A survey of tobacco dependence treatment guidelines content in 61 countries

Nilan, Kapka and McNeill, Ann and Murray, Rachael L. and McKeever, Tricia M. and Raw, Martin (2018) A survey of tobacco dependence treatment guidelines content in 61 countries. Addiction . ISSN 1360-0443

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Abstract

Aims: To assess tobacco dependence treatment guidelines content in accordance with Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) and its guidelines, and association between content and country income level.

Design: Cross sectional study. Setting Online survey from March to July 2016.

Participants: Contacts in 77 countries, including 68 FCTC Parties, six Signatories and three non-Parties which had indicated having guidelines in previous surveys, or had not been surveyed before.

Measurements: A nine item questionnaire on guidelines content, key recommendations, writing and dissemination.

Findings:We received responses from contacts in 63 countries (82%); 61 had guidelines. The majority are for doctors (93%), primary care (92%) and nurses (75%). All recommend brief advice, 82% recording tobacco use in medical notes, 98% nicotine replacement therapy (NRT), 61% quitlines, 31% text messaging, 87% intensive specialist support, and 54% stress the importance of healthcare workers not using tobacco. Only 57% have a dissemination strategy, and 62% have not been updated for five or more years. Compared with high income countries, quitlines are less likely to be recommended in upper middle income countries guidelines, OR 0.15 (95% CI 0.04 ‐ 0.61), and intensive specialist support in lower middle income countries guidelines, OR 0.01 (95%CI 0.00 – 0.20). Guidelines updating is positively associated with country income level (p =0.027).

Conclusions: Although most tobacco dependence treatment guidelines in the 61 countries assessed in 2016 follow the WHO's Framework Convention on Tobacco Control Article 14 recommendations and do not differ significantly by income level, improvements are needed in keeping guidelines up‐to‐date, applying good writing practices, and developing a dissemination strategy.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: A survey of tobacco dependence treatment guidelines content in 61 countries. Nilan K, McNeill A, Murray RL, McKeever TM, Raw M, Addiction. 2018 Feb 28. doi: 10.1111/add.14204 which has been published in final form at https://onlinelibrary.wiley.com/doi/abs/10.1111/add.14204. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: FCTC Article 14, tobacco dependence treatment guidelines, high, middle and low income countries
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
Identification Number: 10.1111/add.14204
Depositing User: Claringburn, Tara
Date Deposited: 23 Mar 2018 11:23
Last Modified: 21 Apr 2018 04:59
URI: http://eprints.nottingham.ac.uk/id/eprint/50612

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