slides on quitline smoking cessation services

15th WCTOH, Singapore, 20-24 March 2012 1 |

The Role of Tobacco

Quitlines in Implementing

the WHO FCTC Article 14

Dongbo Fu

Tobacco Free Initiative

World Health Organization


Outline

The WHO FCTC and Article 14 of the WHO FCTC

Why is Article 14 important?

Guidelines for implementation of Article 14 of the WHO FCTC

The role of tobacco quit lines in promoting tobacco cessation and treatment for tobacco dependence

WHO activities to promote tobacco quit line services


WHO FCTC - The powerful tool to reverse tobacco epidemic

First global health treaty negotiated

under auspices of WHO – adopted

in 2003, entered into force on 27

Feb 2005

174 parties, covering about 90%

of the world population


Core provisions in the WHO FCTC

At the population level: Price and tax measures to reduce the demand for

tobacco (Article 6) and smuggling control (Article 15)

Protection from exposure to tobacco smoke (Article 8)

Packaging and labeling of tobacco products (Article 11,12)

Ban of tobacco advertising, promotion and sponsorship (Article 13)

Monitoring and evaluation (Articles 20, 21)

At the individual level:

Tobacco dependence reduction and cessation (Article 14)


Article 14 of the WHO FCTC

“Each Parties…shall take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence… ”


Supporting current tobacco users to quit is key to achieve health gains in the short to medium term

If adult consumption were to decrease by 50% by the year 2020, approximately 180 million tobacco-related deaths could be avoided

Source: Jha, Prabhat et al. Curbing the epidemic: governments and the economics of tobacco

control. World Bank. Washington DC. 1999


More smokers will

be willing to quit

and ask for help

after the

implementation of

other tobacco

control measures

covered by other

Articles of the

WHO FCTC

The tobacco control measures are complementary

Source: the WHO Report on the Global Tobacco Epidemic, 2011


Guidelines for implementation of Article

14 of the WHO FCTC

When and where adopted

The Conference of Parties to the WHO

FCTC adopted the Article 14

guidelines at its fourth sessions (Punta

del Este, Uruguay, 15–20 November

2010)

Purpose

To assist Parties in meeting their obligations under Article 14 of the WHO FCTC


Quit line: a key component of a treatment

system recommended by Article 14 guidelines

Population-level approaches – Mass communication

– Brief advice: should be integrated into all health-care systems

– Quit lines

Intensive individual approaches – Specialized tobacco dependence treatment

Medications

Novel approaches and media

– Cellphone text messaging


The WHO FCTC Article 14

Guidelines recommend that:

“ All Parties should offer quitlines in which callers can receive advice from trained cessation specialists. Ideally they should be free and offer proactive support. Quitlines should be widely publicized and advertised, and adequately staffed, to ensure that tobacco users can always receive individual support.

Parties are encouraged to include the quitline number on tobacco product packaging. ”


The role of quitlines in implementing


Direct service provider: providing a variety of tobacco cessation services to help tobacco users to quit:

– Telephone counselling

– Self-help materials

– Referral to local in-person cessation services

– Internet-based services

– Cessation medication support

A resource centre to support health-care provider to deliver routine brief tobacco interventions

– A referral resource to help their patients

– Simplify their brief tobacco intervention model (AAR)

– Providing information, support and training

Source: Developing and improving national toll-free tobacco quit line

services: a World Health Organization manual.


The role of quitlines in implementing


A resource centre to support "proxy" callers( family, friends, co-workers and former smokers interested in helping tobacco users they know to quit:

– Providing information, support and training

Normalizing quitting and stimulating quit attempts

among those who do not call

Source: Developing and improving national toll-free tobacco quit line

services: a World Health Organization manual.


WHO activities to promote national toll-free

quit line services

In collaboration with Alere Wellbeing (formerly Free & Clear Inc.), WHO developed a manual on establishing and improving national toll-free tobacco quit line services

Training

– WHO supported the International Quitline Institute (IQI) training held in Seattle October 9-14, 2011 , organized by Alere Wellbeing and University of Washington


We need to redouble our efforts!

