England provides free, comprehensive tobacco dependence treatment to all
The four countries of the United Kingdom of Great Britain and Northern Ireland have a national tobacco dependence treatment service that is universally available to all smokers, mainly free of charge, through the countries’ National Health Service (NHS).
In England for example, nicotine replacement therapy (NRT) is available without prescription through pharmacies and in other stores (e.g. supermarkets and corner shops). NRT, as well as other smoking cessation medications, is also available by prescription at a reduced charge. Because people with low incomes are exempt from prescription charges, all prescription medicines including NRT, Bupropion and Varenicline are free to around half of England’s population, with the remainder paying a small charge equivalent to about US$ 10 for about one month of medications (although this can vary).
There are also two free national quit lines – one operated through the NHS and a separate one run by an independent organization called Quit. The NHS Stop Smoking Helpline is available 16 hours a day, 7 days a week.Callers are offered counselling on the telephone, are proactively called back or sent e-mails or text messages to provide ongoing support and motivation, and are given details about their local treatment services. The NHS Asian Tobacco Helpline, available one day a week, provides similar services in five languages (Bengali, Gujarati, Hindi, Punjabi and Urdu).
Any smoker can go to his or her general practitioner and be referred to specialized treatment or go directly to a treatment centre, at no charge. To further improve treatment services, England has launched a national training centre that will develop evidence-based training for stop smoking counsellors and managers, assess core competences and certify counsellors, and commission and accredit training. An evaluation found that treatment services disproportionately reach low-income smokers in England – the opposite of what usually happens with health promotion – which means that these services are helping those most in need. For additional information on tobacco dependence treatment in England please refer to http:// smokefree.nhs.uk/.
This is an example of what is possible with a significant investment of resources. For low- and middle-income countries that do not have the financial resources to support implementation of a comprehensive cessation programme, there are steps that can be taken to help people quit while more comprehensive initiatives are developed as mentioned above in the case of Uruguay.
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