undertake treatment for nicotine dependence;
- participate in therapy (individual and group) led by a psychologist certified in the treatment of tobacco dependence syndrome;
- continuing to participate in the programme despite the diagnosis of additional other diseases;
- obtain psychological support (individual or group) available to all patients, including those qualified for pharmacotherapy.
The programme is intended to have a reach that is appropriate to the scale of the problem. According to a nationwide survey (Kantar on behalf of the Chief Sanitary Inspectorate) on attitudes towards smoking in Poland in 2019, almost 8 million people smoked tobacco regularly, representing 21 per cent of the Polish population. Among men, the percentage of smokers was 24 per cent, while among women it was 18 per cent. In calculating the number of those willing to participate in the programme, the results of the 2019 National Survey Report on Attitudes Towards Smoking were used, based on which 13 per cent of women and 18 per cent of men had made an attempt to quit smoking in the past year. "Analyses conducted by the Ministry of Health indicate that in 2019, the estimated annual demand for the Tobacco Disease Prevention Programme (including COPD) was 549,000 adults, assuming that 50 per cent of those making an attempt to quit smoking would wish to benefit from the programme," reads the draft regulation.
"Every step taken in the fight against nicotinism - is a step in the right direction. So this one should also be assessed positively". - comments Professor Maciej Banach, President of the Polish Lipid Society. He stresses that the programme run by GP surgeries to date has not had a proper effect. "It is time to draw conclusions from this. For me personally, in addition to the operation of the anti-smoking advice and counselling system, broadly conducted educational activities are very important. If only in terms of dispelling myths about the course of the treatment itself. Patients fear, for example, that they will get fat. It is therefore worth explaining exactly what the process of quitting tobacco consists of, that many myths about risks can be avoided, and explaining how to do so," says Professor Maciej Banach. - says Professor Maciej Banach.
Source: mzdrowie.pl