Source: the WHO Report on the Global Tobacco Epidemic, 2011

Only 19 countries provide comprehensive tobacco dependence treatment

56 countries have toll-free quit lines

http://www.standagainstpoverty.org/

Thank you for your attention

Integrating Tobacco Quitlines into National Tobacco

Control Efforts: Comparing Quitline Models Across the

Spectrum

Ken Wassum ([email protected])

alerewellbeing.com

“Tobacco use is unlike other threats to

global health. Infectious diseases do

not employ multinational public

relations firms. There are no front

groups to promote the spread of

cholera. Mosquitoes have no lobbyists.”

WHO Zeltner Report, 2000

The Case for Treatment of Tobacco

Use and Dependence

• Smoking is a leading cause of premature death

• Nicotine is highly addictive

• Tobacco interests DO have lobbyists

Graphic warnings on cigarette packs in US challenged by the

tobacco industry

• Good news: The global tobacco control community

has identified those areas which must be addressed in

order to turn the tide of the tobacco pandemic

The Case for Quitlines

• Strong evidence-base for phone counseling

• USPHS 2008 / Cochrane Review

• High reach potential

• Easily accessible by anyone with a telephone

• High effectiveness potential

• Proactive calls

• Centers of excellence

• Strong quality control / robust evaluation and reporting

Tobacco Control and Quit Lines

in the US

• 1992 – 1996: 3 state quitlines in existence

• 1996 – 1998:

• Master Settlement Agreement

• Clinical Practice Guideline (1996 / 2000)

• 1999 – 2006: 49 state quitlines launched

• The last 10 years have seen tremendous interest

and growth of quitlines around the world

Impact of Excise Tax on Call Volume

6

• Launched on Monday (March 19, 2012)

• 72% average increase in call volume in first days • Range of volume increases between States is 2% - 413%.

• Highest call increases are seen in states who have not

consistently promoted the Quitline through paid media efforts.

Current CDC Ad Campaign

Projected trend = J • higher volume in the first 4 weeks;

• volume to taper during weeks 5 - 8;

• increase again in the last weeks of the Campaign.

Smoke-free air policy Tobacco price/tax increases

Accessible Treatment

Quitline Models

Quitline Model Components

• Part of broader service or tobacco-only

• National or regional

• Reach versus effectiveness

• Who operates the quitline

Scope of Service

• Quitline as part of a broader service

• Addresses multiple health issues/topics

• TB; HIV;

• Address non-health issues

• Heating for low income persons

• Educational opportunities

• Allows quitline to take advantage of economies of scale and

existing infrastructure

• Train staff across various topics

• Limitations

• Tobacco as a priority can suffer

• Pressure to keep service briefer to handle high call volume

Scope of Service

• Single issue tobacco-specific service

• Most common model

• Higher set up costs

• Tobacco is sole focus

• Opportunity to develop expertise

• Staff recruitment can be more specific to the needs of

delivering tobacco treatment services

Country level or State/Provincial

• Small and medium-size countries (Europe; Asia;

South America) have opted for the country level

approach

• Create and maintain a single call center

• Callers from all parts of country get similar services

• Promotion of quitline somewhat easier

• Larger countries (USA, Canada, Australia) have

opted for the state/provincial approach

• Ability to customize services to needs of specific populations

• Greater insight into local referral resources

• May be conducive to experimentation with services

High Reach

• Number of tobacco users reached is main priority

• Reactive calls are priority

• Shorter calls with less tailoring of services

• Free NRT access --- usually short regimens due to

budget limitations

• Aggressive promotions

• Quitline phone number on cigarette packs

• TV & print promotional activity

High Effectiveness

• Treatment intensity is primary focus

• High engagement = multiple proactive calls (5 +)

• Longer durations of pharmacotherapy

• Maybe more types of pharmacotherapy available

• Combinations of pharmacotherapy

• Tailored treatment for different populations

• 10-call programs for high risk populations (pregnancy;

chronic illness; etc)

• More detailed evaluation and analysis to determine which

elements of treatment are most effective

Mixed Model

• Combine elements of both high reach and high

effectiveness

• Proactive calls

• Promotional activity strikes balance

• Some callers may get more services than others

• Some tailoring of treatment -- but the scientific evidence does

not support a lot of tailoring

Who Operates the Quitline?

