The Smoking Cessation Program

1
The Smoking Cessation Program

• ISMAEL S. PASTOR, MD
• Degenerative Diseases Office
• 2003

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Tobacco Use Smoking Cessation Policies, Nov.
1987 - May 2003

• DC No. 147-A, s 1987 (Nov. 27, 1987), Creation
  of a Smoke-free Environment in the DO. (Dr.
  Bengzon)
• DC No 154-E, s. 1990 (April 19900, Authority for
  the DOH Security Force to enforce strict
  implementation of DC No. 147-A, s 1987. (Dr.
  Bengzon)
• CSC Resolution No. 91-787 (July 4, 1991). Policy
  on Smoking Prohibition. (CSC)
• AO 15, s. 1993, (June 3, 1993) Banning smoking
  in all health care facilities under the DOH.
  (Dr. Flavier)
• Proclamation No. 183 (May 31, 1993), Declaring
  the month of June of every year as National No
  Smoking Month. (OP).
• AO No. 10, s. 1993 (March 22, 1993), Rules and
  regulations on labelling advertisement of
  cigarettes. (Dr. Flavier)
• DO No. 288-E, s. 2001 (Sep. 17, 2001),
  Designation of point persons for tobacco control
  and creation of the TC Task Force. (Dr.
  Dayrit).
• DO No. 70-E, s. 2002 (Feb. 21, 2002). Creation
  of a TWG on Smoking Cessation Program. (Dr.
  Dayrit).
• DO No. 193-Q, s. 2002 (Jul. 10, 2002), Creation
  of the TC and Lifestyle Mgt. Team. (Dr. Dayrit).
• DM No. 38-A, s. 2002 (Mar 11, 2002), Prevent
  Tobacco Industry Participation in any TC
  initiatives. (Dr. Dayrit).
• DM No. 101, s. 2002 (Aug. 12, 2002), Inventory
  of SCC under the DOH. ( Dr. Lopez)

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Rationale

• 30 (22.5 million) Filipinos are smokers
• 80 of current smokers want to quit but did not
  know where and when to approach for assistance.

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Definition of Terms - I

• Smoking cessation the systematic, safe, and
  sustainable process of withdrawing nicotine from
  a nicotine addict
• Smoker user of nicotine
• Smoking a disease due to nicotine addiction
• Environmental tobacco smoke (ETS) cigarette
  smoke that contaminates indoor air

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Definition of Terms - II

• Side stream smoke (SSS) smoke emitted from the
  smoldering of cigarettes between puffs.
• Main stream smoke (MSS) - produced when a smoker
  inhales cigarette smoke.
• Smoke-free environment (SFE) indoor air free of
  ETS.
• SCP coordinator any licensed physician
  connected with the hospital or health facility
  trained in the SCP

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Vision Statement

• A reduction in the number of current smokers in
  the Philippines

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Mission Statement of the SCP

• To establish a smoking cessation program (SCP) in
  every hospital or clinic in the Philippines

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SCP Goals

• Establishment of smoking cessation services
• Training of SCP DOH coordinators at the regional,
  and medical center levels and local government
  unit implementors.
• Healthy lifestyle campaigns.
• Advocacy health education campaigns for the
  utilization of smoking cessation services.

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Objectives

• To train 30 40 CHD personnel, 104 medical
  center personnel and 30 40 local government
  unit health personnel
• To pilot 6 smoking cessation clinics nationwide
• To reduce the prevalence of current smokers (NOH
  p 206)
• To increase the level of awareness on the
  negative health effects of smoking to 80 (NOH p
  206)
• To increase the percentage of smokers who quit to
  16 (NOH p 206).

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SCP Organization
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SCP Components

• The Smoking Cessation Clinic
• Smokers Family Support Group
• Healthy Lifestyle Campaign
• Social Marketing (Counter marketing, etc)
• Program administration management
• Research Development

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The Smoking Cessation Clinic

• The Smoking Cessation Clinic is envisioned in
  every hospital or clinic in the country. All
  trained SCP coordinators are encouraged to do
  active or passive case finding. Counseling,
  behavioral modification, and environmental
  support, which play an important role in the
  succes or failure in smoking cessation, must be
  performed by all implementing units. All
  implementors must manage and administer the SCC
  in accordance with the internal rules and
  regulations of the hospital or health facility in
  a way to ensure its success. Other than this,
  each implementing unit will have to decide the
  operational level at which their unique
  situations require taking into consideration
  their own needs and capabilities.

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The Hospital SCP

• Shall render clinical services to current smokers
• Shall be lodged at the Outpatient Department and
  under the direct supervision of the Chief of
  Hospital
• Shall coordinate with the CHD any SCP related
  activities, TC activities or HL activities
  related to smoking and tobacco

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The Smoking Cessation Clinic

• Case finding
• Screening
• Diagnosis
• Treatment (Pharma. Psy., Beh., Social)
• Case Holding
• Recording and reporting
• Program administration and management

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Different Levels of the SCC
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Human Resources of the SCC
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The CHD SCP Coordinator

• Advocates for the SCP
• Encourages LGUs, schools, industrial
  establishments, other GOs to participate in the
  SCP
• Coordinates with DDO in the implementation of the
  SCP
• Reports to the CHD Director SCP activities
• Supervises the implementation of the SCP
• Assist DDO maintain the information system of the
  SCP
• Monitors the SCP in medical centers LGUs under
  their catchment
• Assist DDO evaluate and review the SCP

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The Hospital SCP Coordinator

• Diagnose and treat nicotine addicts
• Prepare and implement an action plan for the
  hospital SCP
• Coordinates the hospital SCP with the CHD
• Supervises the information system of the hospital
  SCP
• Administers and manages the hospital SCP action
  plan

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The CHD SCP H.E.P.O.

• Designs a social marketing plan for the cluster
  to improve SCP performance
• Seek the approval of the CHD SCP Coordinator for
  the marketing plan
• Implements a social marketing plan for the
  cluster
• Assist the SCP Coordinator attain program targets

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SCP Activities, 2003

• Drafting of the Tobacco Control Policy
• Drafting of the Smoking Cessation Program
• Design of the SCP Training Program
• Training of CHD, Medical Center, and LGU health
  personnel
• Design and production of the SCP Manual of
  Procedures
• Piloting of 6 smoking cessation clinics in
  selected zonal hospital facilities.