Quitting tobacco use benefits health at any age. For smokers, smoking cessation is one of the best ways to add years to their lives. The benefits of quitting occur almost instantly and most smokers want to quit smoking. But quitting is difficult for most smokers, and the majority make multiple quit attempts during their lifetime, during which time they are losing life-years. Moreover, tobacco cessation is a cost-effective healthcare intervention. Accordingly, governments and healthcare providers should make available more and accessible resources to help tobacco users stop, as enshrined in the WHO FCTC Article 14. However, most governments are failing would-be quitters.
It is important to reach young smokers with cessation messages and aids. The younger someone is when they stop smoking, the greater the benefit in terms of years of life saved. Smoking causes a decade of life lost, but quitting before the age of 40 can essentially return 9 of those years on average, because cessation by that age reduces a former smoker’s chance of death from tobacco-related illness by 90%. At the same time, getting adult smokers to stop helps population health almost immediately.
The healthcare system and healthcare workers should be on the frontline of tobacco cessation. They can reach many tobacco users directly, interact regularly with them particularly at key life moments (e.g., disease diagnosis, pregnancy, etc.), and are typically a trusted information source. Using existing health infrastructure, the strategy is also economical. Cessation should be integrated into health professionals’ work by training them to 1) ask individuals if they smoke and record this, 2) advise smokers to stop, and 3) actively offer help for quitting. Currently, less than half of countries even help health workers to quit or integrate tobacco cessation into basic medical advisement, and less than a third mandate recording tobacco use in patient notes.
Currently, there are too few examples of successful population-level cessation strategies. Governments must invest in promoting cessation, by developing evidence-based national strategies and guidelines, and allocating sufficient implementation resources. Governments can introduce and maintain national quitlines, promote and support counseling for quitters (including mobile phone text messaging services), make cessation medicines more accessible and affordable, and establish mass communication programs to promote quitting. In 2017, only a quarter of WHO FCTC parties had a clearly-identified budget for cessation, and less than a quarter had a free, national quitline. Moreover, with only a few exceptions, lower-HDI countries are struggling most to develop cessation strategies. Raising tobacco taxes pairs well with these efforts: higher taxes promote quitting, and a fraction of new tax revenue could support quitting programs.