Who Pros Cons

Universities Strong research / evaluation;

counseling expertise

Large bureaucracies

Health Care Expertise in clinical care; used

to helping large numbers

Medical model vs public

health

Government Funder oversees delivery of

care

Efficiency may suffer

Philanthropic (NGO) Fewer constraints on services Less expertise in complex

delivery of services

Private Companies High service levels; incentive

to increase use; some flexibility

Profit motive may get in way

unless incentives are

aligned

Summary

• Synergy with tobacco control policies is essential

• Global

• National

• Local

• Dedicated tobacco quitline or bundled services?

• National? State / Provincial?

• Operate in-house or out-source?

• Quitline goals and objectives?

• High reach? High effectiveness? Mix?

Thank you

Towards a TOBACCO-FREE WORLD: Planning Globally, Acting Locally 20-24 March, 2012, Suntec Conference Center, SINGAPORE Towards a TOBACCO-FREE WORLD: Planning Globally, Acting Locally 20-24 March, 2012, Suntec Conference Center, SINGAPORE

By

Jintana Yunibhand, RN, PhD.

Director, Thailand National Quitline

24 March 2012, 11.00-1220

Towards a TOBACCO-FREE WORLD: Planning Globally, Acting Locally 20-24 March, 2012, Suntec Conference Center, SINGAPORE

4/26/2012 Jintana Yunihand

2

THAILAND NATIONAL QUITLINE under Thai Wellbeing Foundation

Established and supported by the tri-party agreement among

Ministry of Public Health (MOPH),

National Health Security Office (NHSO) and

Thai Health Promotion Foundation.

MISSION:

To provide telephone counseling services for Thais and

Networking smoking cessation activities with other GOs and NGOs.


Thailand National Quitline is for Thai people who are

thinking about quitting or ready to quit smoking, and proxy

Hour of operation:

Monday to Friday, 730am –800pm Weekend, holidays and after hours all calls

will be tape recorded and callback

As of February 2012, free calls to 1600

4/26/2012 Jintana Yunihand 3


1600 Services Proxy &

interest individuals

Smokers

Brief

intervention

Giving

Information

In-depth Counseling

Brief counseling

No Quit Date

Set Quit Date

Agree for Future services

No interest in Future services

Proactive calls/callback services for Relapse

prevention Protocol-based

Unable to callback

Reactive services 1600 Quitline

Callers

Proactive/Callback service

(Internet clients & U-Refer)

Proactive/Support Calls after Quit Date #1 : 1-7 days # 2: 14 days # 3: 1 month # 4: 3 month # 5: 6 month # 6: 12 month

4/26/2012 4 Jintana Yunihand

mailed self-help materials


Looking back – 3 years in operation

Documented database system Revised database information

4/26/2012 Jintana Yunibhand 5

Sept 2008 Jan 2009 Sept 2009 Aug 2010 Feb 2012

Creating Phase 1

Full scale

operation

Establishing organization

Personnel system

installation

Sustaining QL Creating Phase 2

4 mo. 8 mo. 12 mo. 18 mo.

Service Improvement

Quitline Workshop in Taiwan

April 2010

Quitline Workshop in Korea

June 2011

www.thailandquitline.co.th

Thailand National Quitline


Jan 2009 Dec

2009

Dec

2010

June

2011

No. of telephone

line

10 18 18 30

No. counselor

(Full time/Part-

time)

