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Received Sep 12, 2017; Accepted Feb 19, 2018
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1. Introduction
According to the 2016 World Health Organization/National Cancer Institute Monograph, a global report on tobacco control, the number of global tobacco-related deaths is projected to increase from about 6 million to 8 million annually by 2030, with more than 80% of these occurring in low- and middle-income countries (LMICs) [1]. These are more annual deaths worldwide than are caused by HIV/AIDS, TB, and malaria combined [2]. Moreover, the economic burden of tobacco use is staggering, with the total cost of smoking (including productivity losses from death and disability) reaching more than $1.4 trillion US dollars per year—equivalent to 1.8% of the world’s annual GDP [3].
Though prevalence of smoking in the US is currently around 15% of the adult population, prevalence rates in many other countries, particularly LMICs, can reach over 40%. These high prevalence rates pose a challenge for countries to create a policy climate conducive to tobacco control measures, particularly when it comes to developing the infrastructure necessary to build and maintain a national tobacco dependence treatment program. Evidence from a recent survey suggests that there are additional barriers to implementing tobacco dependence treatment, particularly in LMICs, including perceived costs of providing tobacco dependence treatment support and a lack of clarity about the effectiveness and cost effectiveness of tobacco dependence treatment [4].
In 2005, the world’s first public health treaty, the World Health Organization Framework Convention on Tobacco Control (FCTC), came into force and has since become one of the most widely embraced treaties in United Nations history; 180 Parties have now ratified the treaty and are making progress to address the global tobacco epidemic. FCTC Article 14 relates specifically to the treatment of tobacco dependence and encourages countries to
(1)
strengthen or create a sustainable infrastructure which motivates attempts to quit, ensure wide access to support for tobacco users who wish to quit, and provide sustainable resources to ensure that such support is available;
(2)
identify the key, effective measures needed to promote tobacco cessation and incorporate tobacco dependence treatment into national...