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Thorax 2004;59:623-630
© 2004 BMJ Publishing Group Ltd & British Thoracic Society


OCCASIONAL REVIEW

Promotion of smoking cessation in developing countries: a framework for urgent public health interventions

A S M Abdullah1, C G Husten2

1 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China
2 Office on Smoking and Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA

Correspondence to:
Correspondence to:
Dr A S M Abdullah
Department of Community Medicine, The University of Hong Kong, 5/F Academic Block, New Medical Complex, 21 Sassoon Road, Pokfulam, Hong Kong SAR; asm.abdullah{at}graduate.hku.hk

The rapid rise in smoking in many developing countries will have devastating consequences; by 2030 the developing world is expected to have 7 million deaths annually from tobacco use. Many smokers express a desire to quit, but they often fail because they are addicted to tobacco. Although a number of cessation aids are now available in the developed world, their applicability and affordability in developing countries is less clear. Successful interventions will require many stakeholder groups to take action at the local, national, and international levels. We discuss smoking cessation as a means of reducing disease burden, examine factors that may limit the promotion of smoking cessation in developing countries, and propose a framework for public health action. This framework should comprise intervention with healthcare professionals, strengthening national commitment, development of a model for developing countries, changing the social acceptability of smoking, strengthening community participation, integration of smoking cessation with other healthcare services, specifying the role of healthcare professionals, development of guidelines, mobilisation of the business community, provision of financial incentives, establishing population specific smoking cessation services, increased collaboration between countries, and development of international initiatives.


Keywords: tobacco; smoking cessation; developing countries; health policy


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