2/1 10/18 11/16 12/13

No. of incoming

calls/month

491 5,138 15,369 11,006

No. clients/month 455 2,365 3,115 5,023

Service

delivery/Mo

5,189 7,150 12,512

No. referral to

quitline

0 503

Quitline Workshop in

Taiwan, April 2010

Quitline Workshop

in Korea, June 2011

http://www.thailandquitline.co.th/


Creating Thailand National Quitline

19/03/2012 JINTANA YUNIBHAND 7


WHO: Developing and improving national toll-free tobacco quit line services

10 steps in setting up a national quit line service 1. Identify a quit-line expert 2. Assess the needs for quit-line services 3. Determine the place and the role of quit-line services 4. Determine the goals of the quit line. 5. Determine the range of services 6. Determine strategies for creating demand for service 7. Determine what sponsors could fund and oversee the quit

line 8. Determine a project management plan for implementation 9. Determine what organization will deliver services 10. Determine who is accountable for ensuring the success of

the quit line



Facilitating factors to Success

1. Qualified + experienced quit counselors

2. Evidence-Based Protocol (practical quitting

information, skills building, confidence and motivation enhancement, and social support)

3. Data-base system and effective call center

4. Quality monitoring, CQI system

5. Knowledge management + Researches

6. Adequate resources and technical supports

7. International network Taiwan Helpline, U of

California San Diego, Free & Clear, other individuals (For modeling/mentor/technical consultants)




1600 on packs: Jan 20, 2010

Warning on Packs: 2007


How do callers know quit line no. 1600 ?


Month

No.

Incoming

calls

Seen

1600 on

Packs

% of Total

calls

January 1598 36 2.25

February 2161 464 21.47

March 2767 802 28.98


Outcomes: Jan –Dec 2010


Callers Smokers Receive

intensive counseling

Smokers + Quit date Total Proxy Smoker

Number 34,673 12,922 21,751 16,854 15,296

%

37.27 62.73 77.49 70.32


Challenges

Recruitment and training of Quit counselors

Large number of abandoned calls

Reporting and research

Definition of terms; QA, QR

Gaining public trust

Achieving health professionals acceptance for Faxed-refer (U-Refer)



Sustaining Thailand National Quitline


ศูนย์บริการเลิกบหุร่ีทางโทรศัพท์แห่งชาติ Thailand National Quitline

Challenges: TNQ in April 2011

Focusing on quality: Quality monitoring system Focus on service innovations to: increase the range of services offered and

the range of users served, youth, pregnant, persons with chronic illnesses, etc.

increase the population impact of quitlines, engaging healthcare providers in

promotion, physician, community health personnel

Focus on reporting and researches THINKING: Benchmarking

4/26/2012

Jintana Yunibhand 16


Expanding Thailand National Quitline



Quitline Personnel: As of March 2012

Counselors Permanent Full-time 12 Permanent Part-time 13

Call taker 4 (No volunteer)

Admin. + IT + Supporting staff 9

18.5 FTE


Success & Challenges

Issues Strategies

Abandoned calls

Training “Quit counselors”

Quality monitoring system

Indicators

Cost-effectiveness; Efficacy of Quitline service.

Call take: Registration (ask + assess + arrange)

Group to Individual training

Acceptance + prove to be a tool for improvement

Need process indicators + QA, QR

Reporting of outcome to the national authorities, aiming at continual support and integrated in to Health Care delivery system




Number of Calls to and from TNQ: 2009-2011


Year Incoming calls Outgoing calls

Services delivery

Total completed Abandoned

2009 40,614 22,756 12,356 8,380 31,136

2010 184,426 37,385 147,041 48,411 85,796

2011 138,303 61,868 76,435 95,445 157,313

January (Expect 2012)

8,004 (96,048)

5,212 (62,544)

2,792 (33,504)

18,638 (223,656)

23,850 (286,200)


22

36 items

Thailand National Quitline – Jintana Yunibhand - 3/19/2012 Slide 22

Ask & Assess

Quality Monitoring System : Scale

Counseling skills

Service behaviors

Service agreement

Advise & Assist


1600 Services in 2010 Proxy &

interest individuals

Smokers

Brief

intervention

Giving

Information

In-depth Counseling

Brief counseling

No Quit Date

Set Quit Date

Agree for Future services

No interest in Future services

Proactive calls/callback services for Relapse

prevention Protocol-based

Unable to callback

Reactive services 1600 Quitline

Callers

Proactive/Callback service

(Internet clients & U-Refer)

