Comparative Analysis of Tobacco Cessation Policies in Türkiye and United Kingdom

Abstract

This study aims to compare stop smoking treatment policies in Turkiye with that of United Kingdom. Firstly, tobacco control strategies proposed by World Health Organization and their applications in both countries were examined, and then tobacco cessation treatment policies were compared. Tobacco cessation services consisting of prescription drug treatments, health education and supportive behavior therapy, and brief advice were reimbursed partially free of charge in United Kingdom. Cost of medications in tobacco cessation treatment in Türkiye was not reimbursed by Social Security Institution. However, medications for stop smoking, which were provided by Ministry of Health, were distributed free of charge to those who intended to quit, in case it was prescribed by an authorized physician. Access to tobacco cessation services is critical in achieving equity and eliminating disparities in tobacco control. Hence, greater efforts are needed to make tobacco control strategies more effective.

Keywords

• MPOWER
• global tobacco epidemic
• tobacco control
• reimbursement of medications

Türkiye’de ve Birleşik Krallık’taki Tütün Bırakma Politikalarının Karşılaştırmalı Analizi

Öz

Bu çalışma, Türkiye’de ve Birleşik Krallık’taki tütün ve tütün ürünleri kullanımının sonlandırılmasına yönelik politikaları karşılaştırmalı olarak incelemeyi amaçlamaktadır. Öncelikle Dünya Sağlık Örgütü tarafından önerilen tütün kontrol stratejileri ve her iki ülkedeki uygulamalar incelenmiş, ardından bırakma tedavisi politikaları karşılaştırılmıştır. İlaç tedavileri, sağlık eğitimi ve destekleyici davranış terapisi ve kısa müdahaleden oluşan tütün bırakma hizmetleri, Birleşik Krallık'ta kısmen ücretsiz olarak karşılanmaktadır. Türkiye'de tütün bırakma tedavisinde kullanılan farmakoterapi ürünlerinin bedeli Sosyal Güvenlik Kurumu tarafından karşılanmamakta ancak Sağlık Bakanlığı tarafından temin edilen tütün bırakma ilaçları ücretsiz olarak dağıtılmaktadır. Tütün bırakma hizmetlerine erişim, tütün kontrolünde eşitsizliğin ortadan kaldırılması ve hakkaniyetin sağlanması açısından kritik öneme sahiptir. Bu nedenle tütün kontrol politikalarını etkili hale getirmek için daha fazla çabaya ihtiyaç vardır.

Anahtar Kelimeler

• MPOWER
• küresel tütün salgını
• tütünle mücadele
• ilaç geri ödemesi

Kaynakça

1. Aveyard, P., & West, R. (2007). Managing smoking cessation. BMJ, 335, 37-41.
2. Berkeşoğlu, C., Özgür, E., & Demir, A. (2018). Sigara bırakma başarısını etkileyen faktörler. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 11(3), 355-365.
3. Britton, J. (2016). Electronic cigarettes and smoking cessation in England. BMJ, 354, i4819.
4. Centers for Disease Control and Prevention. (2022). Smoking cessation: a report of the surgeon. https://www.cdc.gov/tobacco/data_statistics/sgr/2020-smoking-cessation/index.html
5. Centers for Disease Control and Prevention. (2022). Smoking cessation: fast facts. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html
6. Çalışkan, S., & Metintaş, S. (2018). Dünyada tütün kontrol uygulamalarının küresel ölçekte değerlendirilmesi. Türk Dünyası Uygulama ve Araştırma Merkezi Halk Sağlığı Dergisi, 3(1), 32-41.
7. Çelik, İ., Yüce, D., Hayran, M., Erman, M., Kılıçkap, S., Buzgan, T., . . . Akdağ, R. (2015). Nationwide smoking cessation treatment support program – Turkey project. Health Policy, 119(1), 50-56.
8. Erdöl, C., Ergüder, T., Morton, J., Palipudi, K., Gupta, P., & Asma, S. (2015). Waterpipe tobacco smoking in Turkey: policy implications and trends from the global adult tobacco survey (GATS). International Journal of Environmental Research and Public Health, 12(12), 15559-15566.

