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CEO Perspective

Remarks given at Global Ministerial Conference on Ending TB

Global Ministerial Conference on Ending TB In the Sustainable Development Era Parallel Panel 1: Synergies Across Responses to TB and NCDs

What practical issues need to be addressed in order for the National TB control Programme to be more involved in tobacco control?

There are some important barriers and challenges that we need to address. This will take work, but it is possible.

The key word is integration. We need to integrate smoking cessation services into TB care. Some of the solutions are very practical.
For example:

Health centers have a TB register and a TB treatment card for each patient. These records can be revised to include information on tobacco use. Health workers treating TB patients should routinely ask if they smoke tobacco. If they do, they should be given the education and support that they need to quit.

The Union did this during patients’ routine DOTS appointments. The approach is called “ABC.” ASK, BRIEF advice, CESSATION support.

In Bangladesh, more than 80 percent of patients on the trial quit tobacco and made their homes smoke-free.

India, Indonesia and China also saw quit rates over 60 percent thanks to this simple intervention.

Data on tobacco use should be collected from health centers and integrated into TB monitoring and evaluation. How many TB patients in each country used tobacco? How many were supported to quit? These are basic questions, and we don’t have answers to them right now.

Doing this will require training. We need to integrate tobacco cessation into the training that TB care providers receive.

And these actives need resources. We need to make sure that we invest adequately to make these changes.

And lastly, we need to use eHealth and mHealth innovations as tools, wherever possible.

There is no one-size-fits-all solution, and we have an opportunity to encourage innovation. The exact solutions should look different in different contexts. We need to design solutions around patients and their needs.