Proactive/Support Calls after Quit Date #1 : 1-7 days # 2: 14 days # 3: 1 month # 4: 3 month # 5: 6 month # 6: 12 month

4/26/2012 23 Jintana Yunihand

21,763

16,890

15,324

13,656 4,144


Quit-line service during Sep 2009 - July 2010

From those who quit-line can reach, (response rate=30%) the number of quitter who: quit at 7 days = 51.14% quit at 1 month = 49.42% quit at 3 months = 37.73% quit at 6 months = 32.86%

[Source: การประเมนิประสทิธผิลการบรกิาร: รศ.ดร.วราภรณ์ ชยัวฒัน์,,รศ.ดร.จนิตนา ยนิูพนัธุ ์,ผศ.ดร.สุนิดา ปรชีาวงษ์ ] Thailand National Quitline – Jintana Yunibhand - 3/19/2012 Slide 24


4/26/2012 จนิตนา ยนูพินัธุ ์ 25

Year 2009-2010 (UNIT COST)

• At 17.46% quit rate at 12 months, this yields a cost of 2,053-2,522 baht (US$64-78) per LYs.

• At 11.6% quit rate at 12 months (the lower rate in sensitivity analysis), this yields a cost of 3,090-3,795 baht (US$96-118) per LYs.

Year 2011 (UNIT COST)

• At 17.46% quit rate at 12 months, this yields a cost of 1,979-2,448 baht (US$61-77) per LYs.

• At 11.6% quit rate at 12 months (the lower rate in sensitivity analysis), this yields a cost of 2,979-3,685 baht (US$93-115) per LYs.


More Challenges

Integrated quit line into health service delivery system.

Researches & knowledge synthesis

Quit line for specific populations

Problem regarding reach



Acknowledgement Progress of Thailand National Quitline Thailand National Quitline Steering committee Tobacco Control Core team, Thai Health Promotion Taiwan helpline California helpline (UCSD) Alere Wellbeing (Formally Free & Clear) The Quit Group of New Zealand Quit Victoria, Australia Quit Queensland, Australia Korea nationwide quit line Other individuals, within and outside Thailand North American Quitline Consortium ASIAN PACIFIC QUITLINE NETWORK



SWASDEE KA

Thank You For Your Attention 4/26/2012 28 Jintana Yunihand

An Overview of Capacity

Building for Quitline in Asia

Min Kyung Lim, PhD., M.P.H.

Director of Nationwide Quitline in Korea

Head of National Cancer Information Center

National Cancer Center, Korea

[email protected]

Global Tobacco Consumption

►12 million cigarette smoked per

minute in the world ► Top 5 cigarette consuming countries :

China, USA, Russia, Japan, Indonesia (Most of them are Asian countries) ► China consumed 37% of World’s

cigarettes

Tobacco atlas 3rd ed., 2009

Liberating smokers from their addiction

NRT and pharmacologic agents

Psychological and behavioral therapies, including

behavior modification

change individual lives

reshape social norms and community values

Risk reduction

By one year, the risk of coronary heart disease is

decreased to half that of a smoker

After five to fifteen years, the risk of a stroke is

reduced virtually to that of never smokers

Cancer risk also reduces significantly over the

decade after quitting

The Goal of Cessation Program

Availability of Quitline in the World

• Phone-based counseling has proliferated in availability

since the 1990s

• Providing services for cessation with easy accessibility,

convenient counseling, and high effectiveness

• Available in north Americas, most countries in the European

Union, Australia, New Zealand, and some countries in

Asian Pacific region

• Existing variation in reach, type, amount, and quality of

services depending on the available resources,

infrastructure, and information techniques

• Policy Supporting

• Needs assessment

• Resources

• Available communication tools

• Effective protocols

• Experts and Evidences ……

Factors to be Considered for

Capacity Building for Quitline

Case Studies in Asia Pacific Area

• Ongoing Quitline in Asia-Pacific areas

– Australia, Beijing(China), Hong Kong(SAR China), Macau, Malaysia,

New Zealand, Republic of Korea, Singapore, Taiwan, Thailand

• Classification of the service type

– Government funded Quitline : Less competition may diminish efficiency

– University or health care center based Quitline

• Less incentive to expand service, complex Bureaucracies

• “Medical” model rather than public health

– Quitline supported or operated by NGO

• Unlikely to have expertise, in complex service delivery

– Combined model

State of Victoria, Australia

Quit Victoria (since 1992)