9. Fai, S. C., Yen, G. K., & Malik, N. (2016). Quit rates at 6 months in a pharmacist-led smoking cessation service in Malaysia. Canadian Pharmacists Journal, 149(5), 303-312.
10. Gürbüz, A., & Coşkunoğlu Kaya, H. (2022). Devletin sigara kullanımı üzerine pazarlamama (demarketing) uygulamaları ve tüketiciler üzerinde covid-19 dönemindeki etkisi. Journal of Humanities and Tourism Research, 12(1), 101-124.
11. Gollust, S. E., Schroeder, S. A., & Warner, K. E. (2008). Helping smokers quit: understanding the barriers to utilization of smoking cessation services. The Milbank Quarterly A Multidisciplinary Journal of Population Health and Health Policy, 86(4), 601-627.
12. Gravely, S., Giovino, G. A., Craig, L., Commar, A., D'Espaignet, E. T., Schotte, K., & Fong, G. T. (2017). Implementation of key demand-reduction measures of the WHO framework convention on tobacco control and change in smoking prevalence in 126 countries: an association study. The Lancet Public Health, e166-e174.
13. Hays, J. T., & Ebbert, J. O. (2008). Varenicline for tobacco dependence. The New England Journal of Medicine, 359(19), 2018–2024.
14. Hurt, R. D., Sachs, D. P., Glover, E. D., Offord, K. P., Johnston, J. A., Dale, L. C., & et al. (1997). A comparison of sustained-release bupropion and placebo for smoking cessation. The New England Journal of Medicine, 337(17), 1195–202.
15. Hurt, R. T., Edakkanambeth Varayil, J., Mundi, M. S., & et al. (2014). Designation of obesity as a disease: lessons dearned from alcohol and tobacco. Current Gastroenterology Reports, 16(415), 1-7.
16. Institute of Health Metrics. (2022). Global burden of disease 2019. https://ghdx.healthdata.org/record/ihme-data/gbd-2019-smoking-tobacco-use-prevalence-1990-2019
17. Joossens, L., & Raw, M. (2006). The tobacco control scale: a new scale to measure country activity. Tobacco Control, 15(3), 247-253.
18. Jorenby, D. E., Hays, J. T., Rigotti, N. A., Azoulay, S., Watsky, E. J., Williams, K. E., & et al. (2006). Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA, 296(1), 56-63.
19. Levy , D. T., Currie, L., & Clancy, L. (2013). Tobacco control policy in the UK: blueprint for the rest of Europe? European Journal of Public Health, 23(2), 201–206.
20. Nagelhout, G. E., Willemsen, M. C., van den Putte, B., de Vries, H., Willems, R. A., & Segaar, D. (2015). Effectiveness of a national reimbursement policy and accompanying media attention on use of cessation treatment and on smoking cessation: a real-world study in the Netherlands. Tobacco Control, 24(5), 455-461.
21. NHS Smoking Cessation Service (SCS). (2022). Community pharmacy advanced service specification. https://www.england.nhs.uk/wp-content/uploads/2022/03/B1298_community-pharmacy-advanced-service-specification-nhs-smoking-cessation-service-090322.pdf
22. NHS Smoking Cessation Service (SCS). (2022). NHS stop smoking services help you quit. https://www.nhs.uk/live-well/quit-smoking/nhs-stop-smoking-services-help-you-quit/
23. Peruga, A., Lopez, M. J., Martinez, C., & Fernandez, E. (2021). Tobacco control policies in the 21st century: achievements and open challenges. Molecular Oncology, 15(3), 744-752.
24. Rajabi, A., Shojaei, A., Janani, L., Farjam, M., Baradaran, H. R., Pedram, K., & Motevalian, S. A. (2021). Cigarette smoking behavior a gateway to opium use disorder: a Mendelian randomization analysis. Behavior Genetics, 51, 385-393.
25. Resmi Gazete. (2013). Tütün ürünlerinin zararlarının önlenmesi ve kontrolü hakkında kanun. https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=4207&MevzuatTur=1&MevzuatTertip=5
26. Safaei Lari, M., Raei, B., Nourizadeh Tehrani, P., & Takian, A. (2021). Evaluation of tobacco control measures in the organization for economic co-operation and development countries: a comparative study using data envelopment analysis. Journal of Research in Health Sciences, 21(3), e00527.
27. Shiffman, J., & et al. (2016). The emergence and effectiveness of global health networks: findings and future research. Health Policy and Planning, 31, i110-i123.
28. TobaccoFree Research Institute Ireland LBG. (2013). Pricing policies and control of tobacco in Europe. Dublin: Final Report - PPACTE (Pricing policies and control of tobacco in Europe).
29. West, R., & Cox, S. (2021). The 1988 US Surgeon General's report nicotine addiction: how well has it stood up to three more decades of research? Addiction, https://doi.org/10.1111/add.15754.
30. West, R., & Croghan, E. (2013). Performance of English stop smoking services in first 10 years: analysis of service monitoring data. BMJ, 347, f4921.
31. World Health Organization. (2003). The WHO framework convention on tobacco control. Geneva: World Health Organization.
32. World Health Organization. (2015). Waterpipe tobacco smoking: health effects, research needs and recommended actions for regulators. Geneva: World Health Organization.
33. World Health Organization. (2021). WHO report on the global tobacco epidemic 2021: addressing new and emerging products. Luxemburg: World Health Organization.
34. World Health Organization. (2022). NCD Global Monitoring Framework on noncommunicable diseases. https://www.euro.who.int/__data/assets/pdf_file/0003/340869/Report-3.pdf
35. World Health Organization. (2022). Tobacco. https://www.who.int/news-room/fact-sheets/detail/tobacco
36. Yaşar, Z., Kar Kurt, Ö., Talay, F., & Kargı, A. (2014). Bir yıllık sigara bırakma poliklinik sonuçlarımız: sigara bırakmada etkili olan faktörler. Eurasian Journal of Pulmonology, 16, 99-104.