New Delhi: As a proactive approach to tobacco cessation as well as tobacco control efforts, the Union Health Ministry has asked all medical institutes to set up tobacco cessation centres (TCC).
"While TCCs have been established in certain centres/district hospitals and dental colleges, their establishment in medical institutions would offer an ideal platform to educate, orient and sensitise medical undergraduate students for a lifetime," said an operational guideline for establishing tobacco cessation centres in medical institutes.
The operational guideline has been prepared by a team of experts from the Health Ministry, National Medical Commission (NMC), Director General of Health Services (DGHS) and AIIMS in consultation with different other stakeholders.
Quitting tobacco becomes exceptionally challenging once addiction has developed, often necessitating the support of a healthcare professional. Medical practitioners and doctors in medical institutions, being the first layer of contact with tobacco users suffering from various diseases, can play a pivotal role in motivating patients to change their behaviour and offering tobacco cessation service.
"These comprehensive guidelines cover all requirements for integrating tobacco cessation clinics in medical and other healthcare institutions, intended to make a valuable contribution to tobacco cessation as well as tobacco control efforts while protecting patients from the significant public health impact of tobacco use," said Health Secretary Apurva Chandra.
He said that India is experiencing a shift in its disease burden from communicable disease to non communicable disease (NCDs). Among these, tobacco use stands out as the leading yet most preventable risk factor, responsible for over 1.3 million deaths in India each year. According to the second Global Adult Tobacco Survey in India, 28.6 per cent adults use tobacco in various forms.
Among them, 10.7 per cent use smoking forms, while 21.4 per cent use smokeless tobacco. Noting that tobacco cessation is most receptive during symptomatic phases of any disease, the ministry said that the establishment of TCC in medical institutions becomes imperative.
As per the operational guideline, incorporating tobacco cessation training in medical and other health professional education, training of health professionals to offer cessation advice in their routine health care practices, disease specific counselling session about diabetes, TB and selected other specialties are likely to result in significant quit rates among current tobacco users.
"Integrating tobacco cessation clinics in medical and other healthcare institutions allows universalising the cessation service and health system strengthening. Therefore, it is crucial for medical institutions to be equipped with dedicated tobacco cessation centres to provide the necessary assistance and guidance to individuals seeking to overcome tobacco addiction,’ the guidelines said.
Tobacco Cessation Centre (TCC)
A Tobacco Cessation Centre is defined as fixed premises where qualified health care professionals and counsellors provide tobacco (smoke and smokeless form) cessation therapy to help patients in their attempts to quit the habit. The therapy can involve individuals or group counselling and may include the dispensing of pharmacological aids, if the centre is registered and equipped to do so.
Organisational structure
The TCC should be run under the department as chosen by the dean/principal of the medical institution. While choosing the department, it is essential to ensure that it has the capacity to operate the TCC on a daily basis with suitable technical know-how and adequate human resources.
Human Resource Requirement
The guidelines have also specified about the human resource aspect of the TCC. It has said that four officials with their different responsibilities like TCC in-charge, specialist, medical social worker and psychologist would be required for each TCC.
"The establishment of tobacco cessation centres within medical institutions is pivotal for training future healthcare professionals in effective cessation techniques, advancing research on tobacco addiction, supporting community health through outreach programs and fostering early intervention strategies to prevent lifelong tobacco use," said Dr L Swasticharan, additional DDG & director (EMR) at the Director General of Health Services (DGHS).
