to be useful to many different partners, including potential funders, tobacco control policy-makers,

Transcription

1 Foreword WHO MAY BENEFIT FROM THIS MANUAL? A broad array of people and institutions with many different types of interests and expertise are needed to bring a quit line into existence and ensure that it realizes its full potential. This manual is designed to be useful to many different partners, including potential funders, tobacco control policy-makers, programme developers, service providers and evaluators. Some sections are very specific, such as those concerned with staffing, and may be of more interest to those actually involved in direct quit-line operations. Others are more theoretical, and may be of more interest to those working to integrate quit lines into the broader context of tobacco control. This manual focuses primarily on national, state and regional quit lines, as opposed to telephone or Internet services provided by clinics, health systems, employers, pharmaceutical companies, or nongovernmental organizations (NGOs). It does not address Internet-based adjunctive services offered by pharmaceutical companies for users of their medications. Although the manual is based on experiences from quit lines around the world, it is primarily intended to help low- and middle-income countries (LMICs) in the early stages of quit-line development. However, many sections will also be of interest to managers of existing quit lines who are keen to improve services, performance, reach or funding. vi

2 Acknowledgements Acknowledgements This manual was developed by WHO Tobacco Free Initiative (TFI). We thank the TFI Regional Advisers and their teams for their assistance in collecting data on the current situation of national quit-line services. A large number of international experts from various institutions and agencies were involved as contributors. The production of this manual was coordinated by Dongbo Fu under the supervision and support of Armando Peruga. Administrative support was provided by Miriamjoy Aryee-Quansah. The text was written by Tim McAfee with contributions from Linda Bailey, Thao Diep, Dongbo Fu, Abigail Halperin, Armando Peruga, Andy Roberts, Gillian Schauer, Etta Short, Gary Tedeschi, Ken Wassum and Susan Zbikowski. This document was reviewed at the different phases of its preparation by Wael Safwat Abdelmageed, OA Ayo-Yusuf, Linda Bailey, Anita Dessaix, Michael Fiore, Dongbo Fu, Tom Glynn, Jagdish Kaur, Harry Lando, Tim McAfee, Cristina Perez, Armando Peruga, Martin Raw, Teresa Salvador-Llivina, Robert West, Dan Xiao and Shu-hong Zhu. Raymond Mailhot helped with collecting data on existing national toll-free quit lines. The development of this manual has been financially supported by Bloomberg Philanthropies and WHO. vii

3 Abbreviations HIV human immunodeficiency virus LMICs low- and middle-income countries NGO nongovernmental organization NRT nicotine replacement therapy WHO World Health Organization WHO FCTC WHO Framework Convention on Tobacco Control viii

4 Glossary Glossary Behavioural support Support, other than medication, aimed at helping people to stop using tobacco. It can include all cessation assistance that imparts knowledge about tobacco use and quitting, provides support, and teaches skills and strategies for changing behaviour. Brief advice Advice on how to stop using tobacco, usually taking only a few minutes, and given to all tobacco users during the course of a routine consultation or interaction. Call centre An organization or a part of an organization that provides a service or conducts business over the telephone. Cost-effectiveness A type of economic analysis comparing the relative expenditure (costs) and outcomes (effects) of one or more intervention options. Counselling Has different meanings in different countries. In the context of quit lines, counselling does not mean deep, extended psychological counselling but rather refers to practical advice and problem-solving coupled with support. It may include the use of some skills, such as cognitive-behavioural and motivational interviewing, but not at the level of a licensed psychologist. Quit-line counsellors are also sometimes referred to as coaches, guides, behavioural support specialists or advisers. Counselling is also called behavioural support. Decision support Unbiased assistance provided to people to help them weigh the advantages and disadvantages of various options with the emphasis on understanding the evidence in layman s terms. De-normalization Policies and activities aimed at changing existing cultural norms around the acceptability of continued tobacco use and second-hand smoke exposure. Metrics Important processes and outcomes that can be measured. ix

5 Over-the-counter Medications that can be purchased without a prescription. Proactive phone support The provision of follow-up outbound telephone calls to a quit-line caller, often on a schedule related to their smoking cessation status. Health-care providers Health-care workers, including medical doctors and allied health professionals, providing care to patients. Quit line A telephone counselling service that can provide both proactive and reactive telephone counselling (see proactive telephone support and reactive telephone support). Reactive phone support Providing counselling and other services when a person calls the quit line (as opposed to proactive phone support). Telephony The technology systems associated with the electronic transmission of voice, fax or other information between distant parties. Tobacco user Anyone who reports the current or occasional use of any tobacco product. Tobacco addiction/dependence A cluster of behavioural, cognitive and physiological phenomena that develop after repeated tobacco use and that typically include: a strong desire to use tobacco; difficulties in controlling its use; persisting in its use despite the harmful consequences; giving higher priority to tobacco use than to other activities and obligations; increased tolerance; and sometimes experiencing a physical withdrawal state 1. Tobacco cessation The process of stopping the use of any tobacco product, with or without assistance. Tobacco dependence treatment The provision of behavioural support or medication, or both, to tobacco users, to help them stop their tobacco use 2. x 1 Definition adapted from: International statistical classification of diseases and related health problems, tenth revision (ICD-10). Geneva, World Health Organization, Also sometimes called cessation support in this document.