• Generals

- Toll free telephone counseling : 13 7848 (13 Quit) (15 quit specialist)

- Language : English, Translator Interpreter Service (more than 170 languages)

- Standard Hours of Operation: Mon-Fri, 08am~08pm (24 hours)

- Free medication : none

• Phone Counseling

- Live pick up of incoming calls

- Standard counselling for an adult smoker - Approximately 6 calls

• Web-based services : http://quit.org.ac/

- Information about the Quitline & tobacco cessation,

- Interactive tools to prepare for and make a quit attempt

• Other Services

- Referral to other services, Quit Courses by trained educators

- Self help book for smoking cessation, Promotional items and materials

People’s Republic of China

China Quit-line (since 2004) • Generals

- Toll free telephone counseling : 440-888-5531

- Language : Mandarin Chinese

- Standard Hours of Operation: Mon-Fri, 09am~06pm



- Initial screening and collection of demographic and smoking information

- Minimal/brief intervention

- Single session counseling and multiple sessions(counselor-initiated mostly)

• Other Services

- Referral to cessation resources(Smoking Cessation Clinics and Web based service)

: www.smokefreehealthcare.org

Integrated Smoking Cessation Hotline of the Department of Health (since 2001) • Generals

- Toll free telephone counseling : 1833-183 (2 full time and 1 part time registered nurse)

- Language : Cantonese, English, Mandarin

- Standard Hours of Operation: Mon-Fri, 09:00am~05:45 pm

- Free medication :Yes


- Pick up incoming calls during office hours, Receiving Fax-to-quit referral forms

- Proactive phone counseling service : 10 calls for 1 year except the initial call

• Web-based services : www.tco.gov.hk

- Information about the Quitline & tobacco cessation

- Interactive counseling and/or email messaging for quit

• Other Services

- SMS, Self help guideline book

- Referral to other services (Cessation clinic), Fax-to-quit programme

Hong Kong (SAR, China)

Nationwide Quitline (since 2006) • Generals

- Phone No : Toll Free Number +82-1544-9030 (14 coaches)

- Language : Korean

- Standard Hours of Operation: Mon-Fri, 09am~08pm



- Standardized counseling program for adult and adolescent smokers

- Minimal/brief intervention with single session counseling

- Multiple session counseling : client-initiated or counselor-initiated

(Up to 21 calls for 1 year for registered smokers)

• Web-based services : http://quitline.hp.go.kr

- Information about the Quitline & tobacco cessation


• Other Services

- Repeated SMS services, Self-help guideline book, Promotion materials

- Refer to public health center based cessation clinics

Republic of Korea

The Quit Group (since 1999) • Generals

- Phone No : 0800 778 778 (30 quit advisors)

- Language : English, Maori, Tongan and Samoan

- Standard Hours of Operation: everyday except for Saturday, 08:00am~09:30pm

- Free medication : Yes (subsidized NRT)

• Phone counseling

- Telephone cessation support based on motivational interviewing methods

• Online cessaton support : www.quit.org.nz

- QuitCoach, Quit Blogs, client Quit statistics, and Quit Tips support emails

• Text-based services

- Txt2Quit text-based service(inceresingly integrated in to the online service)

• Other services

- Resources and information support cessation activity (The Quit Book, online

content and fact sheets, and other promotional materials)

New Zealand

Taiwan Smokers’ Helpline (since 2003) • Generals

- Phone No : Toll Free Number 886-0800636363 (20 part time counselors)

