Tobacco control and Healthcare professionals – growing future leaders

Prof Luke Clancy, Director GeneralTobaccoFree Research Institute Ireland, Dublin

9-10 June, The Gibson Hotel, Dublin

What can HCPs do for TC?

Leadership

Advocacy

Research

Education

Networks

Collaboration

Leadership

Position

Institutional

Organisational

Leadership

Position

Power-to convene

Power-to encourage

Power-to resource

Leadership

Individual- sense of mission, passion

LeadershipPassion is not enough

Commitment

Compassion

Competence

Capacity

Confidence

Leadership

Individual• Imagination to Innovate

• Competence to perform

• Openness to Collaborate

• Understanding the need for Perseverance

Understanding Advocacy Roles

Governments/Institutions adopt policies in a climate of public readiness

Public health advocates need to shift public opinion in the right direction

Political action becomes compelling

Political inaction becomes a liability

Smokefree Success Factors

Sustained consistent simple health message

Sustained political leadership/commitment

Partnership – Health alliance, OTC, DOHC

Cross party political support

Trade union support

“I believe that in every decade, we are presented with one major choice - a choice where, if we call it right, we change the future for the better.”

Micheál Martin TD, Minister for Health and Children, 2003

Research Strategy

• Control Policy not underpinned by Research-2nd Class

• Policy not evidence based not convincing

and not credible

• R & D or wither

TFRI

OTC

ICSIFH

Ash

Promote interest in Tobacco Research

• Identify key people

• Identify key Institutions

• Create an inventory of current Tobacco related research in Irish Institutions

What Type of Research

Health Effects

Exposure Assessments

Prevention

Intervention

Resource Needs

• Human• Do we have the necessary scientists• Research Training• Recruitment and Retention

• Financial• Quantum• Accessibility• Continuity

Global Tobacco Control is

Underfunded

•Globally, tobacco tax revenues are 500 times higher than spending on tobacco control•In low- and middle-income countries, tax revenues are 5,000 times higher

TC Research in the Netherlands• Universities

– Fundamental research– Testing new programs

• Stivoro– Testing effects of their campaigns

• RIVM– Testing cost-efficacy

• Funding:– ZONMW, The Netherlands Organisation for Health, Research and

Development. – Dutch Cancer Society– Dutch Asthma Fund– Dutch Heart Foundation

Research Opportunities

• Healthcare• Economics• Marketing• Advertising • Communications• Legal• Tax

Research Collaboration• Pat Goodman- DIT, Kevin St• Michele Agnew-DIT, St James• Marie McCaffrey-HSE,DIT• Gillian Paul-TCD• Shane Allwright-TCD• Jim McLaughlin-UCD NUI• Kevin Kelleher-UCD NUI• Colin Todd-UCD NUI• Birgit Greiner-UCC NUI

Future

• Economics-Macro, Pharmaco.,

• Marketing-ICT

• Exposure-Exempted areas, Special situations

• Health effects-Resp., CVS, Cancer

• Attitudes in children

• Cross- border

• International

Education

Provide

University Focus

Tobacco Related Studies

General Practioners and the Economics

of Smoking Cessation in Europe (PESCE)

Policy recommendations

3. Structural Factors

TimeGPs perceive that smoking cessation ‘takes too long’

(32%-74% in different studies)

Education and trainingLack of training associated with low cessation activity in some

studies (more training=more cessation activity in other studies)

ReimbursementStudies find mixed results on whether GPs perceive lack of

reimbursement as a barrier (7%-64% across several studies)

PESCE 2008

Formal training on smoking cessation approaches varied between regions, but remains

lowThose who have had formal training on smoking cessation approaches

30.2

53.9

41.9

41.7

19.2

38.5

West

Med

Scan

Cent/E

Balt

All

Ref: Table 3

Percent (%)

European Standards for Accreditation of Tobacco Cessation Services

and of Training in Tobacco Cessation

Luke Clancy

Brussels 3rd October 2012

Social inequalitiesEducation

Occupation

Income

Health care

Disease prevention

Health promotion services

Public policies influencing the quantity, quality

and distribution of these Factors

Living conditions

Health related behaviours

Reducing inequalities through linking up with other policies.

• Smoking related to social position.• Tobacco control aimed at smoking has limited

effect among disadvantaged communities.• Specific tobacco control measures are not

effective.• Effects are larger when combined with policies

aimed to improve quality of life.

Networks

Respiratory PhysicianMedical Director St James President IUATLD-Euro regionChairman Medical Board SJHChairman Clinicians in Management in IrelandChairman ASH IrelandPresident European Network Smoking PreventionChairman Tobacco Control Committee (European Respiratory Society)

Success of Tobacco Control

Framework Convention for Tobacco Control is not enough

Politics

Corruption, Greed, Indifference

Politics

• “the pursuit and exercise of power—in the interest of those who pursue and exercise it”

Plato dialogues

Advantages of using HCP in TC

• Moral authority• Information• Public support• A champion• Persistence• Consistency