- Language : Mandarin, Taiwanese, Hakka, English

- Standard Hours of Operation: Mon-Sat, 09:00am~09:00pm

- Free medication :Yes


- Standardized counseling program for adult smokers

- Minimal/brief intervention with single session counseling

- Multiple session counseling : client-initiated or counselor-initiated

• Web-based services : www.tsh.org

- Information about the tobacco cessation, Interactive counseling by skype

• Other services

- SMS, Self-help guideline for smoking cessation, Other promotional materials

Taiwan (R.O.C)

Thiland National Quitline(since 2009) • Generals

- Phone No : Toll Free Number 1600

- Language : Thai

- Standard Hours of Operation: Mon-Fri, 07:30am~08:00pm

- Free medication : No


- Standardized counseling, reactive and proactive counseling

- Number of sessions provided for a typical smoker : Seven sessions

- Timing of counseling sessions: 7 calls for 1 year as followed

• Web-based services : http://www.thailandquitline.or.th/

- Information about the Quitline service & tobacco cessation


• Other services

- SMS, Self-help guideline book for smoking cessation

- Referral to public health center based cessation clinics and hospital

Thailand

Key Variations among AP Quitlines

• History, Scope and Nature of Operation

• Diversity of special populations served

• Linkages with other organizations

• NRT & Medication

• Evaluation & Research

Common issues among AP Qitlines

• High willingness for service development and improvement

• Small number of Quitline

• Low service coverage & lack of service capacity

• Rapid adoption of information technology on service

• Need for evaluation on the service effectiveness

• Building infrastructure – Basic architecture : Computer based telephony system (IP-PBX, server for IVR, Recording, and DB management) – High speed telecommunication line – Information system : application, program, and etc.

• Expanding coverage – Stable resources – Link to the other cessation service with refereal system – Development of additional tool for communication and counseling (Web, mobile, text message, Quit pack, Blog, SNS, etc.)

• Ensuring Quality service – Evidence based contents, Tailored protocol, training for counselors – Sharing experience from other cases (Quitline) – Planning & Implementation of Research

Direction for Capacity Building in

Individual Quitline in Asia

Regional Capacity Building for

Quitline Development in Asia

• Regarding issues

– High prevalence of smoking

– Increasing awareness on necessity

– Getting funds

– How to develop appropriate services

– Designing pilot projects

– Way of expanding services

• Direction

– Prioritizing in tobacco policy

– Experience sharing

– Rearing expertise

– Setting vision & goal

– Checking available methods

– Tightening regional network : APQN

– Raising international support

– Customizing

Network in Asia Pacific Area

• Asia pacific Quitline Network (APQN)

• Asia Pacific Quitline Workshop based on APQN

– Has been launched since 2007

• In Taiwan (2007, 2010), In Republic of Korea (2011)

• Sharing information and experience on Quitline

• Promoting collaboration and networking

(cessation services have been less available)

• Expanding the activities

– Encouraging capacity buildings for Quitline

– Offering technical support for establishment of

new Quitline in Asia-Pacific Area

Leadership Training Approach

• Backgrounds

– Experts consensus after 2011 APQW

– Funding from National Cancer Center, Korea and WPRO

• Purposes

– To understand the theoretical concepts, disseminating basic guidelines for development, and effective operation of Quitline

• Program & Schedule

– 4 days workshop program (July 2012, NCC, Korea)

– Sharing good practices and developing project for new Quitline establishment

• Participants

– Brunei, China, India, Japan (Hyogo), Macau, Malaysia (Malacca),

Mongolia, Philippines (Davao City and Makati City), Sri Lanka

What Next?

• Continue sharing knowledge and lessons learned

– Formalize APQN to facilitate (MDS, supporting, sharing)

– Evaluation service & its effectiveness

– Collaborate with other networks (ENQ, NAQC)

• Establishing Quitlines in AP countries where it is not set up yet

– Raising internal and external support (funds, expertise, and other things)

• Improving service quality based on new scientific evidence (e.g.

tailoring, relapse prevention)

• Continue to innovate as new technology becomes available

• Look for opportunities for collaboration

Thanks for your attention

Documents

slides on quitline smoking cessation services